ChangeGradients: Promoting Adolescent Health Behavior Change
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ClinicalTrials.gov Identifier: NCT04110756 |
Recruitment Status :
Not yet recruiting
First Posted : October 1, 2019
Last Update Posted : February 8, 2024
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Tracking Information | |||||
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First Submitted Date ICMJE | September 10, 2019 | ||||
First Posted Date ICMJE | October 1, 2019 | ||||
Last Update Posted Date | February 8, 2024 | ||||
Estimated Study Start Date ICMJE | February 12, 2024 | ||||
Estimated Primary Completion Date | December 2024 (Final data collection date for primary outcome measure) | ||||
Current Primary Outcome Measures ICMJE |
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Original Primary Outcome Measures ICMJE | Same as current | ||||
Change History | |||||
Current Secondary Outcome Measures ICMJE | Not Provided | ||||
Original Secondary Outcome Measures ICMJE | Not Provided | ||||
Current Other Pre-specified Outcome Measures | Not Provided | ||||
Original Other Pre-specified Outcome Measures | Not Provided | ||||
Descriptive Information | |||||
Brief Title ICMJE | ChangeGradients: Promoting Adolescent Health Behavior Change | ||||
Official Title ICMJE | Promoting Adolescent Health Behavior Change With Clinically Integrated Sample-Efficient Policy Gradient Methods | ||||
Brief Summary | As most adolescents visit a healthcare provider once a year, health behavior change interventions linked to clinic-based health information technologies hold significant promise for improving healthcare quality and subsequent behavioral health outcomes for adolescents (Baird, 2014, Harris, 2017). Recognizing the potential to leverage recent advances in machine learning and interactive narrative environments, the investigators are now well positioned to design health behavior change systems that extend the reach of clinicians to realize significant impacts on behavior change for adolescent preventive health. The proposed project centers on the design, development, and evaluation of a clinically-integrated health behavior change system for adolescents. CHANGEGRADIENTS will introduce an innovative reinforcement learning-based feedback loop in which adolescent patients interact with personalized behavior change interactive narratives that are dynamically personalized and realized in a rich narrative-centered virtual environment. CHANGEGRADIENTS will iteratively improve its behavior change models using policy gradient methods for Reinforcement Learning (RL) designed to optimize adolescents' achieved behavior change outcomes. This in turn will enable CHANGEGRADIENTS to generate more effective behavior change narratives, which will then lead to further improved behavior change outcomes. With a focus on risky behaviors and an emphasis on alcohol use, adolescents will interact with CHANGEGRADIENTS to develop an experiential understanding of the dynamics and consequences of their alcohol use decisions. The proposed project holds significant transformative potential for (1) producing theoretical and practical advances in how to realize significant impacts on adolescent health behavior change through novel interactive narrative technologies integrated with policy-based reinforcement learning, (2) devising sample-efficient policy gradient methods for RL that produce personalized behavior change experiences by integrating theoretically based models of health behavior change with data-driven models of interactive narrative generation, and (3) promoting new models for integrating personalized health behavior change technologies into clinical care that extend the effective reach of clinicians. |
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Detailed Description | Because the majority of adolescent health problems are amenable to behavioral intervention and most adolescents visit a healthcare provider once a year, health behavior change interventions linked to clinic- based health information technologies hold significant promise for improving healthcare quality and subsequent behavioral health outcomes for adolescents. Recognizing the potential to leverage advances in machine learning and virtual narrative environments, the field of health behavior change is now well-positioned to design health behavior change systems that extend the reach of clinicians to realize significant impacts on behavior change for adolescent preventive health. With a focus on risky behaviors and an emphasis on alcohol use, the project has two specific aims: (1) design, develop, and iteratively refine a policy-based reinforcement learning behavior change system for preventive adolescent health, and (2) investigate the impact of a clinically integrated sample-efficient policy gradient-based behavior change