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

项目概要/摘要 慢性阻塞性肺疾病（COPD）是一种日益普遍和昂贵的慢性健康 在美国，它是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健康相关的生活质量，并预防COPD相关的 住院治疗尽管有临床益处，但这些计划通常是多组分和时间- 资源密集型。到目前为止，还没有进行研究，以孤立的作用，个人自我管理 治疗成分有助于改善COPD结局。本申请提出， 建立使用多阶段优化策略（MOST）框架优化COPD的可行性 美国肺脏协会（ALA）帮助热线提供的自我管理治疗。治疗 评估的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。主要结局是健康相关的生活质量，次要结局是 COPD症状负担、自我管理行为和住院治疗的结局。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），以便成功实施。目标二。建立可行性和 通过对48名COPD患者的初始样本进行初步试验，确定研究设计的可接受性。所得 值将提供招募和保留率，结果测量变异性，治疗保真度， 和治疗组分的可接受性，以告知随后的全功率优化试验。的 拟议的项目还将使PI成为少数采用优化方法的研究人员之一 在COPD自我管理领域。马修博士目前正在完成NHLBI K23奖（K23 HL 138165）开发和测试针对COPD患者的定制戒烟干预。的 拟议的R 03将把她的治疗开发工作扩展到其他行为健康目标， COPD自我管理治疗，如呼吸困难管理、药物依从性、体力活动， 和饮食。公共卫生影响：拟议的研究是解决关键研究差距的第一步 关于确定COPD自我管理治疗的有效要素。这条线的长期目标是 研究旨在优化多组分COPD自我管理干预措施的有效性， 减少COPD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.