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A Mixed Methods Study of Chronic Kidney Disease (CKD) Self-Management

慢性肾脏病 (CKD) 自我管理的混合方法研究

基本信息

批准号：
9906223
负责人：
Sarah Jeanne Schrauben
金额：
$ 19.48万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-03 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9906223
关键词：
Address Adherence Adoption Affect Age Area Award Behavior Biometry Blood Glucose Blood Pressure Monitors Cardiovascular Diseases Characteristics Chronic Kidney Failure Chronic Kidney Insufficiency Clinical Clinical Management Clinical Practice Guideline Clinical Trials Clinical Trials Design Cohort Studies Data Data Analyses Development Dialysis procedure Disease Disease Management Disease Outcome Disease Progression Economic Burden Education End stage renal failure Environment Epidemic Epidemiology Evaluation Feedback Fellowship Funding Grant Guidelines Health Health Technology Health behavior Hypertension Individual Intervention Intervention Studies Intervention Trial Interview Investigation Kidney Longevity Master&apos s Degree Mentored Patient-Oriented Research Career Development Award Mentorship Methods Nature Obesity Outcome Participant Patient Outcomes Assessments Patient Preferences Patients Pennsylvania Persons Physical activity Population Positioning Attribute Postdoctoral Fellow Predictive Factor Publishing Recommendation Research Research Design Research Methodology Research Personnel Research Priority Risk Science Self Management Statistical Data Interpretation Structure Syndrome Technology Testing Time Tobacco Training United States National Institutes of Health Universities Work approach behavior career career development clinical epidemiology cohort comorbidity cost cost effective design experience feasibility trial health economics health literacy healthy lifestyle implementation science improved mHealth multidisciplinary novel strategies patient engagement patient oriented patient oriented research pilot trial prevent programs prototype psychosocial recruit self-management program skills theories therapy design therapy development uptake usability

项目摘要

Chronic kidney disease (CKD) is a growing epidemic, affecting close to 15% of the US population, and is gen- erally progressive, with potentially fatal complications of cardiovascular disease and end-stage kidney disease. Directed treatment of CKD is challenging because CKD is a syndrome with causes that are often not identifia- ble and a dearth of disease-specific interventions. However, there are some cross-cutting approaches that are broadly beneficial for people with CKD, and are recommended by current CKD management guidelines, which include advising patients to engage in self-management behaviors (e.g., monitor blood pressure, maintain physical activity, and avoid tobacco). To date, there has been limited research on self-management in pre- dialysis CKD. The few published studies demonstrate poor uptake of recommended self-management behav- iors, which highlights the need to 1) understand the reasons for substandard engagement in recommended behaviors, and 2) develop and evaluate new approaches to improve CKD self-management. Sarah Schrauben, MD, MSCE, a nephrologist, will target this understudied area in her proposed K23 Award. Dr. Schrauben is positioned to use this award to launch an independently funded research career in the rich environment at the University of Pennsylvania, as she has completed a Masters degree in clinical epidemiology, through which she gained experience in epidemiology, biostatistics, study design, and during her post-doctoral fellowship, conducted a preliminary study on self-management behaviors in a large CKD observational cohort, as well as participated in formal training in qualitative and mixed methods research. Her proposed K23 work will utilize in- depth interviews with CKD patients to understand the influences of participating in health behaviors and identi- fy relevant factors for the design and implementation of a self-management support intervention (Aim 1). In a large cohort of individuals with CKD, Dr. Schrauben will investigate potential predictors of recommended self- management behavior engagement to identify patient characteristics important for a self-management support intervention (Aim 2). Using this information, she will develop a patient-centered self-management support in- tervention harnessing health behavior theory and mobile health (mHealth) technology and then pilot its feasibil- ity (Aim 3). Through her proposed career development, she seeks to gain skills in 1) clinical trial design, im- plementation, and evaluation, 2) mixed research methods, 3) advanced statistical analyses, including the longi- tudinal data analyses from the pilot trial, while garnering expertise in 4) implementation science, and 5) health behavior research. To achieve these objectives, Dr. Schrauben has assembled a multi-disciplinary mentorship team led by national experts in renal epidemiology, biostatistics, clinical trials, mixed research methods, im- plementation science, health behavior research, and interventions leveraging mHealth. Upon completion of these K23 activities, Dr. Schrauben will be poised to conduct a RCT supported by a R01 grant, leveraging her training to improve self-management among persons with CKD.

慢性肾脏疾病（CKD）是一种日益增长的流行病，影响了近15%的美国人口，并且是普遍的