Better Living After Stroke through Technology (BLAST)

通过技术改善中风后的生活 (BLAST)

• 批准号: 9048186
• 负责人: Timothy J. Wolf
• 金额: $ 22.17万
• 依托单位: BRIGHTOUTCOME INC.
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-29 至 2016-09-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9048186
• 关键词: Activities of Daily Living; Address; Adoption; Adult; Affect; Automobile Driving; Back; Behavior; Behavioral; Caregivers; Cessation of life; Cognitive; Communication; Communities; Complex; Development; Evaluation; Executive Dysfunction; Family; Family member; Fees; Focus Groups; Goals; Health Services; Home environment; Impaired cognition; Impairment; Individual; Institution; Leisure Activities; Letters; Life; Marketing; Measures; Minor; Neurologic; Online Systems; Performance; Persons; Phase; Primary Care Physician; Problem Solving; Process; Randomized Controlled Trials; Recommendation; Recovery; Rehabilitation therapy; Reporting; Research; Residual state; Resources; Risk; Self Efficacy; Self Management; Small Business Innovation Research Grant; Social Interaction; Social support; Sorting - Cell Movement; Stroke; Support Groups; Survivors; Symptoms; System; Task Performances; Technology; Testing; Thinking; Wolves; Work; base; cognitive function; cognitive skill; design; disability; emotional experience; evidence base; executive function; family support; follow-up; improved; interest; member; mild cognitive impairment; motor impairment; novel; online community; personalized strategies; prototype; public health relevance; rehabilitation service; satisfaction; screening; social; stroke survivor; stroke symptom; success; tool; usability

 DESCRIPTION (provided by applicant) Stroke, the leading cause of disability, cognitive impairment and death in the US, imposes significant financial and personal burden. The residual effects of stroke affect many aspects of life not addressed by traditional rehabilitation treatments. In particular, persons with mild stroke, typically defined as a stroke with no or sligh motor impairment and a high level of independence in basic activities of daily living, often experience emotional problems, subtle but significant cognitive impairment and decreased participation in productive, social and leisure activity. Despite these problems, persons with mild stroke are typically discharged to home without further referral to health or rehabilitation services other than follow-up with primary care physicians. This is a Fast-Track SBIR application based on the extensive research results from Drs. Baum and Edwards on developing and testing reliable and valid measures of activity participation (Activity Card Sort, o ACS) and cognitive skills supporting performance of simple and complex functional tasks (Functional Behavior Profile, or FBP). These measures have been used to guide treatments to help persons with mild cognitive impairment and their families support functional independence. These measures and the results of other studies will be used to build a dynamic online self-management tool designed to help persons with mild stroke develop individualized strategies that will support optimal recovery. We propose Better Living After Stroke through Technology (BLAST) to help stroke survivors and family members return back to their productive and meaningful lives by proactively 1) helping both the survivor and caregiver set their activity goals using ACS; 2) identifying and addressing the survivors behavioral/functional capabilities using FBP; 3) recognizing and managing stroke symptoms indicative of secondary stroke risks; 4) for both engaging support from online and community resources; and 5) offering tailored self-management recommendations using evidence-based strategies to help them both achieve their activity goals. Stroke survivors and caregivers using our BLAST system are expected to have better survivor self-efficacy and fewer caregiver concerns. In addition, both will have better life satisfaction and increased activity, and the stroke survivor will have better problem solving, task performance and social interaction. Specific Phase I Aims: 1) collect input from stakeholders on system features, perceived usefulness and adoption barriers via focus groups; 2) develop the Web-based mobile-friendly prototype with a user-centric design process; 3) evaluate system usability/usefulness/acceptability. Phase II Aims: 1) enhance and improve the Phase I prototype system; and 2) conduct a randomized controlled trial with 138 dyads of stroke survivors and caregivers to confirm our study hypotheses.

 描述（由申请人提供）中风是美国残疾、认知障碍和死亡的主要原因，造成了巨大的经济和个人负担。中风的残余影响影响生活的许多方面，而传统的康复治疗无法解决。特别地，患有轻度中风的人，通常被定义为没有或轻微运动障碍并且在日常生活的基本活动中具有高水平的独立性的中风，经常经历情绪问题、微妙但显著的认知障碍以及生产、社交和休闲活动的参与减少。尽管存在这些问题， 中风患者通常出院回家，除了由初级保健医生进行随访外，没有进一步转诊到健康或康复服务机构。这是一个快速通道SBIR应用程序，基于Baum博士和Edwards博士关于开发和测试可靠有效的活动参与措施（活动卡分类，o ACS）和支持简单和复杂功能任务（功能行为特征，或FBP）的认知技能的广泛研究结果。这些措施已被用于指导治疗，以帮助轻度认知障碍者及其家人支持功能独立。这些措施和其他研究的结果将用于构建一个动态的在线自我管理工具，旨在帮助轻度中风患者制定个性化策略，以支持最佳康复。我们建议通过技术改善卒中后生活（BLAST），通过主动1）帮助幸存者和护理人员设定活动目标，帮助卒中幸存者和家庭成员恢复生产和有意义的生活 使用ACS; 2）使用FBP识别和解决幸存者的行为/功能能力; 3）识别和管理表明继发性卒中风险的卒中症状; 4）从在线和社区资源中获得支持;以及5）使用循证策略提供量身定制的自我管理建议，以帮助他们实现活动目标。使用我们的BLAST系统的中风幸存者和照顾者预计将有更好的幸存者自我效能和更少的照顾者的关注。此外，双方将有更好的 生活满意度和活动增加，中风幸存者将有更好的解决问题的能力， 任务表现和社会互动。第一阶段的具体目标：1）透过焦点小组，收集持份者对系统功能、感知效用及采用障碍的意见; 2）以用户为中心的设计程序，发展网上流动电话友善的原型; 3）评估系统的可用性/效用/可接受性。第二阶段目标：1）加强和改进I期原型系统; 2）对138名卒中幸存者和照顾者进行随机对照试验，以证实我们的研究假设。