mGlide-Care: A mHealth Partnership with Care Givers to Improve HTN Management in Patients with Cognitive Impairment

mGlide-Care：与护理人员建立 mHealth 合作伙伴关系，以改善认知障碍患者的 HTN 管理

• 批准号: 10661238
• 负责人: KAMAKSHI LAKSHMINARAYAN
• 金额: $ 17.32万
• 依托单位: UNIVERSITY OF MINNESOTA
• 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 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10661238
• 关键词: Acceleration; Address; Adult; Age; Aging; Agreement; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Atherosclerosis Risk in Communities; Behavioral; Biometry; Blood Pressure Monitors; Blood Vessels; Cardiovascular Diseases; Caregiver Burden; Caregivers; Caring; Cellular Phone; Chronic Disease; Clinical Pharmacists; Clinical Research; Clinical Trials; Collaborations; Communities; Community Health; Community Health Systems; Data; Dementia; Disease Management; Economics; Elderly; Environment; Epidemiology; Evidence based intervention; Faculty; Family Caregiver; Focus Groups; Funding; Goals; Grant; Guidelines; Health; Health Policy; Health Resources; Health Services; Health Technology; Health system; Healthcare; Home; Hypertension; Impaired cognition; Institution; Intervention; K-Series Research Career Programs; Leadership; Low income; Measures; Mediating; Medical; Medical Care Team; Medication Management; Mentors; Minnesota; Modeling; Monitor; Neurocognitive; Neurology; Nursing Faculty; Outcome; Participant; Patient Education; Patients; Persons; Pharmaceutical Preparations; Population; Prevention; Principal Investigator; Provider; Public Health Schools; Recommendation; Recovery; Reporting; Research; Research Personnel; Research Support; Resources; Risk Factors; Role; Scientific Advances and Accomplishments; Self Care; Site; Stroke; Stroke prevention; Technology; Testing; Time; Training Programs; Underrepresented Populations; United States National Institutes of Health; Universities; Work; cardiovascular disorder prevention; cardiovascular risk factor; career; cohort; cost; dementia risk; design; disorder risk; disparity reduction; evidence base; graduate student; health care disparity; health equity; health management; hypertension control; hypertension treatment; implementation science; improved; innovation; investigator training; mHealth; medical schools; member; middle age; mild cognitive impairment; overtreatment; pilot trial; primary care patient; primary care provider; primary outcome; satisfaction; side effect; skills; social; stroke cognitive outcome; stroke risk; stroke survivor; transmission process; treatment as usual

Project Summary The principal investigator Dr. Lakshmi’s goal is to develop evidence-based technology interventions that support chronic disease care in older persons including those with mild cognitive impairment (MCI) and early stage Alzheimer’s disease and Alzheimer’s Disease Related Dementia (AD/ADRD). This K24 application will provide her with protected time to: 1) build skills in implementation science, aging research and the conduct of research with persons with cognitive impairment and their family caregivers; 2) accelerate mentoring of early career clinical faculty in the Department of Neurology particularly on K-awards and transition to the 1st R01; 3) obtain pilot feasibility and effect size data for a larger clinical trial of a mobile health technology (mHealth) intervention to improve hypertension (HTN) care in persons with MCI and early stage AD/ADRD. Dr. Lakshmi is a tenured faculty in the Division of Epidemiology and Community Health, School of Public Health (SPH) at the University of Minnesota and in the Department of Neurology. Her rich institutional environment includes partnerships with the Divisions of Biostatistics and Health Policy and Management, Medical School departments and community health systems. Dr. Lakshmi is a member of the Center for Health Aging and Innovation, a collaboration that aims to advance interdisciplinary aging research. The research focus of this K24 is improving the management of uncontrolled HTN in persons with MCI and early stage AD/ADRD. HTN is the most significant stroke, cardiovascular disease and dementia risk factor and is substantially under-treated especially in older persons. Dr. Lakshmi has worked on mHealth interventions since 2011, with a successful record of multiple funded grants. Her clinical trial, mGlide RCT, is implementing a mHealth-based care model for HTN care in community health systems serving diverse, low-income patients. In this K24, Dr. Lakshmi will develop mGlide-Care – an adaptation of mGlide – to address uncontrolled HTN in people with MCI and early AD/ADRD. Aim 1 will engage stakeholders to study the acceptability of mHealth mediated HTN care and will use their input to develop mGlide-Care. Stakeholders are persons with early stage AD/ADRD and MCI, unpaid family caregivers, primary care providers, geriatricians and clinical pharmacists. Aim 2 is a feasibility pilot to test mGlide-Care vs. usual care in 75 participants with uncontrolled HTN and early stage AD/ADRD or MCI. Caregivers will assist participants. Outcomes will include HTN control and participant and caregiver reported measures. Dr. Lakshmi is the site-PI for two NIH research networks, StrokeNet and DISCOVERY (Determinants of Incident Stroke Cognitive Outcomes and Vascular Effects on RecoverY). She also has access to rich cohort data including Atherosclerosis Risk in Communities-Neurocognitive study (ARIC-NCS) and others. Dr. Lakshmi will leverage the substantial resources from her health technology grants, StrokeNet, DISCOVERY, and cohorts including ARIC-NCS to mentor junior investigators in NIA priority areas. Her goal is to prepare her mentees for their own major scientific advances and independent research careers.

