Gender Differences in Physical Activity Among Patients with Implantable Cardioverter Defibrillators (ICDs)

植入式心脏复律除颤器 (ICD) 患者体力活动的性别差异

• 批准号: 10468724
• 负责人: Lindsey Rosman
• 金额: $ 17.13万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10468724
• 关键词: Accelerometer; Address; Arrhythmia; Behavioral; Behavioral Medicine; Biometry; Cardiac Electrophysiologic Techniques; Cardiac rehabilitation; Cardiology; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chronic Disease; Clinic; Clinical; Clinical Management; Clinical Trials; Computerized Medical Record; Data; Data Analyses; Databases; Development; Enrollment; Environment; Epidemiology; Excess Mortality; Feedback; Future; Gender; Goals; Health; Healthcare; Heart; Heart Arrest; Hour; Implant; Implantable Defibrillators; Intervention; K-Series Research Career Programs; Knowledge; Longitudinal trends; Mental Depression; Mentors; Methods; Monitor; Morality; Motivation; Observational Study; Online Systems; Osteoporosis; Outcome; Outpatients; Patient Outcomes Assessments; Patient Recruitments; Patients; Pattern; Physical activity; Psychologist; Quality of life; Records; Reporting; Research; Risk; Risk Factors; Sampling; Self Efficacy; Social support; Surveys; Technology; Testing; Time; Training; Woman; Work; adverse outcome; base; behavior change; cardiac device; cardiac implant; cardiovascular health; career; chronic pain; cohort; cost effective; disparity reduction; evidence base; exercise intervention; expectation; experience; falls; functional status; gender difference; health care disparity; health disparity; heart rhythm; high risk; improved; innovation; insight; knowledge base; mHealth; medical schools; men; mortality; mortality risk; multidisciplinary; novel; patient oriented; physical inactivity; preference; prospective; recruit; tool; trend; wireless

PROJECT SUMMARY/ABSTRACT This career development award will facilitate Dr. Rosman’s transition to an independent research career and support her becoming a future leader in women’s cardiovascular health. It will equip her with the knowledge, tools, and experiences needed to develop patient-centered interventions to improve cardiovascular and quality of life outcomes in women with cardiac arrhythmias and implantable cardioverter-defibrillators (ICDs). These long-term goals are supported by a 5-year training plan to develop expertise in: (1) chronic disease epidemiology and biostatistics; (2) physical activity (PA) assessment and data analysis; (3) clinical trials; and (4) technology-based interventions (mHealth). She has assembled a multidisciplinary team of mentors who are experts in epidemiology, biostatistics, PA, cardiac electrophysiology, and technology-based (mHealth) clinical trials to facilitate her transition to independence in a rich research environment. Dr. Rosman is a Clinical Health Psychologist and a postdoctoral research fellow in Cardiovascular Behavioral Medicine at the Yale School of Medicine. This proposal builds logically on her clinical background and prior research, which has focused on functional status and quality of life outcomes in women with cardiovascular disease and patients with arrhythmias. For the past 6 years, much of Dr. Rosman’s clinical work and research has focused on a subset of arrhythmia patients with ICDs who have an elevated mortality risk due to physical inactivity. Women are among the least active ICD patients and have an elevated risk for adverse outcomes, yet participation in traditional PA interventions (e.g., cardiac rehabilitation) remains low. mHealth may offer an innovative and cost-effective method to engage women with ICDs, collect detailed behavioral data (e.g., from built-in ICD accelerometer), and integrate these data with patient-reported outcomes to provide targeted feedback in real-time and promote behavior change. Yet the knowledge base upon which to build these interventions for ICD patients and tailor it for women (e.g., gender differences in the patterns, predictors, and barriers to PA after ICD implant) is lacking. Also lacking is the requisite data concerning levels of PA associated with lower mortality risk, gender differences in these outcomes, and preferences for PA intervention(s). Dr. Rosman’s research plan will address these critical gaps in knowledge using longitudinal ICD-accelerometer and EMR data from a large, national sample of prospectively enrolled ICD patients. She will: AIM 1: examine gender differences in PA and risk factors for inactivity after ICD implant; and AIM 2: examine associations between PA and mortality in these patients. In AIM 3: she will conduct a survey of newly implanted ICD patients to identify gender differences in PA characteristics, goals, barriers, and preferences for PA intervention. The acceptability of mHealth technology will also be assessed. The proposed research will provide an evidence base to support my next career goal of developing and testing a patient-centered intervention to increase PA in women with ICDs.

项目概要/摘要 该职业发展奖将促进罗斯曼博士向独立研究职业的过渡，并 支持她成为女性心血管健康的未来领导者。这将使她具备知识， 开发以患者为中心的干预措施以改善心血管和质量所需的工具和经验 患有心律失常和植入式心脏复律除颤器 (ICD) 的女性的生活结果。这些 长期目标由五年培训计划支持，以培养以下方面的专业知识：(1) 慢性病 流行病学和生物统计学； （2）体力活动（PA）评估和数据分析； （三）临床试验；和 (4) 基于技术的干预措施（移动医疗）。她组建了一支多学科的导师团队 流行病学、生物统计学、PA、心脏电生理学和基于技术的 (mHealth) 临床专家 尝试帮助她在丰富的研究环境中过渡到独立。罗斯曼博士是一名临床健康专家 耶鲁大学心理学家、心血管行为医学博士后研究员 药品。该提案逻辑上建立在她的临床背景和先前的研究基础上，该研究的重点是 患有心血管疾病的女性和患有以下疾病的患者的功能状态和生活质量结果 心律失常。 在过去的 6 年里，罗斯曼博士的大部分临床工作和研究都集中在以下子集上： 佩戴 ICD 的心律失常患者由于缺乏身体活动而死亡风险较高。女性也在其中 最不活跃的 ICD 患者，不良后果的风险较高，但参与传统 PA 干预措施（例如心脏康复）仍然很少。移动医疗可能会提供一种创新且具有成本效益的方法 让女性佩戴 ICD 的方法，收集详细的行为数据（例如，通过内置 ICD 加速度计）， 并将这些数据与患者报告的结果相结合，实时提供有针对性的反馈并促进 行为改变。然而，为 ICD 患者建立这些干预措施并进行定制的知识基础 女性的情况（例如 ICD 植入后 PA 的模式、预测因素和障碍方面的性别差异）缺乏。 还缺乏与较低死亡率风险、性别相关的 PA 水平的必要数据。 这些结果的差异以及 PA 干预的偏好。罗斯曼博士的研究计划将 使用纵向 ICD 加速度计和来自大型、 前瞻性入组 ICD 患者的全国样本。她将： 目标 1：检查 PA 中的性别差异和 ICD 植入后不活动的危险因素；目标 2：检查这些领域的 PA 与死亡率之间的关联 患者。在 AIM 3 中：她将对新植入 ICD 的患者进行一项调查，以确定性别差异 PA 干预的特征、目标、障碍和偏好。移动医疗的可接受性 技术也将受到评估。拟议的研究将为支持我的下一步提供证据基础 开发和测试以患者为中心的干预措施以增加患有 ICD 的女性的 PA 的职业目标。