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      Evaluating Machine Learning–Based Automated Personalized Daily Step Goals Delivered Through a Mobile Phone App: Randomized Controlled Trial

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          Abstract

          Background

          Growing evidence shows that fixed, nonpersonalized daily step goals can discourage individuals, resulting in unchanged or even reduced physical activity.

          Objective

          The aim of this randomized controlled trial (RCT) was to evaluate the efficacy of an automated mobile phone–based personalized and adaptive goal-setting intervention using machine learning as compared with an active control with steady daily step goals of 10,000.

          Methods

          In this 10-week RCT, 64 participants were recruited via email announcements and were required to attend an initial in-person session. The participants were randomized into either the intervention or active control group with a one-to-one ratio after a run-in period for data collection. A study-developed mobile phone app (which delivers daily step goals using push notifications and allows real-time physical activity monitoring) was installed on each participant’s mobile phone, and participants were asked to keep their phone in a pocket throughout the entire day. Through the app, the intervention group received fully automated adaptively personalized daily step goals, and the control group received constant step goals of 10,000 steps per day. Daily step count was objectively measured by the study-developed mobile phone app.

          Results

          The mean (SD) age of participants was 41.1 (11.3) years, and 83% (53/64) of participants were female. The baseline demographics between the 2 groups were similar ( P>.05). Participants in the intervention group (n=34) had a decrease in mean (SD) daily step count of 390 (490) steps between run-in and 10 weeks, compared with a decrease of 1350 (420) steps among control participants (n=30; P=.03). The net difference in daily steps between the groups was 960 steps (95% CI 90-1830 steps). Both groups had a decrease in daily step count between run-in and 10 weeks because interventions were also provided during run-in and no natural baseline was collected.

          Conclusions

          The results showed the short-term efficacy of this intervention, which should be formally evaluated in a full-scale RCT with a longer follow-up period.

          Trial Registration

          ClinicalTrials.gov: NCT02886871; https://clinicaltrials.gov/ct2/show/NCT02886871 (Archived by WebCite at http://www.webcitation.org/6wM1Be1Ng).

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          Most cited references65

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          Self-evaluative and self-efficacy mechanisms governing the motivational effects of goal systems.

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            Increasing Physical Activity With Mobile Devices: A Meta-Analysis

            Background Regular physical activity has established physical and mental health benefits; however, merely one quarter of the U.S. adult population meets national physical activity recommendations. In an effort to engage individuals who do not meet these guidelines, researchers have utilized popular emerging technologies, including mobile devices (ie, personal digital assistants [PDAs], mobile phones). This study is the first to synthesize current research focused on the use of mobile devices for increasing physical activity. Objective To conduct a meta-analysis of research utilizing mobile devices to influence physical activity behavior. The aims of this review were to: (1) examine the efficacy of mobile devices in the physical activity setting, (2) explore and discuss implementation of device features across studies, and (3) make recommendations for future intervention development. Methods We searched electronic databases (PubMed, PsychINFO, SCOPUS) and identified publications through reference lists and requests to experts in the field of mobile health. Studies were included that provided original data and aimed to influence physical activity through dissemination or collection of intervention materials with a mobile device. Data were extracted to calculate effect sizes for individual studies, as were study descriptives. A random effects meta-analysis was conducted using the Comprehensive Meta-Analysis software suite. Study quality was assessed using the quality of execution portion of the Guide to Community Preventative Services data extraction form. Results Four studies were of “good” quality and seven of “fair” quality. In total, 1351 individuals participated in 11 unique studies from which 18 effects were extracted and synthesized, yielding an overall weight mean effect size of g = 0.54 (95% CI = 0.17 to 0.91, P = .01). Conclusions Research utilizing mobile devices is gaining in popularity, and this study suggests that this platform is an effective means for influencing physical activity behavior. Our focus must be on the best possible use of these tools to measure and understand behavior. Therefore, theoretically grounded behavior change interventions that recognize and act on the potential of smartphone technology could provide investigators with an effective tool for increasing physical activity.
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              A comparison of the general linear mixed model and repeated measures ANOVA using a dataset with multiple missing data points.

              Longitudinal methods are the methods of choice for researchers who view their phenomena of interest as dynamic. Although statistical methods have remained largely fixed in a linear view of biology and behavior, more recent methods, such as the general linear mixed model (mixed model), can be used to analyze dynamic phenomena that are often of interest to nurses. Two strengths of the mixed model are (1) the ability to accommodate missing data points often encountered in longitudinal datasets and (2) the ability to model nonlinear, individual characteristics. The purpose of this article is to demonstrate the advantages of using the mixed model for analyzing nonlinear, longitudinal datasets with multiple missing data points by comparing the mixed model to the widely used repeated measures ANOVA using an experimental set of data. The decision-making steps in analyzing the data using both the mixed model and the repeated measures ANOVA are described. Copyright 2004 Sage Publications
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                January 2018
                25 January 2018
                : 6
                : 1
                : e28
                Affiliations
                [1] 1 Department of Industrial Engineering and Operations Research University of California Berkeley, CA United States
                [2] 2 Institute for Health & Aging School of Nursing University of California San Francisco, CA United States
                [3] 3 Department of Physiological Nursing School of Nursing University of California San Francisco, CA United States
                [4] 4 Department of Electrical Engineering and Computer Sciences University of California Berkeley, CA United States
                [5] 5 Institute for Human Genetics University of California San Francisco, CA United States
                Author notes
                Corresponding Author: Anil Aswani aaswani@ 123456berkeley.edu
                Author information
                http://orcid.org/0000-0003-4772-9838
                http://orcid.org/0000-0002-2245-9264
                http://orcid.org/0000-0002-0670-1794
                http://orcid.org/0000-0001-6747-9499
                http://orcid.org/0000-0002-3079-0299
                http://orcid.org/0000-0002-7054-7533
                http://orcid.org/0000-0001-5777-7185
                Article
                v6i1e28
                10.2196/mhealth.9117
                5806006
                29371177
                535ea54c-1db8-4571-8d01-02115467f030
                ©Mo Zhou, Yoshimi Fukuoka, Yonatan Mintz, Ken Goldberg, Philip Kaminsky, Elena Flowers, Anil Aswani. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.01.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 4 October 2017
                : 2 November 2017
                : 29 November 2017
                : 16 December 2017
                Categories
                Original Paper
                Original Paper

                physical activity,cell phone,fitness tracker,clinical trial

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