Optimizing self-management COPD treatment through the American Lung Association Helpline

项目摘要/摘要 慢性阻塞性肺疾病(COPD)是一种日益普遍和昂贵的慢性疾病 这种疾病是导致美国发病率和死亡率的第三大原因。自我管理 COPD的治疗方案被证明可以改善与健康相关的生活质量，并预防与COPD相关的 住院治疗。尽管它们的临床益处，这些计划通常是多个组成部分和时间-和 资源密集型。到目前为止，还没有进行任何研究来隔离个人自我管理的作用 治疗部分有助于改善慢性阻塞性肺疾病的预后。当前的应用程序建议 建立使用多阶段优化策略(MOST)框架优化COPD的可行性 由美国肺脏协会(ALA)帮助热线提供的自我管理治疗。治疗 评估内容包括自我管理教育的持续时间、地面行走训练、 同伴支持和照顾者支持。主要结果是与健康相关的生活质量，其次是 COPD症状负担、自我管理行为和住院的结果。具体目标是：目标 1.设计析因实验并制定操作程序(即筛选/招募、 随机化和数据库管理)，以确保成功实施。目标2.确定可行性和 通过对48名COPD患者的初始样本进行试点测试研究设计的可接受性。结果 这些值将提供对招募和保留率、结果测量可变性、治疗保真度、 和治疗成分的可接受性，以通知随后的全动力优化试验。这个 拟议的项目还将使PI成为少数几个使用优化方法的研究人员之一 在慢性阻塞性肺病自我管理领域。马修博士目前正在完成NHLBI K23奖项(K23 HL138165)开发和测试针对COPD患者的量身定制的戒烟干预措施。这个 提议的R03将把她的治疗开发工作扩展到其他行为健康目标，由 COPD自我管理治疗，如呼吸困难管理、服药依从性、体力活动、 和节食。公共健康影响：拟议的研究是解决关键研究差距的第一步 关于确定慢性阻塞性肺疾病自我管理治疗的有效要素。这条线路的长期目标是 研究旨在优化多组分COPD自我管理干预的有效性，以及 减轻慢性阻塞性肺疾病相关疾病负担。

PROJECT SUMMARY/ ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) is an increasingly prevalent and costly chronic health condition, and is the third major cause of morbidity and mortality in the United States. Self-management treatment programs for COPD are shown to improve health-related quality of life and prevent COPD-related hospitalizations. Despite their clinical benefits, these programs are typically multi-component and time- and resource-intensive. To date, no study has been conducted to isolate the role of individual self-management treatment components in contributing to improved COPD outcomes. The current application proposes to establish the feasibility of using the Multiphase Optimization Strategy (MOST) framework to optimize COPD self-management treatment delivered by the American Lung Association (ALA) Helpline. Treatment components to be evaluated include duration of self-management education, ground-based walking training, peer support, and caregiver support. The primary outcome is health-related quality of life, with secondary outcomes of COPD symptom burden, self-management behaviors, and hospitalization. Specific aims are: Aim 1. Design a factorial experiment and develop operational procedures (i.e., screening/ recruitment, randomization, and database management) for successful implementation. Aim 2. Establish feasibility and acceptability by pilot testing the study design with an initial sample of 48 individuals with COPD. Resulting values will provide estimates of recruitment and retention rates, outcome measure variability, treatment fidelity, and acceptability of treatment components to inform a subsequent fully-powered optimization trial. The proposed project will also establish the PI as one of the few researchers employing optimization methods within the field of COPD self-management. Dr. Mathew is currently completing an NHLBI K23 award (K23 HL138165) to develop and test a tailored smoking cessation intervention for individuals with COPD. The proposed R03 will extend her treatment development work to additional behavioral health targets addressed by COPD self-management treatment, such as dyspnea management, medication adherence, physical activity, and diet. Public Health Impact: The proposed study is an initial step to address a critical research gap regarding identifying effective elements of COPD self-management treatment. The long-term goal of this line of research is to optimize the effectiveness of multi-component COPD self-management interventions, and reduce COPD-related disease burden.