Effectiveness of an Automated Walking Program Targeting Veterans with COPD

针对慢性阻塞性肺病退伍军人的自动步行计划的有效性

• 批准号: 8182127
• 负责人: CAROLINE R. RICHARDSON
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2013-07-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8182127
• 关键词: Address; Adherence; Adult; American; Area; Blood Pressure; Caring; Chronic; Chronic Disease; Chronic Obstructive Airway Disease; Communities; Complex; Consent; Coronary Arteriosclerosis; Coronary artery; Data; Diabetes Mellitus; Dyspnea; Effectiveness; Enrollment; Exercise; Exercise Tolerance; Feedback; General Population; Goals; Health; Health Care Costs; Healthcare; Heart Diseases; High Prevalence; Hospitalization; Hospitals; Individual; Informatics; Internet; Intervention; Life; Lung; Measures; Mediating; Medical; Medical center; Methods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Outcome Assessment; Participant; Patients; Persons; Physical activity; Prevalence; Procedures; Quality of Care; Quality of life; Randomized; Randomized Controlled Trials; Rehabilitation therapy; Research; Rural; Rural Health; Self Management; Social support; Symptoms; Testing; Veterans; Waiting Lists; Walking; Weight; arm; base; cost; design; experience; fitness; health related quality of life; improved; primary outcome; programs; respiratory; rural area; satisfaction; urban area; web site

TITLE: EFFECTIVENESS OF AN AUTOMATED WALKING PROGRAM TARGETING VETERANS WITH COPD Anticipated Impact: Chronic Obstructive Pulmonary Disease (COPD) is a common disabling chronic condition that is more prevalent in veterans than in the general population. Limitations in daily activities due to reduced exercise tolerance along with frequent hospitalizations for COPD exacerbations contribute to poor quality of life and increased health care costs. A low cost and widely disseminated intervention that improves quality of life and exercise tolerance while decreasing rates of hospitalization for veterans with COPD could significantly improve quality of care and decrease costs. This research program addresses three HRS&D priority areas: 1) Access / Rural Health, 2) Care of Complex Chronic Conditions, and 3) Healthcare Informatics. Project Background / Rationale: Individuals with COPD who undergo a facility-based, exercise-focused pulmonary rehabilitation program experience significant improvements in health related quality of life, dyspnea, and exercise tolerance as well as reduced rates of hospitalization. Unfortunately, only a small percent of individuals with COPD who could benefit from pulmonary rehabilitation have access to and participate in such programs. Moreover, the benefits of short-term pulmonary rehabilitation programs tend to diminish rapidly after the program ends. Rural veterans are less likely to have access to facility-based pulmonary rehabilitation than urban veterans. Health related quality of life in rural veterans with COPD is significantly worse than for veterans with COPD who live in urban areas. An internet-mediated self-management program for veterans with COPD that focuses on walking could be disseminated widely at low marginal cost to any veteran with COPD who has internet access. Stepping Up to Health is a fully automated internet-mediated walking program that has been studied and is effective in individuals with other chronic diseases including type 2 diabetes, coronary artery disease and obesity. The SUH program uses inexpensive, enhanced uploading pedometers and provides automated, individually tailored coaching with gradually incrementing step-count goals and feedback. SUH results in an average increase in walking of approximately 1 mile or 2000 steps per day in individuals with chronic disease. The effectiveness of SUH with respect to COPD relevant outcomes has not been tested. Project Objectives: The proposed research is designed to test the effectiveness of an automated internet-mediated walking program for veterans with COPD on improving health related quality of life and reducing days of hospitalization. Additionally, the proposed research will compare measures of intervention reach, participation and satisfaction between urban and rural veterans. Project Methods: The study is a two-arm randomized controlled trial of an automated internet- mediated walking program targeting veterans with COPD. The two arms are 1) SUH for COPD and 2) wait list control. All study procedures will be delivered remotely including recruitment, consent, medical clearance, intervention delivery and outcome assessment. Equal numbers of urban and rural veterans will be invited, allowing comparisons of intervention reach, participation and satisfaction between urban and rural veterans.

标题：自动行走机器人的自主性 针对患有COPD的退伍军人 预期影响：慢性阻塞性肺疾病（COPD）是一种常见的致残性疾病， 在退伍军人中比在普通人群中更普遍的慢性疾病。限制 由于运动耐量降低沿着， COPD急性加重导致生活质量下降和医疗保健费用增加。低 成本和广泛传播的干预措施，提高生活质量和运动耐量 而降低COPD退伍军人的住院率可以显著改善 护理质量和降低成本。该研究计划涉及HRS&D的三个优先事项 领域：1）获取/农村卫生，2）复杂慢性病护理，3）医疗保健 信息学. 项目背景/依据：接受基于机构的， 以运动为重点的肺康复计划的经验显着改善， 与健康相关的生活质量、呼吸困难和运动耐量以及 住院不幸的是，只有一小部分COPD患者可以受益， 从肺康复有机会获得并参与这些方案。而且 短期肺康复计划的好处往往会迅速减少后， 节目结束。农村退伍军人不太可能获得基于设施的肺 比城市退伍军人的康复。农村退伍军人COPD患者的健康相关生活质量 明显比居住在城市地区的COPD退伍军人更糟糕。一个互联网中介 一项针对COPD退伍军人的自我管理计划，重点是步行， 以较低的边际成本广泛传播给任何有互联网接入的COPD退伍军人。 Stepping Up to Health是一个完全自动化的互联网介导的步行计划， 研究并对患有其他慢性疾病的个体有效，包括2型糖尿病， 冠状动脉疾病和肥胖。SUH程序使用廉价、增强的上传 步数计，并提供自动化，个性化定制的指导，逐步增加 计步目标和反馈。SUH导致步行平均增加约 1英里或2000步，每天与慢性疾病的人。SUH的有效性， 尚未对COPD相关结局进行测试。 项目目标：建议的研究旨在测试 为患有COPD的退伍军人提供自动化互联网介导的步行计划，以改善健康 相关的生活质量和减少住院天数。此外，拟议的研究 将比较城市和城市之间的干预范围、参与和满意度， 农村退伍军人 项目方法：该研究是一项自动化互联网的双臂随机对照试验， 针对COPD退伍军人的介导步行计划。两组为1）COPD的SUH 2）等待列表控制。所有研究程序都将远程进行，包括招募， 知情同意、医疗许可、干预实施和结果评估。相等数量的 城市和农村退伍军人将被邀请， 城乡退伍军人的满意度。