Piloting a mobile health intervention to increase physical activity for adolescents with ADHD

Physical activity (PA) reduces symptoms of Attention Deficit Hyperactivity Disorder (ADHD); interventions to increase PA may improve functioning and health for adolescents with ADHD. Mobile health (mHealth) technology and social media constitute promising interactive modalities for engaging adolescents—who are at highest risk for ADHD treatment drop-out—in interventions to increase PA. The current pilot study evaluated feasibility and acceptability of an innovative intervention incorporating an mHealth-linked wearable activity tracker (Fitbit Flex) and a Facebook group to increase PA among adolescents with ADHD. 11 adolescents diagnosed with ADHD (age 14–18, m = 15.5; 54% female) participated in a 4-week trial utilizing the Fitbit Flex in conjunction with (1) weekly personalized step count goals (2) social support through a Facebook group and (3) daily text messages about PA. The study took place in the greater Seattle, Washington area in the fall of 2015. Adolescents completed online surveys twice per week to rate their ADHD symptoms and positive and negative mood states, and parents rated adolescent ADHD symptoms weekly. Participants were adherent to the study protocol and acceptability of the intervention was high. Linear mixed models indicated that participants significantly increased their average weekly steps over the course of the study and demonstrated improvements in both adolescent and parent-reported ADHD Inattentive symptoms. Results indicate that this mHealth intervention is engaging and promising for increasing PA among adolescents with ADHD, and warrant further study. Implications for improving ADHD symptoms and overall functioning for this undertreated population are discussed.

[1]  Jane D. Brown,et al.  A social media-based physical activity intervention: a randomized controlled trial. , 2012, American journal of preventive medicine.

[2]  J. Etnier,et al.  The effects of physical activity on attention deficit hyperactivity disorder symptoms: the evidence. , 2011, Preventive medicine.

[3]  David R Bassett,et al.  2011 Compendium of Physical Activities: a second update of codes and MET values. , 2011, Medicine and science in sports and exercise.

[4]  Kevin Patrick,et al.  Mobile health: the killer app for cyberinfrastructure and consumer health. , 2011, American journal of preventive medicine.

[5]  S. Kollins,et al.  Topical Review: ADHD and Health-Risk Behaviors: Toward Prevention and Health Promotion. , 2016, Journal of pediatric psychology.

[6]  A. Byrne,et al.  The effect of exercise on depression, anxiety and other mood states: a review. , 1993, Journal of psychosomatic research.

[7]  J. Krystal,et al.  Move over ANOVA: progress in analyzing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. , 2004, Archives of general psychiatry.

[8]  R. Houts,et al.  Moderate-to-vigorous physical activity from ages 9 to 15 years. , 2008, JAMA.

[9]  C. Ko,et al.  The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. , 2007, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[10]  W. Hargreaves,et al.  Assessment of client/patient satisfaction: development of a general scale. , 1979, Evaluation and program planning.

[11]  Kimberly A. Patton Teens and Technology , 2011 .

[12]  G. McCabe,et al.  A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children , 2014, Journal of abnormal child psychology.

[13]  P. O’Connor,et al.  Acute Exercise Improves Mood and Motivation in Young Men with ADHD Symptoms. , 2016, Medicine and science in sports and exercise.

[14]  M. Moreno,et al.  Using A Facebook Group As An Adjunct To A Pilot mHealth Physical Activity Intervention: A Mixed Methods Approach. , 2015, Studies in health technology and informatics.

[15]  Steven Reise,et al.  The 10-Item Positive and Negative Affect Schedule for Children, Child and Parent Shortened Versions: Application of Item Response Theory for More Efficient Assessment , 2012, Journal of Psychopathology and Behavioral Assessment.

[16]  A. Nierenberg,et al.  Review of Medication Adherence in Children and Adults with ADHD , 2010, Postgraduate medicine.

[17]  D. Botter,et al.  Exercise impact on sustained attention of ADHD children, methylphenidate effects , 2010, Attention deficit and hyperactivity disorders.

[18]  James Dunbar,et al.  Waste the waist: a pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk , 2015, International Journal of Behavioral Nutrition and Physical Activity.

[19]  Nan M. Laird,et al.  Using the General Linear Mixed Model to Analyse Unbalanced Repeated Measures and Longitudinal Data , 1997 .

[20]  R. Furberg,et al.  Systematic review of the validity and reliability of consumer-wearable activity trackers , 2015, International Journal of Behavioral Nutrition and Physical Activity.

[21]  E. Taylor,et al.  Attention-deficit hyperactivity disorder: treatment discontinuation in adolescents and young adults , 2009, British Journal of Psychiatry.

[22]  K. Patrick,et al.  Health and the mobile phone. , 2008, American journal of preventive medicine.

[23]  J. Shuster,et al.  Cardiac Safety of Central Nervous System Stimulants in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder , 2007, Pediatrics.

[24]  Leonard Bickman,et al.  Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. , 2003, Journal of pediatric psychology.