title: Design and rationale of the STRIVE trial to improve cardiometabolic health among children and families.
abstract: Many of the health behaviors known to contribute to cardiometabolic risk and disease (CMRD), including physical activity, diet, sleep, and screen time, begin during childhood. Given the population-wide burden of CMRD, novel ways of assessing risk and providing feedback to support behavior change are needed.
  
  
  
  This paper describes the design and rationale for the Study for using Technology to Reach Individual Excellence (STRIVE), a randomized controlled trial testing the use of an integrated, closed-loop feedback system that incorporates longitudinal, patient-generated, mobile health technology (mHealth) data on health behaviors and provides clinical recommendations to help manage CMRD among at-risk families.
  
  
  
  STRIVE is a 6-month trial among 68 children, ages 6-12year olds with a body mass index≥85th percentile from Massachusetts with at least one parent with CMRD. Data on several health behaviors will be collected daily over 6months. Children and parents will each wear wristbands that collect objective physical activity, sleep, and screen time data via accelerometry, noise, and infrared detection. Sugar sweetened beverage consumption will be assessed by self-report via a smartphone application. Weight will be collected using a wireless scale. Intervention group parents receive feedback on their child's health behaviors and personalized CMRD counseling via mobile messaging. Control parents receive standard of care recommendations and weekly health behavior reports for self-guided care.
  
  
  
  The STRIVE trial will test the use of mHealth and closed-loop feedback systems to improve health behaviors among families at-risk for or with established CMRD.
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, USA; Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: noreskovic@mgh.harvard.edu.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Oreskovic
authors.affiliation: Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA. Electronic address: fletcher@media.mit.edu.
authors.forename: Richard
authors.initials: R
authors.lastname: Fletcher
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: msharifi@mgh.harvard.edu.
authors.forename: Mona
authors.initials: M
authors.lastname: Sharifi
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: jknutsen@mgh.harvard.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Knutsen
authors.affiliation: Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA. Electronic address: anic@mit.edu.
authors.forename: Ani
authors.initials: A
authors.lastname: Chilingirian
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: etaveras@mgh.harvard.edu.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
mesh_terms: D061725:Accelerometry; D002648:Child; D005190:Family; D005240:Feasibility Studies; D005246:Feedback; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D050177:Overweight / Q000534:rehabilitation; D063766:Pediatric Obesity / Q000534:rehabilitation*; D017216:Telemedicine
keywords: Cardiometabolic; Childhood; Health behaviors; Obesity; Technology; mHealth