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.

项目概要 首席研究员 Lakshmi 博士的目标是开发基于证据的技术干预措施， 支持老年人的慢性病护理，包括患有轻度认知障碍 (MCI) 和早期认知障碍的老年人 阶段阿尔茨海默病和阿尔茨海默病相关痴呆症 (AD/ADRD) 此 K24 应用程序将。 为她提供受保护的时间来：1）培养实施科学、老龄化研究和开展 与认知障碍人士及其家庭照顾者进行研究；2) 加速早期指导； 神经病学系的职业临床教师，特别是 K 奖和过渡到 1st R01 3)； 获取移动医疗技术 (mHealth) 更大规模临床试验的试点可行性和效果大小数据 改善 MCI 和早期 AD/ADRD 患者高血压 (HTN) 护理的干预措施 Lakshmi 博士。 是公共卫生学院 (SPH) 流行病学和社区卫生部门的终身教员 她丰富的机构环境包括明尼苏达大学和神经病学系。 与医学院生物统计和卫生政策与管理系建立伙伴关系 拉克什米博士是健康老龄化中心的成员。 创新，旨在推进跨学科衰老研究的合作。 K24 正在改善 MCI 和早期 AD/ADRD 患者不受控制的 HTN 的管理。 中风、心血管疾病和痴呆症最重要的危险因素，且治疗严重不足 Lakshmi 博士自 2011 年以来一直致力于移动医疗干预，并取得了成功。 她的临床试验 mGlide RCT 正在实施基于移动医疗的护理模式。 Lakshmi 博士将在社区卫生系统中为多样化的低收入患者提供高血压护理。 开发 mGlide-Care（mGlide 的改编版本），以解决 MCI 和早期患者不受控制的高血压问题 AD/ADRD。目标 1 将让利益相关者研究 mHealth 介导的 HTN 护理的可接受性，并将 利用他们的意见来开发 mGlide-Care 利益相关者是患有早期 AD/ADRD 和 MCI 的人，无报酬。 目标 2 是一项可行性试点，旨在帮助家庭护理人员、初级保健提供者、老年病学家和临床药剂师。 在 75 名患有不受控制的 HTN 和早期 AD/ADRD 或 MCI 的参与者中测试 mGlide-Care 与常规护理。 护理人员将协助参与者，结果将包括 HTN 控制以及参与者和护理人员的报告。 Lakshmi 博士是 NIH 两个研究网络 StrokeNet 和 DISCOVERY 的站点 PI。 （中风事件认知结果的决定因素和血管对恢复的影响）。 获取丰富的队列数据，包括社区动脉粥样硬化风险-神经认知研究 (ARIC-NCS) Lakshmi 博士将利用她的健康技术拨款 StrokeNet 的大量资源， DISCOVERY 以及包括 ARIC-NCS 在内的 NIA 优先领域的初级指导研究人员的群体。 帮助她的学员为自己的重大科学进步和独立研究生涯做好准备。