Disability Health Promotion Research Center - Recruitment, adherence, and retention are critical challenges in medical rehabilitation and health promotion research for people with physical disabilities. These challenges often result in small sample sizes, poor adherence, and high dropout rates, which limit the generalizability of research findings. In addition, combining data from existing and new datasets to develop research questions and analyze data across studies is a complex task. The Deep South, particularly Alabama, Mississippi, and Louisiana, has some of the highest disability rates in the nation. Chronic conditions like diabetes and obesity are significantly more prevalent in people with physical disabilities in this region, exacerbated by environmental barriers and an unsupportive environment that hinder healthy behaviors. The primary goal of this research project, supported by the Administrative, Resource, and Community Engagement and Outreach (CEO) Cores, is to apply AI and behavioral economics-based approaches to develop tools and strategies to optimize data utilization and improve retention and adherence to health promotion and secondary condition prevention (HP/SCP) interventions for PWD. These resources will be promoted to medical rehabilitation and health promotion researchers to facilitate more robust research in HP/SCP for people with physical disabilities. Aim 1 will develop AI-enabled tools to conduct data harmonization, leveraging existing data to support medical rehabilitation and health promotion researchers. Aim 2 will utilize behavioral economics–based approaches to learn participant preferences toward HP/SCP interventions. Aim 3 will develop and test the usability of an AI-enabled multichannel digital HP/SCP platform to improve adherence and retention in trial studies. Aim 4 will conduct factorial experimentation to pilot three behavioral economics–related design features in gamification and financial incentives to determine which optimizes adherence and engagement. Leveraging our ongoing digital health promotion tools at the National Center on Health, Physical Activity and Disability (NCHPAD) Data Coordinating Center, we aim to develop resources that will allow researchers to systematically address these barriers and develop their own digital HP/SCP interventions. Our research project is innovative through its use of behavioral economics and AI-enabled tools to improve intervention adherence and retention in HP/SCP trials. The resources developed will be invaluable for investigators in digital medical rehabilitation and health promotion research. They will facilitate data harmonization and analysis, incorporate user preferences to enhance intervention delivery, and ensure high usability through inclusive design and gamification. Ultimately, they will enable precision-based recruitment and adherence recommendations and support future optimization trials for digital HP/SCP interventions for people with physical disabilities. This research project aligns with the NCMRR/NICHD RFA-HD-25-001 to promote healthy behaviors and preventative medicine for secondary conditions, ultimately improving health and function for people with physical disabilities.
