MOVE Trial: MOtiVational Strategies to Empower African Americans to Improve Dialysis Adherence

MOVE 试验：激励非裔美国人提高透析依从性的策略

• 批准号: 10504154
• 负责人: Ebele M Umeukeje
• 金额: $ 62.61万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10504154
• 关键词: Accounting; Address; Adherence; African American; African American population; Attention; Behavior Therapy; Budgets; Caring; Chronic; Chronic Disease; Communities; Complex; Counseling; Data; Dialysis patients; Dialysis procedure; End stage renal failure; Evidence based intervention; Financial Hardship; Financial cost; Future; Goals; Health; Health behavior; Health system; Hemodialysis; High Prevalence; Hospitalization; Intervention; Kidney Diseases; Lead; Link; Medicare; Minority; Minority Groups; Mission; Modeling; Morbidity - disease rate; Motivation; National Institute of Diabetes and Digestive and Kidney Diseases; Outcome; Patients; Population; Predictive Factor; Prevalence; Prevention; Process; Prospective cohort; Protocols documentation; Provider; Psychosocial Factor; Public Health; Race; Randomized; Randomized Clinical Trials; Research; Risk; Testing; base; behavior change; behavioral adherence; effectiveness implementation trial; effectiveness trial; efficacy evaluation; efficacy testing; ethnic minority; evidence base; health disparity; health equity; health equity promotion; health training; hospital readmission; improved; improved outcome; innovation; intervention delivery; medication compliance; mortality; motivational enhancement therapy; novel; psychosocial; public health relevance; racial and ethnic; treatment adherence

Hemodialysis treatment non-adherence is a public health issue because of its association with excessive hospitalizations, high morbidity, and mortality, and increased financial costs. Compared to whites, African Americans have a four-fold higher prevalence of end-stage kidney disease (ESKD), higher non-adherence rates to hemodialysis, and higher odds of hospitalizations. Motivational interviewing, an evidence-based intervention that creates a bond between patients and providers, targets improvement in motivation-related psychosocial factors associated with adherence behaviors. Interventions for such factors are typically developed based on the dominant culture and may not be valid and generalizable to minority groups. Culturally tailored interventions lead to more durable change in African Americans yet there is a lack of studies testing the efficacy of such approaches to improve hemodialysis treatment adherence in African Americans. Use of culturally tailored motivational interviewing in African Americans with ESKD will promote health equity by improving dialysis treatment adherence, reducing hospitalizations, and enhancing other critical outcomes. Our long-term goal is to establish culturally sensitive strategies and multi-level interventions to improve outcomes in kidney disease. The overall objective of this project is to evaluate the efficacy of a culturally tailored motivational interviewing intervention developed using a rigorous theoretical framework on improving hemodialysis treatment adherence in African Americans with ESKD. The central hypothesis is that culturally tailored motivational interviewing will lead to improved hemodialysis treatment adherence. We will test this hypothesis in the following Specific Aims in a randomized clinical trial (RCT) in African American patients with ESKD. Compared to usual dialysis care, we aim to: Evaluate the efficacy of 8 weeks of culturally tailored motivational interviewing (MOVE) on improving hemodialysis treatment adherence at (1) 3 months, and (2) 6 months post-randomization. At the successful completion of the proposed research, the expected outcomes will include evidence of the efficacy of culturally tailored motivational interviewing on improving hemodialysis treatment adherence in African American patients with ESKD. The proposed research is innovative because of the novel application of a culturally tailored, evidence-based behavioral intervention developed using a rigorous theoretical framework (PEN-3); the use of specifically-trained health coaches to optimize intervention delivery; and the focus on understudied and overrepresented African American patients with ESKD to address the public health issue of hemodialysis treatment non-adherence. Study results will provide a strong basis for conducting an effectiveness and implementation trial, which is expected to have a significant impact on hemodialysis adherence, hospitalizations, morbidity, and mortality. This research strongly aligns with NIDDK's mission to promote health equity by addressing health disparities in kidney disease.

血液透析治疗不依从性是一个公共卫生问题，因为它与血液透析治疗过度相关