The proposed Sequential Multiple Assignment Randomized Trial (SMART) study seeks to
develop an effective 32-week, resource sensitive strategy to improve physical activity
levels in people with mobility impairments.
During the run-In period before the start of the intervention, interested individuals
will consent to be part of the study. Once providing consent, Participants will respond
to a baseline survey packet through REDCap. Participants must also complete a welcome
call and set up an online account. Additionally, during the run-in period, the research
team will ship an exercise tracker device, and an exercise band for the participant to
wear during the intervention. The participant will receive an orientation call to assist
them with using the website, setting up their exercise tracking device, and linking the
device to the website. (see attached call outline)
After the run-in period, participants will be randomized into 1 of 2 groups: Asynchronous
Exercise Program (AEP) and AEP + Smart Health Coaching (SHC). Finally, participants will
be given access to the FitWithUs online platform, hosted on UAB servers, to access all
the exercise content (exercise videos and articles). All participants will receive at
least one new health and wellness article per week for eight weeks, and new exercise
videos for 16 weeks.
The Adoption Phase will be split into two 4-week phases: early adoption (weeks 1 to 4)
and late adoption (weeks 5 to 8). Participants in both groups will engage in pre-recorded
exercise content. The AEP + SHC group may receive up to 12 health coaching calls. Machine
learning will be used in Weeks 2, 6, and 10 to predict which AEP + HC participants should
receive coaching calls for the next four weeks.
The proposed Sequential Multiple Assignment Randomized Trial (SMART) study seeks to
develop an effective 32-week, resource-sensitive strategy to improve physical activity
levels in people with mobility impairments. During the run-in period before the start of
the intervention, interested individuals will consent to be part of the study. Once
providing consent, participants will respond to a baseline survey packet through REDCap.
Participants must also complete a welcome call and set up an online account.
Additionally, during the run-in period, the research team will ship an exercise tracker
device, and an exercise band for the participant to wear during the intervention. The
participant will receive an orientation call to assist them with using the website,
setting up their exercise tracking device, and linking the device to the website. After
the run-in period, participants will be randomized into 1 of 2 groups: Asynchronous
Exercise Program (AEP) and AEP + Smart Health Coaching (SHC). Finally, participants will
be given access to the FitWithUs online platform, hosted on UAB servers, to access all
the exercise content (exercise videos and articles). All participants will receive at
least one new health and wellness article per week for eight weeks, and new exercise
videos for 16 weeks. This intervention will be administered in 8 waves of ~33-34
participants each (pilot wave data excluded from analyses). The Adoption Phase will be
split into two 4-week phases: early adoption (weeks 1 to 4) and late adoption (weeks 5 to
8). Participants in both groups will engage in pre-recorded exercise content. The AEP +
SHC group may receive up to 12 health coaching calls. Machine learning will be used in
Weeks 2, 6, and 10 to predict which AEP + HC participants should receive coaching calls
for the next four weeks. At the end of the early adoption phase, the participant will
complete a short set of questions (See week 4 questionnaire) the research team will
classify participants in both groups into either a responder or a non-responder. If a
participant is a responder, they will continue with their group assignment through the
late adoption phase (AEP only or AEP + SHC). If the participant is a non-responder, they
will be randomized a second time into 1 of 2 sub-groups: Live 1-on-1 training or Live
group training for the late adoption phase. All live training will occur remotely through
ZOOM. Participants in non-responder sub-groups will be asked to participate in their
respective live training up to 3 times per week for weeks 5 to 8. This second
randomization results in six possible intervention groups: 1) AEP only responder, 2) AEP
- HC responder, 3) AEP non-responder + LAT_1-1, 4) AEP non-responder + LAT_GRP, 5) AEP +
HC non-responder + LAT_1-1, 6) AEP + HC non-responder + LAT_GRP. Upon finishing the late
adoption phase, all participants will complete another survey packet and a
semi-structured interview (see interview guide), and receive AEP only for a 24-week
maintenance phase (weeks 9-32). Upon completion of week 32, the participant will complete
a final survey packet. Throughout the study, we will be collecting data from the
participant's exercise tracker. These data include steps and minutes of
activity/inactivity. During weeks 9 to 32, participants will have open access to the
website and its library of exercise content. The research team will continue to collect
activity data and website analytics (for example video watch minutes). Participants may
receive a reminder call to complete surveys. We will use the following validated
measures: [existing measures list unchanged].
