Improving heart health with an app: Study aims to get young people moving

Previous research in the field has found that texting can be used to encourage physical activity. To build on this research, David Conroy, professor of kinesiology, human development and family studies and public health sciences and partner in the Center for Healthy Aging, and Constantino Lagoa, professor of electrical engineering, created a customized system that motivates people between the ages of 18 and 29 years to move more, sit less and slow their future weight gain. Research shows that over time, young adults have increased their sedentary behavior and decreased their physical activity, which may lead to increased cardiovascular health problems as they enter middle age.

“Most people start out with ideal heart health,” Conroy said. “Unfortunately, this health deteriorates over time due to age, unhealthy behaviors and other health complications. And once cardiovascular health is compromised, it is very difficult to recover. This is why it is so important to work to promote physical activity in young adulthood, before people develop serious cardiovascular risks such as diabetes, hypertension or obesity.

Conroy studies how to motivate people to engage in healthy behaviors. He said healthy young adults have traditionally been a difficult audience for health interventions to reach because they often do not have regular contact with doctors. However, young adults have quickly adopted wearable technology such as Fitbits and Apple Watches, making this technology an attractive intervention tool. This technology also allows researchers to respond to local conditions that may affect physical activity, such as the weather.

In this study, researchers will provide participants with a Fitbit smartwatch, an app for their smartphone, and an Internet-connected scale to automatically collect data without significantly disrupting the participants’ lives.

Lagoa studies data-driven approaches to controller design that ensure system behavior conforms to specifications. In this project, researchers will develop personalized computer models for each participant based on which messages have successfully motivated them to become physically active. Each pattern will include information about the day of the week, time of day, location-specific time, and the individual’s past response or non-response to different types of messages.

“Different people respond differently to the same stimuli,” Lagoa said. “We know that messages can motivate activity, but some people respond to messages that encourage them to stop being sedentary, while others respond better to messages that encourage them to get active.”

The researchers plan to recruit more than 300 study participants from across the US in early 2023. Over 12 months, one-third of participants will receive text messages on a customized schedule, one-third will receive the same text messages on a random schedule, and one-third will not to receive no messages. This will allow the researchers to understand whether the messages change physical activity and whether their personalization approach improves people’s responses to the messages.

Internet-connected scales will report participants’ weight to researchers at the start of the study, six months later, at the end of the 12-month study, and six months after the end of the study.

“Individual behavior changes over time,” Lagoa said. “Therefore, individual behavioral patterns will be periodically updated to reflect these changes. We hope that the model-based controller will provide the best ‘treatment’ just in time for the individual’s current environment and condition.”

Conroy and Lagoa have collaborated for years, and both expressed gratitude for Penn State’s unique support for interdisciplinary collaborations. The researchers emphasized that this project would not have been possible without the application of engineering skills to the complex real-world problem of motivating healthy behaviors in humans.

“We want to help people build healthy habits while they’re young,” Conroy said. “We know that behavioral habits – good and bad – can last for decades. By intervening before people develop problems, we may be able to put young adults on the path to long, healthy lives.

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