Digital Health Physical Activity Program for Older Family Care Partners of Patients with Heart Failure

项目摘要/摘要 我的职业目标是建立一个独立的老龄化研究项目，专注于设计和评估 高质量、以技术为基础的行为健康干预，以提高自我管理和生活质量 (QOL)社区居住的老年人，特别是老年人家庭护理伙伴(FCP)。1700多万 在美国，FCP包括家人、朋友和亲戚，为患有慢性病的老年人提供护理。高 照顾负担使FCP面临身体功能下降、心理痛苦和健康状况不佳的风险 状态。具体地说，年长的FCP比年轻的FCP更容易受到攻击，因为 心理负担，更多与年龄相关的卫生保健需求，以及较少的情感和社会支持。物理 活动(PA)有可能促进老年FCP的健康和福祉。因为照看的责任 将FCP限制在家里，并阻止面对面的互动(在新冠肺炎大流行期间尤其如此)，使用 数字健康技术是让老年FCP参与基于家庭的PA干预的有效方式。然而， 针对较老的FCP的数字健康PA干预研究存在空白；我打算填补这一空白。这 K23奖将为我提供受保护的时间，让我获得(1)设计和 在老年人中实施临床试验，(2)体力活动行为的改变，(3)扩大健康 信息学，以及(4)为成功的独立研究事业而进行的专业发展。这项研究 科罗拉多大学的环境，我组建的跨学科指导团队，以及 护理学院的支持提供了一个特殊的培训机会。《公约》的总体目标 建议的研究是使用数字健康严格设计和测试定制的PA教练计划 技术，TPA4You，并进行一项试验性RCT，以评估TPA4You的可行性及其对健康的影响 在较老的FCP中的结果。心力衰竭患者的老年FCP(HF-FCP)将是这一主题的重点 研究是因为HF-FCP是一个研究不足的人群，容易受到他们自己的健康相关问题的影响。 该提案的具体目标是：(1)通过评估其技术来开发TPA4You干预 功能(n=15；第一年)，(2)进行TPA4You的现场测试，以优化可用性和可接受性(n=20； 第二年)，以及(3)进行一项试点RCT，以评估TPA4You干预的可行性和初步效果 (n=62；3-5岁)。对于目标1，使用基于场景的设计方法，我们将引发HF-FCPS对以下方面的看法 一对一访谈中的集成技术组件。对于目标2，我们将反复增强 TPA4您需要满足HF-FCPS的PA需求，并优化可用性和可接受性。对于AIM 3，较旧的HF-FCP将 随机接受为期12周的TPA4You计划或注意力控制。这项拟议的研究的小说 TPA4You计划有可能增加PA，并改善身体功能、心理结果、 以及老年HF-FCP患者的生存质量。这项建议将为R01药效研究提供基础 TPA4You计划在更大、更多样化的老年HF-FCP人群中进行。

PROJECT SUMMARY/ABSTRACT My career goal is to establish an independent aging research program focused on designing and evaluating high quality, technology-based behavioral health interventions to improve self-management and quality of life (QoL) of community-dwelling older adults, particularly older family care partners (FCPs). More than 17 million FCPs, including family, friends, and relatives, provide care for older adults with chronic illness in the US. High caregiving burden places FCPs at risk for physical function decline, psychological distress, and poor health status. Specifically, older FCPs are more vulnerable than younger FCPs because of greater physical and psychological burden, more age-related health care needs, and less emotional and social support. Physical activity (PA) has the potential to promote the health and well-being of older FCPs. Because caregiving duties limit FCPs to the home and preclude face-to-face interactions (more so during the COVID-19 pandemic), using digital health technologies is an effective way to engage older FCPs in home-based PA interventions. However, there is a gap in research for digital health PA interventions targeting older FCPs; I intend to fill this gap. This K23 award will provide me with the protected time to acquire advanced skills and knowledge in (1) design and implementation of clinical trials in older adults, (2) physical activity behavior change, (3) expansion of health informatics, and (4) professional development for a successful independent research career. The research environment at the University of Colorado, the interdisciplinary mentorship team I have assembled, and support from the College of Nursing provide an exceptional training opportunity. The overall objective of the proposed study is to rigorously design and test a tailored PA coaching program using digital health technologies, TPA4You, and conduct a pilot RCT to assess feasibility of TPA4You and its effects on health outcomes among older FCPs. Older FCPs of patients with heart failure (HF-FCPs) will be the focus of this study because HF-FCPs are an understudied population that is vulnerable to their own health-related issues. The specific aims of this proposal are to: (1) develop the TPA4You intervention by evaluating its technology features (n=15; Year 1), (2) conduct field-testing of TPA4You to optimize usability and acceptability (n=20; Year 2), and (3) conduct a pilot RCT to assess feasibility and preliminary effects of the TPA4You intervention (n=62; Years 3-5). For Aim 1, using scenario-based design methods, we will elicit HF-FCPs' perceptions about the integrated technology components in one-on-one interviews. For Aim 2, we will iteratively enhance TPA4You to meet HF-FCPs' PA needs and optimize usability and acceptability. For Aim 3, older HF-FCPs will be randomized to receive the TPA4You program or attention control for 12 weeks. This proposed study's novel TPA4You program has the potential to increase PA, and improve physical function, psychological outcomes, and QoL among older HF-FCPs. This proposal will provide the foundation for an R01 efficacy study of the TPA4You program in a larger, more diverse population of older HF-FCPs.