teleABLE: Adapting a Behavioral Activation-Based Intervention to Reduce Post-Stroke Sedentary Behavior Using Telehealth

项目总结/摘要 此K23应用程序提出了一个职业发展计划，以帮助艾米丽Kringle博士建立一个独立的 研究计划，重点是优化健康的成年人与中风有关的残疾和其他 神经性残疾她将在一个由资深科学家组成的跨学科小组的指导下接受培训， 行为临床试验研究专业知识，参与干预开发，定性 研究方法、人际关系理论与方法。她将继续使用目前的T32 导师，马俊博士和梅根刘易斯，他们都有丰富的经验指导学员。这将 由Bethany Barone Gibbs，Elizabeth斯基德莫尔， 还有迪利普·潘迪总的来说，这个团队将提供一个出色的培训环境，使博士。 Kringle填补了她在生活方式干预研究方面的知识和技能方面的关键空白， 影响卒中后久坐行为和生活质量的人际社会动力学。她的训练 目标是培养以下技能：（1）设计和分析传统和当代行为临床 试验，（2）利益相关者参与数据的定性分析，（3）理论、测量和分析 人际（二元）对脑卒中后健康行为的影响;（4）跨学科的专业技能 团队科学和科学领导。实现这些目标将加强她的学术活动，建立 重要的合作，并获得关键数据，以确保她成功过渡到独立。到 为此，Kringle博士提出的研究计划直接建立在她先前开发激活剂的工作基础上。 持续参与行为（ABLE）干预。ABLE使用行为激活来减少中风后 久坐行为减少久坐行为对于促进健康在这样的背景下尤为重要 中风相关的残疾即使损伤（运动、认知、感觉）完全消退，中风幸存者也不会 随着损伤的减少，自动重新参与非久坐活动。此外，残余损伤， 社会影响（保护性护理提供者）和环境因素（交通，可达性） 参与个人有意义的非久坐的日常活动的障碍。说这一点是为 使ABLE适应远程医疗（teleABLE），目标是中风后第一年，并评估其可接受性， 保真度和潜在的影响，在试点随机临床试验。我们还将探索潜在的因素， 调解人或理论上驱动的干预结果的调解人。这个试验中包含的数据 收集中风幸存者的社会支持者，以探讨人际（二元）影响后， 中风久坐行为这项研究的结果，结合职业发展计划，将 使Kringle博士能够启动一项独立的研究计划，旨在1）开发干预措施， 减少中风后久坐行为，以提高健康和生活质量，以及2）阐明 脑卒中相关残疾成年人健康行为和生活质量的人际社会动力学

PROJECT SUMMARY/ABSTRACT This K23 application proposes a career development plan to help Dr. Emily Kringle establish an independent research program that focuses on optimizing health among adults with stroke-related disability and other neurological disabilities. She will train under the mentorship of a transdisciplinary group of senior scientists with research expertise in behavioral clinical trials, stakeholder-engaged intervention development, qualitative research methods, and interpersonal theories and methods. She will continue working with her current T32 mentors, Drs. Jun Ma and Megan Lewis, both of whom have extensive experience mentoring trainees. This will be complemented by content and mentoring expertise from Drs. Bethany Barone Gibbs, Elizabeth Skidmore, and Dilip Pandey. Collectively, this team will provide an outstanding training environment that will allow Dr. Kringle to fill critical gaps in her knowledge and skill set relating to the study of lifestyles interventions and interpersonal social dynamics that influence post-stroke sedentary behavior and quality of life. Her training goals are to develop skills in (1) design and analyses of conventional and contemporary behavioral clinical trials, (2) qualitative analyses of stakeholder engagement data, (3) theory, measurement, and analyses of interpersonal (dyadic) influences on post-stroke health behaviors, and (4) professional skills in interdisciplinary team science and scientific leadership. Achieving these goals will strengthen her scholarly activities, establish important collaborations, and acquire critical data that will ensure her successful transition to independence. To this end, Dr. Kringle’s proposed research plan that builds directly on her prior work developing the Activating Behavior for Lasting Engagement (ABLE) intervention. ABLE uses behavioral activation to reduce post-stroke sedentary behavior. Reducing sedentary behavior is particularly important for promoting health in the context of stroke-related disability. Even if impairments (motor, cognitive, sensory) fully resolve, stroke survivors do not automatically re-engage in non-sedentary activities as impairments diminish. Further, residual impairments, social influences (protective care providers), and environmental factors (transportation, accessibility) create barriers to engagement in personally meaningful non-sedentary daily activities. The purpose of this proposal is to adapt ABLE to telehealth (teleABLE), targeting the first year post-stroke, and evaluate its acceptability, fidelity, and potential effects in a pilot randomized clinical trial. We will also explore factors that are potential moderators or theoretically driven mediators of intervention outcomes. Embedded within this trial is data collection from stroke survivors’ social support person to explore interpersonal (dyadic) influences on post- stroke sedentary behavior. Findings from this study, in combination with the career development plan, will enable Dr. Kringle to launch an independent program of research that aims to 1) develop interventions that reduce post-stroke sedentary behavior to enhance health and quality of life, and 2) elucidate the role of interpersonal social dynamics in health behaviors and quality of life among adults with stroke-related disability.