Developing, Refining, and Testing a Mobile Health Question Prompt List in Gastroesophageal Reflux Disease

开发、完善和测试胃食管反流病移动健康问题提示表

• 批准号: 10739903
• 负责人: Afrin Kamal
• 金额: $ 19.3万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10739903
• 关键词: Acids; Address; Adherence; American; Barrett Esophagus; Behavioral; Clinical; Clinical Trials; Communication; Communities; Data; Development; Disease; Dose; Empathy; Esophageal Adenocarcinoma; Esophageal Diseases; Esophagus; Face; Feedback; Focus Groups; Foundations; Funding; Future; Gastroenterology; Gastroesophageal reflux disease; Goals; Health; Health Status; Healthcare; Individual; Infrastructure; Intervention; K-Series Research Career Programs; Knowledge; Manuscripts; Measures; Medical; Mentorship; Methodology; Methods; Mobile Health Application; Modeling; Outcome; Paper; Patient-Focused Outcomes; Patients; Physicians; Pilot Projects; Population Heterogeneity; Process; Protocols documentation; Qualitative Methods; Quality of life; Randomized; Research; Resources; Risk; Role; Sampling; Severities; Shapes; Socioeconomic Status; Symptoms; System; Testing; Thinking; Time; Translating; Update; Visit; Work; behavior change; career development; clinical care; community setting; cost; design; effective intervention; efficacy testing; experience; health care service utilization; health related quality of life; ideation; implementation science; improved; innovation; insight; mHealth; medication compliance; mobile application; motivated behavior; persistent symptom; pilot test; primary outcome; prototype; reduce symptoms; secondary outcome; skills; standard of care; success; usability; user centered design

Project Summary Up to 42% of Americans with gastroesophageal reflux disease (GERD) experience uncontrolled, chronic symptoms that reduce health-related quality of life and heighten the risk of long-term complications. My long- term goal is to improve health outcomes for patients with esophageal disorders. This proposal aims to improve health outcomes for patients with GERD, by harnessing patient activation and motivating behavioral change as a framework for a mobile health (mHealth) Question Prompt List (QPL) intervention. Patient activation emphasizes patients’ knowledge, skills, and confidence in managing their health care and predicts patients’ level of health success. However, almost half of patients with GERD demonstrate low patient activation scores. Low patient activation leads to poor adherence to medical therapy. Remarkably, very little research has focused on developing an intervention to improve patient activation and motivate behavior change in GERD. Emerging evidence suggests effective patient-physician communication interventions, such as disease-specific QPLs, increase patient activation. The objective of this proposal is to apply a 5-step user-centered Design Thinking model to develop, refine, and test a mobile app based QPL specific for GERD patients titled “Esophagus-Qs.” The central hypothesis is that Esophagus-Qs will be usable and has potential to harness patient activation and motivate behavior change. Our specific aims include: 1) Develop the design of Esophagus-Qs by empathizing, defining the problems patients face, and ideating to generate solutions; 2) Refine the design of Esophagus-Qs by prototyping and testing usability; and 3) Collect preliminary data on Esophagus-Qs in a randomized controlled pilot study to estimate the effect size of the intervention. We will pursue these aims using an innovative combination of qualitative and quantitative methodologies and implementation science to inform app development. The proposed research is significant, because it has potential to harness patient activation and motivate behavior change, that can translate into improved health outcomes. It is also significant because it will develop a platform that can be extended to develop mHealth QPLs in other esophageal disorders. The proximate expected outcome of this work is to develop a usable Esophagus-Qs and collect preliminary data on differences in patient activation over time, medication adherence, health-related quality of life, and GERD symptom severity between Esophagus-Qs and standard of care. Pilot data from this career development award will be the foundation for an R01-funded clinical trial to rigorously test the efficacy of Esophagus-Qs among a large, diverse population.

项目摘要 多达42％的美国人患有胃食管反应疾病（GERD）经历了不受控制的慢性 降低与健康相关的生活质量并增加长期并发症的风险的症状。我的长期 术语目标是改善食管疾病患者的健康状况。该建议旨在改善 通过利用患者激活并激励行为改变为GERD患者的健康结果 移动健康框架（MHealth）问题提示列表（QPL）干预措施。患者激活 强调患者在管理医疗保健和预测患者方面的知识，技能和信心。 健康成功水平。但是，几乎一半的GERD患者表现出患者的激活评分较低。 患者的激活较低会导致对医疗疗法的依从性不佳。值得注意的是，研究很少 专注于开发干预措施，以改善GERD的患者激活和动机行为的改变。 新兴的证据表明有效的患者 - 医学沟通干预措施，例如疾病特异性 QPL，增加患者的激活。该提案的目的是应用5步以用户为中心的设计 思考模型以开发，完善和测试基于移动应用的基于移动应用的QPL，专门针对名为的GERD患者 “食道。”中心假设是食道-QS将是可用的，并且具有利用的潜力 患者激活和动机行为改变。我们的具体目的包括：1）开发设计的设计 食管-QS通过同情，定义患者面临的问题并确定生成解决方案； 2） 通过原型制作和测试可用性来完善食道Q的设计； 3）收集有关的初步数据 在一项随机控制的试验研究中，食管-QS估计干预措施的效果大小。我们将 通过定性和定量方法的创新组合来追求这些目标以及 实施科学以告知应用程序开发。拟议的研究很重要，因为它具有 利用患者激活和动机行为改变的潜力，可以转化为改善的健康 结果。这也很重要，因为它将开发一个可以扩展以开发MHealth的平台 其他食管疾病中的QPL。这项工作的直接预期结果是开发可用的 食道QS并收集有关随时间推移患者激活差异的初步数据，药物治疗 依从性，与健康相关的生活质量以及食管Q和标准之间的GERD症状严重程度 关心。该职业发展奖的试点数据将是R01资助的临床试验的基础 严格测试大型潜水人群中食道Q的效率。