system on adolescent behavior. The project will culminate with an investigation of the behavioral effects of the CHANGEGRADIENTS system using adolescent patients recruited from two outpatient primary care clinics within the UCSF Department of Pediatrics: Mt. Zion Pediatrics and the Adolescent/Young Adult Clinic. It is hypothesized that adolescents who interact with CHANGEGRADIENTS will reduce number of days of alcohol use, reduce binge drinking, and increase self-efficacy to engage in healthy behavior and avoid risky substance use. It is anticipated that CHANGEGRADIENTS will provide a testbed for a broad range of health behavior change research and serve as the foundation for next-generation personalized preventive healthcare through computationally-enabled behavior change that is designed to be tightly integrated into clinical practice workflow. By taking advantage of the high degree of adaptive interactivity offered by its personalized behavior change environment, CHANGEGRADIENTS holds significant potential for creating compelling interactions that promote self-efficacy and engagement in healthy lifestyle behaviors to prevent cancer through improving cancer-related behaviors and risk factors. |
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Study Type ICMJE | Interventional | ||||
Study Phase ICMJE | Not Applicable | ||||
Study Design ICMJE | Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description: In Year 4 of the study, we will investigate the effect of the CHANGEGRADIENTS system on behavior related to alcohol use:100 adolescents will be enrolled in the CHANGEGRADIENTS intervention, and 100 will be enrolled in the comparison, non-intervention condition, for a total of 200 participants. Masking: None (Open Label)Primary Purpose: Prevention |
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Condition ICMJE |
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Intervention ICMJE | Behavioral: ChangeGradients
In the proposed intervention, adolescents at the UCSF clinics who endorse alcohol use on the Health e-Check screen, a 5-minute confidential risk behavior module, will be randomly assigned to either the CHANGEGRADIENTS Intervention or Comparison (no intervention). The CHANGEGRADIENTS system will generate behavior change narrative episodes that are tailored to the adolescent (e.g. level of alcohol use) while also universally addressing a core set of topics related to health behavior change. Shortly following the clinic visit, through 4 weekly, 20 minute episodes, adolescent participants will interact with the CHANGEGRADIENTS health behavior change environment outside of clinic. Adolescents will complete a brief alcohol screening-past 7-day use-at the beginning of each episode. At the end of the final episode, the system will produce an individualized adolescent report that summarizes use of the CHANGEGRADIENTS modules as well as self-reported alcohol use since clinic visit baseline.
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Study Arms ICMJE |
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Publications * |
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* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||
Recruitment Status ICMJE | Not yet recruiting | ||||
Estimated Enrollment ICMJE |
200 | ||||
Original Estimated Enrollment ICMJE | Same as current | ||||
Estimated Study Completion Date ICMJE | December 2024 | ||||
Estimated Primary Completion Date | December 2024 (Final data collection date for primary outcome measure) | ||||
Eligibility Criteria ICMJE | Inclusion Criteria:
Exclusion Criteria:
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Sex/Gender ICMJE |
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Ages ICMJE | 15 Years to 17 Years (Child) | ||||
Accepts Healthy Volunteers ICMJE | Yes | ||||
Contacts ICMJE | |||||
Listed Location Countries ICMJE | United States | ||||
Removed Location Countries | |||||
Administrative Information | |||||
NCT Number ICMJE | NCT04110756 | ||||
Other Study ID Numbers ICMJE | 19-28893 | ||||
Has Data Monitoring Committee | No | ||||
U.S. FDA-regulated Product |
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IPD Sharing Statement ICMJE |
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Current Responsible Party | University of California, San Francisco | ||||
Original Responsible Party | Elizabeth Ozer, PhD, University of California, San Francisco, Professor of Pediatrics | ||||
Current Study Sponsor ICMJE | University of California, San Francisco | ||||
Original Study Sponsor ICMJE | Same as current | ||||
Collaborators ICMJE | North Carolina State University | ||||
Investigators ICMJE |
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PRS Account | University of California, San Francisco | ||||
Verification Date | February 2024 | ||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |