An Integrated Closed-Loop Feedback System for Pediatric Cardiometabolic Disease (Massachusetts)

Project Final Report (PDF, 440.43 KB) Disclaimer

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Summary:

Cardiometabolic disease, which includes obesity, diabetes, impaired liver function, and an increased risk in children for adult-onset cardiovascular disease, represents a major health burden in the United States. Many of the lifestyle and health behaviors that contribute to cardiometabolic disease are difficult to modify once established, and childhood represents an opportune time for promoting healthy behaviors. Patient-centered outcomes research (PCOR) has identified a number of factors as important and actionable in modifying cardiometabolic risk. Mobile health (mHealth) technology could be used to monitor and counsel on common health behaviors associated with cardiometabolic risk.

This ongoing pilot research designed, developed, and tested new strategies for using mHealth technology to collect health behavior data and then provide feedback on cardiometabolic risk in youth. A wearable wristband was developed to collect objective health data in real time and upload the data to a mobile app on a parent’s cell phone daily. The mobile app then offers automatic clinical feedback regarding cardiometabolic risk behaviors based on the health data collected.

The specific aims of the research were as follows:

  • Develop an integrated closed-loop feedback system that incorporates longitudinal mHealth data and uses clinical decision support systems to manage cardiometabolic disease among at-risk families. 
  • Determine the extent to which an integrated closed-loop system that provides feedback on objective patient-generated data improves cardiometabolic risk. 

Aim 1 has been completed, but Aim 2 is continuing, as it was unable to be finished during the grant period. For Aim 1, a wearable wristband sensor, mobile application, and a website were developed to collect and measure data on physical activity, sleep, screen time, sugar beverage consumption, height, and weight. For Aim 2, the researchers will evaluate whether providing clinical feedback via daily text messages on these health behaviors reduces obesity and improves health behaviors among children 2-12 years of age and their families. A randomized controlled trial will examine the clinical effectiveness of a 6-month long family-based intervention on body mass index (BMI) in child participants. BMI in adult family members and decreases in health behaviors associated with cardiometabolic risk in children and adults will also be examined.

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An Integrated Closed-Loop Feedback System for Pediatric Cardiometabolic Disease - Final Report

Citation:
Oreskovic N. An Integrated Closed-Loop Feedback System for Pediatric Cardiometabolic Disease - Final Report. (Prepared by Massachusetts General Hospital under Grant No. R21 HS024001). Rockville, MD: Agency for Healthcare Research and Quality, 2019. (PDF, 440.43 KB)

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison).
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