A positive psychology intervention to promote health behaviors in heart failure

促进心力衰竭患者健康行为的积极心理学干预

• 批准号: 9276107
• 负责人: Christopher M Celano
• 金额: $ 17.93万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9276107
• 关键词: Accelerometer; Adherence; Affect; American; Area; Award; Behavior; Behavior Therapy; Behavioral Medicine; Biometry; Bipolar Depression; Cardiac; Cardiology; Cardiovascular Diseases; Cardiovascular system; Chronic; Clinical; Clinical Research; Control Groups; Coronary Arteriosclerosis; Coronary heart disease; Data; Diagnosis; Diet; Ensure; Exercise; Feeling; Future; General Hospitals; Happiness; Health Promotion; Health behavior; Health behavior outcomes; Heart; Heart Diseases; Heart failure; Hospitalization; Impaired health; Impairment; Individual; Inpatients; Intake; Intervention; Intervention Studies; Intervention Trial; Interview; Journals; Knowledge; Lead; Letters; Life; Link; Massachusetts; Measurement; Measures; Medical; Mental Depression; Mental Health; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodological Studies; New York; Outcome; Outcome Measure; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Physical activity; Pilot Projects; Play; Population; Population Intervention; Principal Investigator; Provider; Psyche structure; Psychiatrist; Psychiatry; Psychology; Public Health; Public Health Schools; Publishing; Qualitative Research; Quality of life; Randomized; Reading; Research; Research Personnel; Research Project Grants; Risk; Role; Sodium; Structure; Telephone; Testing; Training; Treatment Efficacy; Woman; Writing; arm; attentional control; base; behavior measurement; cardiovascular health; cohort; control trial; efficacy testing; experience; good diet; gratitude; health related quality of life; high risk population; improved; improved outcome; interest; medication compliance; meetings; mortality; novel strategies; nutrition; optimism; percutaneous coronary intervention; physical conditioning; pilot trial; programs; psychologic; psychological outcomes; public health relevance; responsible research conduct

 DESCRIPTION (provided by applicant): Dr. Celano is a clinically trained psychiatrist and research fellow at the Massachusetts General Hospital (MGH). His research, performed primarily with the Cardiac Psychiatry Research Program at MGH, has centered on the promotion of psychological health in patients with cardiovascular disease and psychiatric illness. He has experience as a co-investigator on multiple studies in cardiac patients and currently is the principal investigator of a pilot study to enhance positive psychological states in patients with bipolar depression. He has published 18 articles (7 as first-author) that focus largely on the identification and management of psychiatric illness in cardiac patients. He serves as an ad hoc reviewer for several cardiology journals and has received local and national awards for his research. As a result of his research and clinical experience with cardiac patients, Dr. Celano has developed an increasing interest in the promotion of health behaviors (e.g., physical activity, medication adherence) in patients with heart failure (HF). HF is a chronic, debilitating, and progressive illness that affects nearly 6 million Americans and leads to significant impairments in functioning, quality of life, and survival. Health behaviors are associated with improved outcomes, including survival, in HF, but HF patients often have difficulty adhering to these behaviors. A potential way to improve adherence in this population is to use interventions that can boost positive psychological states, such as optimism, gratitude, or happiness. These states are associated with improved adherence to health behaviors in healthy and medically ill populations, suggesting that an intervention to boost them in HF patients may be an effective way to promote these behaviors and improve physical and mental health. Positive psychology, which uses systematic exercises (e.g., writing a letter of gratitude, using a personal strength in new way) to target positive feelings, may be a highly promising approach to improve health behaviors. In this K23 award proposal, Dr. Celano will obtain the experience needed to become an independent researcher who can develop and implement psychological interventions to increase healthy behavior in patients with HF. This will be accomplished through a research project and formal training plan to enhance his ability to: (1) create, administer, and analyze qualitative interviews, (2) create positive psychology interventions that promote health behaviors in HF patients, (3) develop and complete single-arm and controlled intervention trials, (4) measure and analyze diet and physical activity data, and (5) extend his knowledge of biostatistics. In his research project, Dr. Celano will develop a telephone-based positive psychology intervention to increase health behaviors in patients with New York Heart Association class II or III HF, then test the intervention's feasibility and preliminary efficacy. First, he will perform qualitative interviews to identify links between deficits in positive psychological states (e.g., optimism) and impaired health behavior completion. He will then create a positive psychology intervention based on these results. Next, he will perform a small, proof- of-concept trial to ensure initial feasibility of the intervention and to refine it as needed. Finally, he will perfor a randomized, controlled pilot trial to gather information about the intervention's feasibility, immediate impact on optimism, and preliminary efficacy at promoting health behaviors in this cohort. The results from this project will form the basis of a future R01 application to formally test the efficacy of the intervention in a larger group of subjects. Dr. Celano's research trial will be supplemented by a formal training plan to increase his understanding of biostatistics, HF and its treatment, nutrition and physical activity measurement, the responsible conduct of research, and psychological interventions for cardiac patients. His training will consist of biostatistics classes at the Harvard School of Public Health, clinical and research meetings related to HF, weekly seminars at MGH's Behavioral Medicine Program, formal training in qualitative research and the responsible conduct of research, structured reading programs in diet and physical activity, and regular meetings with mentors and consultants who have expertise in qualitative research, positive psychology, HF, health behavior outcomes, and behavioral interventions. Dr. Celano's proposal will provide him with invaluable experience in performing qualitative research, proof- of-concept trials, and controlled trials and will enhance his knowledge of HF, behavioral interventions, health behavior measurement, and biostatistics. Furthermore, this experience will enable Dr. Celano to become an independent investigator in a critically important area-namely, the promotion of health behaviors in HF. As patients with HF have trouble adhering to life-sustaining health behaviors, effective psychological interventions to enhance positive psychological states and promote these behaviors have the potential to improve mental and physical well-being in patients with this devastating illness.

