Assessing an adherence intervention for adolescents with kidney transplants

评估青少年肾移植的依从性干预

• 批准号: 8536791
• 负责人: Sandra Amaral
• 金额: $ 17.23万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8536791
• 关键词: Address; Adherence; Adolescent; Adult; African American; Allografting; Area; Behavior; Belief; Calculi; Caring; Child; Childhood; Chronic Disease; Clinic; Commit; Communication; Communities; Complement; Country; Data; Development; Dialysis procedure; Education; Effectiveness; Environment; Etiology; Goals; Health; Health Sciences; Health behavior; Health education; Healthcare; Individual; Intervention; Kidney Transplantation; Knowledge; Life; Life Style; Manuscripts; Measures; Mediating; Medicare; Medicine; Mentors; Meta-Analysis; Mission; Operative Surgical Procedures; Organ; Organ Transplantation; Outcome; Patients; Pediatric Research; Pediatrics; Pharmaceutical Preparations; Pharmacy facility; Phase; Positive Reinforcements; Preparation; Psychology; Public Health Schools; Quality of life; Questionnaires; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Research Personnel; Resources; Risk; SF-36; Self Efficacy; Self Management; Services; Social Work; Social support; Solid; Surveys; Survival Rate; Telephone; Testing; Time; Training; Transplant Recipients; Transplantation; Universities; Waiting Lists; Woman; Work; Writing; age group; base; beneficiary; career; career development; cost; data registry; driving force; evidence base; experience; graft failure; health disparity; health economics; health related quality of life; improved; interest; malignant breast neoplasm; medication compliance; meetings; multidisciplinary; novel; patient population; pediatric department; peer; premature; prevent; programs; psychosocial; role model; standard of care; success; treatment as usual; young adult

DESCRIPTION (provided by applicant): Candidate: Dr. Amaral is a pediatric nephrologist at Emory-University, Children's Healthcare of Atlanta (Emory-CHOA), where she has initiated an adolescent transition clinic. She has a Masters in Health Science from Johns Hopkins School of Public Health. Her broad long, term career goals are to 1)become a pioneer in the development of evidence- based transitional care strategies for adolescents with chronic illness and 2)to assess and develop practices to eliminate health disparities in transplantation. Her proposed project is directed toward the first of these goals. Research: In this project, Dr. Amaral proposes to address the important problem of poor allograft survival in adolescent kidney transplant recipients due to nonadherence. Her first aim is to conduct a single center phase II randomized controlled trial that will test the effectiveness of a peer mentoring program to improve medication adherence and health-related quality of life (HRQOL) versus usual care in adolescents with kidney transplants. She will measure HRQOL by written survey and medication adherence by the Brief Medication Questionnaire and pharmacy refill data. Her second aim is to determine the mechanisms by which peer mentoring impacts medication adherence and HRQOL. Specifically, she hypothesizes that peer mentoring provides social support which increases patient self-efficacy and leads to positive health outcomes. Her proposed peer-mentoring program will be telephone-based, with e-communication as deemed mutually agreeable to mentors and mentees. This approach is novel and practical, meeting patients in their "real world." Environment: The Emory-CHOA Pediatric Transplant Center is one of the busiest in the country, providing a rich population of patients for Dr. Amaral's single center proposal. Dr. Amaral has formed a solid team of mentors from the Dept. of Pediatrics (Dr. Larry Greenbaum), Dept. of Transplant Surgery (Dr. Allan Kirk) and School of Public Health (Dr. Arriola and Prof. Easley) to facilitate her success. Dr. Arriola has research experience with peer mentoring, having developed a program of patient navigators for African American women with breast cancer. The Rollins School of Public Health offers several relevant courses to Dr. Amaral's career development. The Department of Pediatrics is committed to the success of young investigators, providing support for statistical analysis, grantsmanship and manuscript preparation as well as opportunities to engage with the research community through the Pediatric Research Center. This project's aims are directed at improving the health of adolescents with solid organ transplants by improving medication adherence and consequently long-term allograft function. Patients who maintain functioning transplants have better quality of life and live longer than those who have failed grafts and return to dialysis. This project's aims are well matched to the NIH's mission to supportive investigative efforts to improve health and save lives.

描述（由申请人提供）： 候选人：Amaral 博士是埃默里大学亚特兰大儿童保健中心 (Emory-CHOA) 的儿科肾病专家，她在那里创办了一个青少年过渡诊所。她拥有约翰霍普金斯大学公共卫生学院的健康科学硕士学位。她广泛的长期职业目标是 1) 成为为慢性病青少年制定循证过渡护理策略的先驱，2) 评估和制定消除移植方面健康差异的实践。她提出的项目旨在实现第一个目标。研究：在该项目中，Amaral 博士建议解决青少年肾移植受者因不依从性而导致同种异体移植物存活率低的重要问题。她的第一个目标是开展一项单中心 II 期随机对照试验，以测试同伴指导计划与肾移植青少年的常规护理相比，在提高药物依从性和健康相关生活质量 (HRQOL) 方面的有效性。她将通过书面调查来衡量 HRQOL，并通过简短用药问卷和药房补充数据来衡量用药依从性。她的第二个目标是确定同伴指导影响药物依从性和 HRQOL 的机制。具体来说，她假设同伴指导提供社会支持，从而提高患者的自我效能并带来积极的健康结果。她提议的同伴辅导计划将以电话为基础，并采用导师和受训者双方都同意的电子通信方式。这种方法新颖且实用，可以满足患者在“现实世界”中的需求。环境： Emory-CHOA 儿科移植中心是全国最繁忙的中心之一，为 Amaral 博士的单一中心提案提供了丰富的患者群体。 Amaral 博士组建了一支由来自儿科（Larry Greenbaum 博士）、移植外科（Allan Kirk 博士）和公共卫生学院（Arriola 博士和 Easley 教授）的导师组成的坚实团队，以促进她的成功。阿里奥拉博士拥有同伴指导方面的研究经验，为患有乳腺癌的非裔美国女性制定了患者导航计划。罗林斯公共卫生学院为阿马拉尔博士的职业发展提供了几门相关课程。儿科致力于帮助年轻研究者取得成功，为统计分析、资助和稿件准备提供支持，并通过儿科研究中心提供与研究界接触的机会。该项目的目标是通过提高药物依从性以及长期同种异体移植功能来改善接受实体器官移植的青少年的健康。与移植失败并返回透析的患者相比，维持移植功能的患者生活质量更高，寿命也更长。该项目的目标与 NIH 支持改善健康和拯救生命的调查工作的使命非常吻合。