Model, architecture and application of cross-platform just-in-time adaptive intervention (JITAI): AN implementation in behavioral sleep intervention

摘要: Cognitive-behavioral therapies (CBT) are common types of non-pharmacological therapy used in treating mental illnesses and behavioral disorders. Smartphone-based interventions have the potential for improving the delivery of traditional CBT with such novel features as personalization and context awareness. Assessments and interventions are best delivered when they are personalized to fit each individual’s needs and conditions. Just in Time Adaptive Intervention (JITAI) combines this personalized and adaptive intervention with the use of mobile technology. An increasing number of studies have been conducted to assess the effect of JITAI on regulating human health behavior, however there has been no published theoretical model underlying the use of smartphones and mobile devices in relation with JITAI. Therefore, this work aimed to provide 1) a behavioral model and application architecture for JITAI, 2) implementation of the JITAI model and application architecture on behavioral sleep intervention, 3) clinical and usability outcomes of the implementation, and 4) evaluate the model and its clinical feasibility. The JITAI model, architecture and application were designed to accommodate various adaptive health/behavioral interventions. Nevertheless, in this dissertation, sleep intervention was chosen as the case study because 1) sleep is universal recurrent behavior; 2) behavioral sleep treatments are “adaptive” treatment, highly manualized and have well defined outcome measurements. This cross-platform implementation of the JITAI architecture for sleep intervention is named the interactive Resilience Enhancing Sleep Tactics (iREST …