项目摘要 首席研究员Lakshmi博士的目标是制定基于证据的技术干预措施 支持老年人的慢性病护理，包括轻度认知障碍（MCI）和早期 阿尔茨海默氏病和阿尔茨海默氏病有关的痴呆症（AD/ADRD）。此K24应用程序将 为她提供受保护的时间：1）在实施科学，衰老研究和行为中建立技能 与认知障碍及其家庭护理人员的人进行研究； 2）加速早期心理 神经病学系的职业临床教师，尤其是在K-awards和向第一R01的过渡方面； 3） 获取对移动卫生技术（MHealth）更大临床试验的飞行员可行性和效果大小数据 在MCI和早期AD/ADRD患者中改善高血压（HTN）护理的干预措施。 Lakshmi博士 是流行病学和社区健康部的终身教师，公共卫生学院（SPH） 明尼苏达大学和神经病学系。她丰富的机构环境包括 与生物统计学和卫生政策与管理部门的伙伴关系，医学院 部门和社区卫生系统。 Lakshmi博士是卫生衰老中心的成员 创新，旨在提高跨学科老龄化研究的合作。研究重点 K24正在改善MCI和早期AD/ADRD的不受控制的HTN的管理。 htn是 最重要的中风，心血管疾病和痴呆症危险因素，并且处理得很低 特别是在老年人中。 Lakshmi博士自2011年以来一直从事MHealth干预措施，并取得了成功 多个资助赠款的记录。她的临床试验MGlide RCT正在实施基于MHealth的护理模型 用于为潜水员低收入患者提供服务的社区卫生系统中的HTN护理。在这个K24中，Lakshmi博士将 开发MGLIDE-CARE - 一种MGLIDE的改编 - 以解决MCI和早期患者的不受控制的HTN 广告/adrd。 AIM 1将吸引利益相关者研究MHealth介导的HTN护理的可接受性，并将 使用他们的输入来发展MGLIDE-CARE。利益相关者是具有早期广告/ADRD和MCI的人，未付 家庭护理人员，初级保健提供者，老年医生和临床药剂师。 AIM 2是可行性飞行员 测试MGLIDE-CARE与常规护理的75名参与者，患有不受控制的HTN和早期AD/ADRD或MCI。 护理人员将协助参与者。成果将包括HTN控制和参与以及报告的护理人员 措施。 Lakshmi博士是两个NIH研究网络的站点，即Strotent和Discovery （事件中风认知结果的决定因素和对恢复的血管影响）。她也有 获取丰富的队列数据，包括社区神经认知研究（ARIC-NCS）中的动脉粥样硬化风险 还有其他。 Lakshmi博士将利用其健康技术赠款的大量资源，Strokenet， 发现以及包括ARIC-NC在内的NIA优先领域的精神少年研究人员的同伙。她的目标是 为自己的主要科学进步和独立的研究职业做好准备。