Optimizing a Telehealth Behavioral Intervention for Fatigue in People with Multiple Sclerosis

优化多发性硬化症患者疲劳的远程医疗行为干预

• 批准号: 10642604
• 负责人: Lindsey Major Knowles
• 金额: $ 16.16万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642604
• 关键词: Adult; Affect; Analysis of Variance; Behavior Therapy; Behavioral; Behavioral Model; Case Series; Chronic; Clinical Trials; Cognitive; Cognitive Therapy; Data; Disease; Doctor of Philosophy; Emotional; Evidence based intervention; Exclusion; Fatigue; Fellowship; Funding; Future; Goals; Health; Healthcare Systems; Hour; Improve Access; Individual; Intervention; Intervention Studies; Knowledge; Long COVID; Malignant Neoplasms; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Multiple Sclerosis; Observation in research; Outcome; Persons; Physical Medicine; Physiological; Population; Postdoctoral Fellow; Pre-Post Tests; Private Sector; Psychologist; Qualitative Research; Quality of life; Randomized; Randomized, Controlled Trials; Reaction; Rehabilitation therapy; Relaxation; Relaxation Therapy; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Resources; Role; Scientific Advances and Accomplishments; Self Efficacy; Spinal cord injury; Stress; Stress and Coping; Stroke; Symptoms; Testing; Therapeutic Intervention; Training; Training Activity; Traumatic Brain Injury; United States; Universities; Washington; Work; Writing; acceptability and feasibility; behavioral health intervention; career; career development; daily functioning; design; disability; disabling symptom; effective therapy; evidence base; experience; follow up assessment; follow-up; implementation barriers; implementation determinants; implementation facilitation; improved; improved outcome; intervention effect; intervention refinement; multiphase optimization strategy; multiple sclerosis patient; multiple sclerosis treatment; patient engagement; pilot test; post intervention; primary outcome; prospective; psychosocial; rehabilitation research; skill acquisition; skills; sound; symptomatic improvement; telehealth; theories; therapy development; translational model

Project Summary/Abstract: Lindsey Knowles, PhD is a psychologist and postdoctoral fellow in the University of Washington (UW) and VA Puget Sound Health Care System (VAPSHCS) Seattle Collaborative Fellowship in Multiple Sclerosis (MS) Rehabilitation Research. She is fully committed to becoming an independently funded investigator who develops, optimizes, and evaluates theory-driven, implementable interventions to improve symptoms, psychosocial function, and quality of life in adults with chronic health conditions/disability. Dr. Knowles is an ideal candidate for this field of research given her strong background in observational and intervention research on stress and coping and advanced fellowship training in rehabilitation research. This K23 award will provide foundational career development skills for achieving her long-term goal of optimizing evidence-based and accessible treatment for improving symptoms, function, and quality of life in people with chronic health conditions. The proposed project will develop, refine, and optimize a telehealth Cognitive Behavioral Therapy (CBT) intervention for fatigue in people with MS (PwMS). Findings will support a randomized controlled trial to evaluate the optimized CBT-based intervention for MS fatigue. Career Development and Training Plan: The proposed work will be carried out at the UW and utilize resources within the UW Department of Rehabilitation Medicine and VAPSHCS MS Center of Excellence West. Dr. Knowles’s distinguished mentorship team includes Drs. Dawn Ehde (Primary Mentor; telehealth CBT and MS expert), Aaron Turner (MS behavioral intervention expert), Linda Collins [Multiphase Optimization Strategy (MOST) expert], and Anna Kratz (qualitative research expert). Dr. Knowles’s training goals align her research and career plans via didactic and hands-on training in: (1) Intervention optimization and clinical trials methods via MOST, (2) Rapid qualitative research methods, and (3) Proficiency in grantsmanship and scientific dissemination. Research Plan: The proposed aims will address a gap in knowledge related to the active ingredients of CBT for improving MS fatigue. This knowledge will facilitate optimization of CBT for MS fatigue to maximize efficacy and efficiency, thereby improving implementation and accessibility. The study aims are to (1) Develop, pilot test, and refine three telehealth CBT components for fatigue in PwMS (Relaxation Training, Behavioral Activation, Cognitive Therapy) to maximize feasibility and acceptability; (2a) Conduct component analysis (via factorial optimization trial) to test the main and interactive effects of the three telehealth CBT components for improving fatigue and psychosocial function in fatigued PwMS (primary outcomes); (2b) Assess change in hypothesized unique and common mechanisms of the three telehealth CBT components; (2c) Evaluate the durability of outcome improvements through the 3-month follow-up. Components will be selected for an optimized intervention if they meet the threshold effect size for either primary outcome and meet the key implementation objective (defined in a preliminary study) as an optimized intervention package.

项目摘要/摘要：Lindsey Knowles博士是大学的心理学家和博士后研究员 华盛顿（UW）和VA Puget Sound Health Carey System（VAPSHCS）西雅图合作奖学金 在多发性硬化症（MS）康复研究中。她完全致力于成为一个独立的 资助的调查员，他们开发，优化和评估理论驱动的，可实施的干预措施 改善患有慢性健康状况/残疾的成年人的症状，社会心理功能和生活质量。 Knowles博士是该研究领域的理想候选人，鉴于她的观察性背景很强 康复研究中的压力和应对和高级奖学金培训的干预研究。这 K23 Award将提供基本的职业发展技能，以实现她优化的长期目标 循证且可访问的治疗方法，以改善患有患者的症状，功能和生活质量 慢性健康状况。拟议的项目将开发，完善和优化远程医疗认知 MS（PWMS）患者疲劳的行为疗法（CBT）干预。调查结果将支持 随机对照试验评估了基于CBT的优化干预措施，以进行MS疲劳。职业 发展和培训计划：拟议的工作将在UW上进行并利用资源 在大学康复医学和VAPSHCS MS卓越中心西部。博士 诺尔斯的杰出攻击团队包括Drs。 Dawn Ehde（主要导师； Telehealth CBT和MS 专家），亚伦·特纳（MS行为干预专家），琳达·柯林斯[多相优化策略 （大多数）专家]和Anna Kratz（定性研究专家）。诺尔斯博士的培训目标使她的研究保持一致 以及通过教学和实践培训的职业计划：（1）干预优化和临床试验方法 通过大多数，（2）快速定性研究方法，以及（3）熟练和科学的熟练程度 传播。研究计划：拟议的目标将解决与活动有关的知识差距 CBT的成分可改善MS疲劳。这些知识将有助于对MS疲劳的CBT优化 为了最大程度地提高效率和效率，从而提高了实施和可访问性。研究的目的是 （1）开发，试点测试和完善三个远程医疗CBT组件，以用于PWMS中的疲劳（放松培训， 行为激活，认知疗法），以最大化可行性和可接受性； （2a）进行组件 分析（通过阶乘优化试验）测试三个远程医疗CBT的主要和互动效果 改善疲劳和社会心理功能的组成部分（主要结果）； （2b） 评估三种远程医疗CBT组件的假设独特和共同机制的变化； （2C）通过3个月的随访评估结果改善的耐用性。组件将是 如果以优化的干预措施符合阈值效应大小的主要结果，并且 满足关键实施目标（在初步研究中定义）作为优化的干预套件。