CLINICAL EFFECTIVENESS OF SELF MANAGEMENT INTERVENTION POST-MILD STROKE

轻度中风后自我管理干预的临床有效性

• 批准号: 8849466
• 负责人: Timothy J. Wolf
• 金额: $ 0.64万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-20 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8849466
• 关键词: Acute; Area; Award; Behavior; Benign; Caring; Chronic; Chronic Disease; Clinical Oncology Supplement (K12); Clinical Research; Clinical Trials; Clinical effectiveness; Complement; Cost Analysis; Cost Effectiveness Analysis; Data; Development Plans; Diabetes Mellitus; Ensure; Event; Fatigue; Funding; Goals; Grant; Health; Health Care Costs; Health Insurance; Health Status; Health behavior; Healthcare Systems; Hospitals; Hour; Hypertension; Impaired cognition; Impairment; Individual; Institution; Intervention; Knowledge; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Negligence; Neurologic; Outcome; Participant; Persons; Population; Publications; Publishing; Qualifying; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Rehabilitation therapy; Research; Research Methodology; Research Personnel; Research Priority; Research Project Grants; Research Training; Resources; Risk; Self Management; Single-Blind Study; Stroke; Subgroup; Symptoms; Testing; Time; Training; United States; United States National Institutes of Health; Universities; Washington; Work; acute stroke; career; career development; cognitive rehabilitation; cost; depressive symptoms; design; effective intervention; experience; group intervention; health care service utilization; high risk; improved; improved functioning; multidisciplinary; post intervention; pre-doctoral; programs; rehabilitation strategy; research study; treatment as usual; trial design

DESCRIPTION (provided by applicant): The goal of this K23 award is to obtain the mentored training necessary for the candidate to have a smooth transition to become an independent investigator in the rehabilitation of persons with mild stroke. This proposal builds logically on te candidate's previously NIH-funded clinical research training and NIH-funded pre-doctoral training; however, the protected time and mentorship associated with this award are necessary to guarantee the candidate's independence. The candidate has a track record of grant funding and publications that have established him as an expert in the area of mild stroke. From his previous work and other published studies, it is clear that persons with mild stroke are at high risk of developing further chronic disease and even higher risk of dying from a second stroke. Self-management intervention has been proven to be an effective intervention to increase healthy behaviors, improve overall health status/health behaviors, decrease healthcare utilization/cost, and decrease depressive symptoms in several studies with people with a variety of chronic conditions; however, current treatment of mild stroke is mostly focused on the acute event with little emphasis on chronic disease. The critical next step and overall goal of the proposed research study will be to evaluate if self-management intervention will improve health outcomes for persons with mild stroke. A single-blinded pilot randomized controlled trial design will be used with individuals with mild stroke. At baseline all participants will complete an assessment battery and then be randomly assigned to either the intervention group or the usual-care group. The intervention group will receive the Chronic Disease Self-Management Program (CDSMP) and the usual-care group will receive hospital rehabilitation recommendations. Six months after the start of the intervention, both groups will be reassessed using a subset of the same assessment battery completed at baseline. A subgroup of participants will be asked to allow the investigators to have access to health insurance data to be used for a preliminary cost analysis. The long-term goal of this study is to improve function and quality of life for persons with mild stroke. This study will be a critical step in achieving tis long term goal and also the candidate's long term career goal to have a funded research program to develop and evaluate cognitive rehabilitation strategies that will improve function and quality of life for persons with mild stroke. In conjunction with this research project, the candidate has developed a rigorous career development plan in order to become technically proficient in clinical trial research methodology and cost-effectiveness analysis. Both the research project and career development plan associated with this award are designed to capitalize on the vast resources available to the candidate at his institution, Washington University in St. Louis. Washington University is a top research institution in the United States and the candidate has assembled a highly qualified multidisciplinary mentorship team to ensure he becomes an independent investigator by the end of the award period.

描述（由申请人提供）：该K23奖的目标是获得候选人进行平稳过渡到成为独立康复的独立调查员所必需的指导培训，以恢复轻度中风的人。该提案以逻辑为基础，基于TE候选人以前由NIH资助的临床研究培训和NIH资助的博士前培训；但是，与该奖项相关的受保护时间和指导是为了保证候选人的独立性。候选人拥有赠款和出版物的记录，使他成为中风领域的专家。从他以前的工作和其他已发表的研究中，显然中风的患者具有发展进一步的慢性疾病，甚至更高的第二笔中风风险更高的风险。事实证明，自我管理干预是一种有效的干预措施，以提高健康行为，改善整体健康状况/健康行为，降低医疗保健利用/成本，并减少对患有多种慢性病患者的多项研究；然而，当前的轻度中风治疗主要集中在急性事件上，几乎不强调慢性病。拟议的研究研究的关键下一步和整体目标是评估自我管理干预是否会改善轻度中风患者的健康状况。单叶试点随机对照试验设计将与轻度中风的个体一起使用。在基线时，所有参与者将完成评估电池，然后随机分配给干预组或通常的护理组。干预小组将获得慢性疾病自我管理计划（CDSMP），通常的护理小组将获得医院的康复建议。干预开始后六个月，将使用基线时完成的同一评估电池的子集重新评估两组。将要求参与者的一个子组允许调查人员访问健康保险数据，以进行初步成本分析。这项研究的长期目标是改善轻度中风患者的生活质量和生活质量。这项研究将是实现长期目标的关键一步，也是候选人的长期职业目标，是制定资助的研究计划，以制定和评估认知康复策略，以改善轻度中风的人的功能和生活质量。结合该研究项目，该候选人制定了一项严格的职业发展计划，以便在技术上熟练地熟练临床试验研究方法和成本效益分析。与该奖项相关的研究项目和职业发展计划均旨在利用其在圣路易斯华盛顿大学的候选人可用的大量资源。华盛顿大学是美国的顶级研究机构，候选人召集了一个高素质的多学科指导团队，以确保他在奖励期结束时成为独立的研究员。