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La inactividad física es uno de los principales factores que contribuyen a la morbilidad y la mortalidad en todo el mundo. Muchas intervenciones comportamentales de actividad física en la actualidad han mostrado un éxito limitado al abordar el problema desde una perspectiva a largo plazo que incluye el mantenimiento. Este artículo propone el diseño de un algoritmo de decisión para una intervención adaptativa de salud móvil e inalámbrica (mHealth) que se basa en conceptos de ingeniería de control. El proceso de diseño se basa en un modelo dinámico que representa el comportamiento basada en la Teoría Cognitiva Social (TCS), con una formulación de controlador fundamentada en el control predictivo por modelo híbrido (HMPC por sus siglas en inglés) la cual se utiliza para implementar el esquema de decisión. Las características discretas y lógicas del HMPC coinciden naturalmente con la naturaleza categórica de los componentes de la intervención y las decisiones lógicas que son propias de una intervención para actividad física. La intervención incorpora un modo de reconfiguración del controlador en línea que aplica cambios en los pesos de penalización para lograr la transición entre las etapas de entrenamiento de iniciación comportamental y mantenimiento. Resultados de simulación se presentan para ilustrar el desempeño del controlador utilizando un modelo ARX estimado de datos de un participante representativo de Just Walk, una intervención de actividad física diseñada usando principios de sistemas de control.

Pregnant women are at a high risk for experiencing sleep disturbances, excess energy intake, low physical activity, and excessive gestational weight gain (GWG). Scant research has examined how sleep behaviors influence energy intake, physical activity, and GWG over the course of pregnancy. This study conducted secondary analyses from the Healthy Mom Zone Study to examine between- and within-person effects of weekly sleep behaviors on energy intake, physical activity, and GWG in pregnant women with overweight/obesity (PW-OW/OB) participating in an adaptive intervention to manage GWG. The overall sample of N = 24 (M age = 30.6 years, SD = 3.2) had an average nighttime sleep duration of 7.2 h/night. In the total sample, there was a significant between-person effect of nighttime awakenings on physical activity; women with >1 weekly nighttime awakening expended 167.56 less physical activity kcals than women with

High gestational weight gain (GWG) in overweight/obese pregnant women increases maternal-fetal complications. We conducted a 6-week GWG intervention based on an energy balance model that includes theories of planned behavior (TPB) and self-regulation constructs to promote exercise and healthy eating motivation and behaviors. The purposes of this proof-of-concept feasibility study were to examine: (1) the energy balance model constructs over the intervention, and (2) pre-post intervention, weekly, and dose-response changes in study constructs. Methods. Overweight/obese pregnant women (N=17) were randomized to 1 of 6 conditions, increasing in intensity, and included varied combinations of components (exercise sessions, healthy eating demonstrations, etc.). Exercise and healthy eating TPB (attitude, subjective norm, perceived behavioral control, intention), and self-regulation (prospective, retrospective) constructs were collected weekly. Exercise behavior, energy intake, and GWG were collected daily. Results. We observed: (a) significant increases in exercise TPB constructs, healthy eating attitude (limit unhealthy foods), exercise/healthy eating retrospective self-regulation; (b) significant decrease in healthy eating subjective norm (limit unhealthy foods); (c) trending increases for healthy eating perceived behavioral control (limit unhealthy foods), healthy eating prospective self-regulation, and energy intake; (d) significantly higher active time, steps, and energy expenditure at W3 relative to other weeks; (e) no significant increase in GWG; and, (f) a dose response effect such that women in more intensive dosages had greater gains in exercise and healthy eating perceived behavioral control (eat healthy/limit unhealthy foods). Conclusion. Brief exposure to a theoretically-driven, GWG intervention resulted in changes to exercise and healthy eating TPB and self-regulation motivational determinants, no significant increase in GWG, and suggests intervention intensity can strengthen perceived ability to engage in exercise/healthy eating behaviors; offering initial proof-of-concept for the intervention to regulate GWG in overweight/obese pregnant women. Future research will test this intervention over the course of pregnancy to understand long-term impact on maternal-fetal health outcomes.