 描述（由适用提供）：Celano博士是马萨诸塞州综合医院（MGH）的临床训练精神病医生和研究人员。他的研究主要由MGH的心脏精神病学研究计划进行，以促进心血管疾病和精神病患者的心理健康促进。他在心脏病患者的多项研究中担任共同评估者的经验，目前是一项试点研究的主要研究者，旨在增强双极抑郁症患者的阳性心理状态。他发表了18篇文章（有7篇作为第一名），主要关注心脏病患者精神病的识别和管理。他担任多个心脏病学期刊的临时审稿人，并获得了本地和国家奖项的研究。 由于他对心脏患者的研究和临床经验，塞拉诺博士对心力衰竭（HF）患者的健康行为（例如体育活动，药物依从性）的促进越来越兴趣。 HF是一种长期，令人衰弱和进步的疾病，影响近600万美国人，并导致重大损害 功能，生活质量和生存。健康行为与HF中的改善结局有关，包括生存，但HF患者通常很难坚持这些行为。提高该人群依从性的一种潜在方法是使用可以提高积极心理状态的干预措施，例如乐观，感激或幸福。这些状态与健康和医学不适的人群中对健康行为的遵守有关，这表明对HF患者提高他们的干预措施可能是促进这些行为并改善身心健康的有效方法。积极的心理学使用系统的练习（例如，以新的方式撰写感激之书，以个人力量来瞄准积极的感觉）可能是改善健康行为的一种高度有希望的方法。 在这项K23颁奖建议中，Celano博士将获得成为一名独立研究人员所需的经验，他们可以开发和实施心理干预措施，以增加健康行为 HF患者。这将通过一项研究项目和正式培训计划来增强其能力：（1）创建，管理和分析定性访谈，（2）创建积极的心理学干预措施，促进HF患者的健康行为，（（3）开发并完成单臂和对照干预试验，（4）测量和分析饮食和身体活动数据，以及（5）的知识。 在他的研究项目中，Celano博士将开发一种基于电话的积极心理学干预，以增加纽约心脏协会II类或III级HF患者的健康行为，然后测试干预措施的可行性和初步有效性。首先，他将进行定性访谈，以确定积极心理状态（例如乐观）和健康行为完成障碍的防御能力之间的联系。然后，他将根据这些结果创建积极的心理干预。接下来，他将进行一项小型的概念证明试验，以确保干预的最初可行性并根据需要进行完善。最后，他将进行一项随机，受控的试点试验，以收集有关干预措施的可行性，立即影响优化的信息，以及在促进该队列中健康行为方面的初步有效性。该项目的结果将构成未来R01应用程序的基础，以正式测试在较大的受试者中干预的效率。 Celano博士的研究试验将通过正式的培训计划进行补充，以提高他对生物统计学，HF及其治疗，营养和体育锻炼测量，负责任的研究以及对心脏病患者的心理干预措施的理解。他的培训将包括哈佛公共卫生，临床和 与HF有关的研究会议，MGH行为医学计划的每周半段，定性研究的正式培训以及负责任的研究，饮食和体育活动中的结构化阅读计划以及与心理学，积极心理学，HF，健康行为局势和行为干预措施方面具有专业知识的心态和顾问的定期会议。 Celano博士的建议将为他提供有效的经验，以进行定性研究，概念证明试验和对照试验，并将增强他对HF，行为干预，健康行为测量和生物统计学的了解。此外，这种经验将使Celano博士能够成为非常重要的领域的独立研究者，即促进HF的健康行为。由于HF患者遵守生命维持的健康行为，因此有效的心理干预措施可以增强积极的心理状态并促进这些行为，有可能改善这种破坏性疾病的患者的心理和身体健康。