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 博士是该大学的心理学家和博士后研究员 华盛顿大学 (UW) 和 VA 普吉特湾医疗保健系统 (VAPSHCS) 西雅图合作奖学金 她致力于成为一名独立的多发性硬化症（MS）康复研究人员。 资助研究人员开发、优化和评估理论驱动的、可实施的干预措施 改善患有慢性健康问题/残疾的成年人的症状、心理社会功能和生活质量。 鉴于诺尔斯博士在观察和研究领域的深厚背景，她是该研究领域的理想人选。 压力和应对的干预研究以及康复研究中的高级奖学金培训。 K23 奖将为实现她优化的长期目标提供基础职业发展技能 基于证据且易于获得的治疗，可改善患有此病的患者的症状、功能和生活质量 拟议的项目将开发、完善和优化远程医疗认知系统。 针对多发性硬化症患者疲劳的行为疗法 (CBT) 干预 (PwMS) 的研究结果将支持以下观点： 评估基于 CBT 的优化 MS 职业疲劳干预措施的随机对照试验。 发展和培训计划：拟议的工作将在华盛顿大学进行并利用资源 华盛顿大学康复医学系和 VAPSHCS MS 卓越中心 West 博士。 Knowles 杰出的指导团队包括 Dawn Ehde 博士（主要导师；远程医疗 CBT 和 MS） 专家）、Aaron Turner（多发性硬化症行为干预专家）、Linda Collins [多阶段优化策略 （大多数）专家]和安娜·克拉茨（定性研究专家）诺尔斯博士的培训目标与她的研究相一致。 通过以下方面的教学和实践培训制定职业计划：(1) 干预优化和临床试验方法 通过 MOST，(2) 快速定性研究方法，以及 (3) 精通资助和科学 研究计划：拟议的目标将解决与活性相关的知识差距。 改善多发性硬化症疲劳的 CBT 的成分这一知识将有助于优化多发性硬化症疲劳的 CBT。 最大限度地提高功效和效率，从而改善实施和可及性。 (1) 开发、试点测试和完善 PwMS 中针对疲劳的三个远程医疗 CBT 组件（放松训练、 (2a) 行为成分 分析（通过因子优化试验）来测试三种远程医疗 CBT 的主要效果和交互效果 改善疲劳 PwMS 中的疲劳和心理社会功能的成分（主要结果）（2b）； 评估三个远程医疗 CBT 组成部分首创的独特和通用机制的变化； (2c) 通过 3 个月的随访评估结果改善的持久性。 如果满足主要结果的阈值效应大小，则选择进行优化干预 作为优化的干预方案来满足实施关键目标（在初步研究中定义）。