A Mixed Methods Study of Chronic Kidney Disease (CKD) Self-Management

慢性肾脏病 (CKD) 自我管理的混合方法研究

基本信息

批准号：
9906223
负责人：
Sarah Jeanne Schrauben
金额：
$ 19.48万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-03 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9906223
关键词：
Address Adherence Adoption Affect Age Area Award Behavior Biometry Blood Glucose Blood Pressure Monitors Cardiovascular Diseases Characteristics Chronic Kidney Failure Chronic Kidney Insufficiency Clinical Clinical Management Clinical Practice Guideline Clinical Trials Clinical Trials Design Cohort Studies Data Data Analyses Development Dialysis procedure Disease Disease Management Disease Outcome Disease Progression Economic Burden Education End stage renal failure Environment Epidemic Epidemiology Evaluation Feedback Fellowship Funding Grant Guidelines Health Health Technology Health behavior Hypertension Individual Intervention Intervention Studies Intervention Trial Interview Investigation Kidney Longevity Master&apos s Degree Mentored Patient-Oriented Research Career Development Award Mentorship Methods Nature Obesity Outcome Participant Patient Outcomes Assessments Patient Preferences Patients Pennsylvania Persons Physical activity Population Positioning Attribute Postdoctoral Fellow Predictive Factor Publishing Recommendation Research Research Design Research Methodology Research Personnel Research Priority Risk Science Self Management Statistical Data Interpretation Structure Syndrome Technology Testing Time Tobacco Training United States National Institutes of Health Universities Work approach behavior career career development clinical epidemiology cohort comorbidity cost cost effective design experience feasibility trial health economics health literacy healthy lifestyle implementation science improved mHealth multidisciplinary novel strategies patient engagement patient oriented patient oriented research pilot trial prevent programs prototype psychosocial recruit self-management program skills theories therapy design therapy development uptake usability

项目摘要

Chronic kidney disease (CKD) is a growing epidemic, affecting close to 15% of the US population, and is gen- erally progressive, with potentially fatal complications of cardiovascular disease and end-stage kidney disease. Directed treatment of CKD is challenging because CKD is a syndrome with causes that are often not identifia- ble and a dearth of disease-specific interventions. However, there are some cross-cutting approaches that are broadly beneficial for people with CKD, and are recommended by current CKD management guidelines, which include advising patients to engage in self-management behaviors (e.g., monitor blood pressure, maintain physical activity, and avoid tobacco). To date, there has been limited research on self-management in pre- dialysis CKD. The few published studies demonstrate poor uptake of recommended self-management behav- iors, which highlights the need to 1) understand the reasons for substandard engagement in recommended behaviors, and 2) develop and evaluate new approaches to improve CKD self-management. Sarah Schrauben, MD, MSCE, a nephrologist, will target this understudied area in her proposed K23 Award. Dr. Schrauben is positioned to use this award to launch an independently funded research career in the rich environment at the University of Pennsylvania, as she has completed a Masters degree in clinical epidemiology, through which she gained experience in epidemiology, biostatistics, study design, and during her post-doctoral fellowship, conducted a preliminary study on self-management behaviors in a large CKD observational cohort, as well as participated in formal training in qualitative and mixed methods research. Her proposed K23 work will utilize in- depth interviews with CKD patients to understand the influences of participating in health behaviors and identi- fy relevant factors for the design and implementation of a self-management support intervention (Aim 1). In a large cohort of individuals with CKD, Dr. Schrauben will investigate potential predictors of recommended self- management behavior engagement to identify patient characteristics important for a self-management support intervention (Aim 2). Using this information, she will develop a patient-centered self-management support in- tervention harnessing health behavior theory and mobile health (mHealth) technology and then pilot its feasibil- ity (Aim 3). Through her proposed career development, she seeks to gain skills in 1) clinical trial design, im- plementation, and evaluation, 2) mixed research methods, 3) advanced statistical analyses, including the longi- tudinal data analyses from the pilot trial, while garnering expertise in 4) implementation science, and 5) health behavior research. To achieve these objectives, Dr. Schrauben has assembled a multi-disciplinary mentorship team led by national experts in renal epidemiology, biostatistics, clinical trials, mixed research methods, im- plementation science, health behavior research, and interventions leveraging mHealth. Upon completion of these K23 activities, Dr. Schrauben will be poised to conduct a RCT supported by a R01 grant, leveraging her training to improve self-management among persons with CKD.

慢性肾脏疾病（CKD）是一种日益增长的流行病，影响了近15％的美国人群，并且是一般性的渐进性，患有心血管疾病和终末期肾脏疾病的潜在致命并发症。 CKD的定向治疗是具有挑战性的，因为CKD是一种综合征，其原因通常无法识别为 BLE和疾病特异性干预措施的缺乏。但是，有一些横切方法对CKD患者的广泛有益，并由当前的CKD管理指南推荐，这是包括建议患者从事自我管理行为（例如，监测血压，维持体育锻炼，避免烟草）。迄今为止，关于自我管理的研究有限透析CKD。少数发表的研究表明，推荐的自我管理行为的吸收不佳 - IORS，强调需要1）了解建议参与不合格的原因行为以及2）开发和评估新的方法以改善CKD自我管理。莎拉·施劳本（Sarah Schrauben）， MD，MSCE，肾脏科医生，将在她拟议的K23奖中针对这个研究的领域。 Schrauben博士是可以利用该奖项在富裕环境中启动独立资助的研究职业宾夕法尼亚大学，由于她已经完成了临床流行病学硕士学位，她获得了流行病学，生物统计学，研究设计的经验，并在博士后奖学金期间，在大型CKD观察队列中进行了有关自我管理行为的初步研究，参加了定性和混合方法研究的正式培训。她提出的K23工作将利用与CKD患者进行深度访谈，以了解参与健康行为和识别的影响 FY的设计和实施自我管理支持干预措施的相关因素（AIM 1）。在 Schrauben博士大量具有CKD的人群，将研究推荐的自我的潜在预测指标管理行为参与以确定对自我管理支持重要的患者特征干预（目标2）。使用这些信息，她将在以患者为中心的自我管理支持中延长利用健康行为理论与移动健康（MHealth）技术，然后驾驶其feasibil- ity（目标3）。通过她提出的职业发展，她试图在1）临床试验设计中获得技能培养和评估，2）混合研究方法，3）包括longi-longi的高级统计分析从试验试验中进行的拓展数据分析，同时获得4）实施科学专业知识，5）健康行为研究。为了实现这些目标，Schrauben博士召集了多学科指导由肾脏流行病学，生物统计学，临床试验，混合研究方法的国家专家领导的团队利用MHealth的努力科学，健康行为研究和干预措施。完成后这些K23活动，Schrauben博士将有望在R01赠款的支持下进行RCT，并利用她培训以改善CKD患者之间的自我管理。