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

项目概要/摘要 此 K23 申请提出了职业发展计划，以帮助 Emily Kringle 博士建立独立的 研究计划的重点是优化患有中风相关残疾和其他疾病的成年人的健康 神经功能障碍。她将在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、利益相关者参与干预开发、定性研究方面的研究专业知识 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，博士。马骏和梅根刘易斯，两人都有丰富的指导学员的经验。这将 得到博士的内容和指导专业知识的补充。贝瑟尼·巴罗·吉布斯、伊丽莎白·斯基德莫尔、 和迪利普·潘迪。总的来说，该团队将提供出色的培训环境，使 Dr. Kringle 填补了她与生活方式干预研究相关的知识和技能方面的关键空白 影响中风后久坐行为和生活质量的人际社会动态。她的训练 目标是培养以下方面的技能：(1) 传统和当代行为临床的设计和分析 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）对中风后健康行为的影响，以及（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，并获取关键数据，以确保她成功过渡到独立。至 为此，Kringle 博士提出了研究计划，该计划直接建立在她之前开发 Activating 持久参与行为（ABLE）干预。 ABLE 使用行为激活来减少中风后的发生 久坐行为。减少久坐行为对于促进健康尤为重要 中风相关的残疾。即使损伤（运动、认知、感觉）完全解决，中风幸存者也不会 当损伤减轻时，会自动重新从事非久坐的活动。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）创造了 参与对个人有意义的非久坐日常活动的障碍。该提案的目的是 使 ABLE 适应远程医疗 (teleABLE)，以中风后第一年为目标，并评估其可接受性， 试点随机临床试验中的保真度和潜在影响。我们还将探讨潜在的因素 干预结果的调节因素或理论上驱动的调节因素。该试验中嵌入了数据 收集中风幸存者的社会支持人员的资料，以探索人际（二元）对中风幸存者的影响 中风久坐行为。这项研究的结果与职业发展计划相结合，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，以增强健康和生活质量，2）阐明 患有中风相关残疾的成年人的健康行为和生活质量的人际社会动态。

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.