Examining the association between psychosocial factors and adherence to a home exercise program for upper extremity recovery in Veteran stroke survivors

检查退伍军人中风幸存者的心理社会因素与坚持家庭锻炼计划以促进上肢恢复之间的关联

• 批准号: 10636974
• 负责人: Gabrielle Scronce
• 金额: --
• 依托单位: RALPH H JOHNSON VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10636974
• 关键词: Accelerometer; Address; Adherence; Admission activity; Affect; Behavior Therapy; Behavioral; Cellular Phone; Clinical Practice Guideline; Clinical Trials Design; Data; Department of Defense; Development; Diabetes Mellitus; Doctor of Philosophy; Elderly; Employment; Foundations; Future; General Population; Goals; Home; Human; Hypertension; Impairment; Individual; Intervention; Interview; K-Series Research Career Programs; Kinesiology; Measures; Medical; Mentors; Mentorship; Methods; Monitor; Moods; Neuronal Plasticity; North Carolina; Observational Study; Outpatients; Patient Self-Report; Persons; Pharmaceutical Preparations; Physical Rehabilitation; Physical activity; Physical therapy; Postdoctoral Fellow; Psychosocial Factor; Publications; Quality of life; Randomized, Controlled Trials; Recommendation; Recovery; Recovery of Function; Recreation; Regression Analysis; Rehabilitation therapy; Research; Research Methodology; Research Personnel; Research Training; Self Care; Self Efficacy; Sleep; South Carolina; Stroke; Structure; Survivors; Time; Training; Treatment/Psychosocial Effects; United States; United States Department of Veterans Affairs; Universities; Upper Extremity; Veterans; Visit; Work; Wrist; active duty; career; community engagement; compliance behavior; design; effective intervention; exercise program; experience; flexibility; health literacy; improved; medication compliance; motor recovery; physical therapist; post stroke; service member; skills; stroke rehabilitation; stroke survivor; systematic review

The proposed VA Career Development Award (CDA-1) is designed to provide support and mentorship for the PI, Dr. Gabrielle Scronce, to become a successful, independent VA investigator improving the lives of Veteran stroke survivors. Dr. Scronce obtained her Doctor of Physical Therapy and PhD in Human Movement Science at the University of North Carolina at Chapel Hill. She is currently a WOC researcher at the Ralph H. Johnson VAMC and a postdoctoral scholar at the Medical University of South Carolina under the primary mentorship of Dr. Na Jin Seo. The PI’s career and research training goals are influenced by her experience as a physical therapist working with Veterans and active duty service members, as these interactions have allowed her to appreciate the unique strengths and needs of these individuals that are insufficiently understood and addressed by standard physical therapy practice. Specifically, her training goals are to develop the foundation for psychosocial factors and behavioral interventions to improve Veterans’ adherence to home exercise programs (HEP), enhance skills in quantitative, qualitative, and mixed-methods research, develop proficiency in clinical trial design and management for stroke rehabilitation, and advance her professional development through grantsmanship, publications, scientific presentations, mentorship, and community engagement. The interprofessional team of mentors in this CDA-1 is well-suited to guide the PI as she works towards achieving her training goals. This CDA-1 adds new mentorship to Dr. Scronce from Dr. Lisa McTeague in psychosocial factors/measures and behavioral interventions, from Dr. Jillian Harvey in qualitative and mixed methods research, and from Dr. Viswanathan Ramakrishnan in quantitative research. In this CDA-1, Dr. Scronce will continue to receive mentorship from Dr. Seo with the addition of training in objective accelerometry to track HEP adherence. The study Dr. Scronce has proposed in this CDA-1 addresses the important problem of inadequate adherence to upper extremity (UE) HEP among stroke survivors, a problem that limits recovery and survivors’ subsequent ability to participate in desired activities. The objective of this study is to explain how modifiable psychosocial factors manifest themselves in terms of barriers and facilitators for HEP adherence among Veteran stroke survivors. This objective will be met through an observational study with mixed-methods design in which Veterans with UE impairment after stroke will be asked to complete objective measures of modifiable psychosocial factors, complete a HEP for 7 days during which adherence will be objectively monitored, and participate in semi-structured interviews to share barriers and facilitators to HEP adherence. Quantitative findings relating psychosocial factors with HEP adherence and qualitative findings from the semi-structured interview will be integrated to elucidate the relationship among psychosocial factors, barriers and facilitators for HEP adherence, and objective HEP adherence level. The long-term goal is to use the results of this study to develop a new enhanced behavioral intervention that can be delivered within a rehabilitation visit and that targets individual Veterans’ psychosocial factors to increase adherence to HEP, ultimately improving UE recovery in Veteran stroke survivors.

拟议的VA职业发展奖（CDA-1）旨在为 PI，Gabrielle Scronce博士，成为一名成功的独立VA调查员，以改善退伍军人的生活 中风存活。 Scronce博士在人类运动科学上获得了物理治疗博士和博士学位 在北卡罗来纳大学教堂山分校。她目前是拉尔夫·H·约翰逊（Ralph H. Johnson）的WOC研究员 VAMC和南卡罗来纳州医科大学的博士后科学在主要心态下 Na Jin Seo博士。 PI的职业和研究培训目标受她作为身体的经验的影响 与退伍军人和现役成员合作的治疗师，因为这些互动使她得以 欣赏这些人的独特优势和需求，这些人不足以理解和解决 通过标准的物理疗法实践。具体来说，她的培训目标是为 社会心理因素和行为干预措施，以改善退伍军人对家庭锻炼计划的遵守 （HEP），提高定量，定性和混合方法研究的技能，发展临床水平 试用中风康复的设计和管理，并通过 授予技巧，出版物，科学演讲，指导和社区参与。这 该CDA-1中的跨专业导师团队非常适合指导PI，因为她致力于实现 她的训练目标。此CDA-1为Lisa McTeague博士的Scronce博士添加了新的Mentalship 因定性和混合方法的吉利安·哈维（Jillian Harvey）博士的因素/措施和行为干预措施 研究，以及Viswanathan Ramakrishnan博士的定量研究。在此CDA-1中，Scronce博士将 继续从SEO博士那里获得精神验证，并增加了客观加速度计的培训以跟踪HEP 坚持。 Scronce博士在此CDA-1中提出的研究解决了不充分的重要问题 中风存活中遵守上肢（UE）HEP，这一问题限制了恢复和生存的问题 随后参加所需活动的能力。这项研究的目的是解释如何修改 社会心理因素在退伍军人中遵守的障碍和促进者表现出来 中风幸存者。该目标将通过与混合方法设计的观察性研究来实现 中风后患有UE损害的退伍军人将被要求完成可修改的客观度量 心理社会因素，完成7天的HEP，在此期间将对依从性进行客观监控，并且 参加半结构化的访谈，以分享障碍和促进者以遵守HEP。定量发现 将心理社会因素与半结构化访谈中的HEP依从性和定性发现有关 集成以阐明HEP的心理社会因素，障碍和促进因素之间的关系 依从性和客观的HEP依从性水平。长期目标是利用本研究的结果来发展 可以在康复访问中进行的新的增强行为干预措施，并针对 个人退伍军人的心理因素增加了对HEP的依从性，最终改善了UE的恢复 退伍军人冲浪者。