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HL-132: Increasing Adherence to Guideline-Based Exercise Therapy For Chronic Heart Failure

HL-132：提高对慢性心力衰竭基于指南的运动疗法的依从性

基本信息

批准号：
10357590
负责人：
Paul J Mills
金额：
$ 75.24万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-01-15 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10357590
关键词：
Accelerometer Adherence Adopted Aerobic Affect Age American Biological Markers California Cardiac health Cardiology Clinic Clinical Congestive Heart Failure Cost Analysis Counseling Data Diagnosis EFRAC Education Educational Materials Effectiveness Elderly Ensure Environment Event Exercise Exercise Therapy Exercise Tolerance Feedback Funding Galectin 3 Goals Guidelines Hand Strength Health Health Educators Healthcare Systems Heart Heart Rate Heart failure Hospitals Individual Infrastructure Intervention Lead Leadership Measures Modeling Moderate Exercise Monitor Moods Morbidity - disease rate Motivation National Heart, Lung, and Blood Institute National Institute on Aging Outcome Participant Patients Physical Function Physical activity Public Health Quality of life Randomized Controlled Trials Regimen Request for Proposals Research Resistance Running Schedule Site Social support Specialist Support Groups Telephone Testing Training Universities Use Effectiveness Walking Woman Work base behavior change cost effectiveness design disorder later incidence prevention ethnic diversity exercise adherence exercise intervention exercise program exercise regimen exercise training follow-up health training implementation outcomes implementation strategy improved inclusion criteria interest intervention program life time cost markov model men mortality pedometer peer peer support preservation programs response role model sex sleep quality social social cognitive theory socioeconomics strength training successful intervention tool

项目摘要

PROJECT SUMMARY/ABSTRACT This proposal is in response to NHLBI Topics of Interest: HL-132 Advancing Research in Exercise Therapy for Chronic Heart Failure (R01). This proposal aims to optimize adherence to exercise regimens in heart failure (HF), improve physical functioning and quality of life, and reduce morbidity. HF is a major public health concern, and while survival has improved over the decades the absolute mortality rate for HF remains high at approximately 50% within 5 years of initial diagnosis. Numerous studies show that regular physical activity / exercise significantly improves exercise tolerance as well as clinical outcomes in HF. Exercise as a reliable adjunctive intervention, however, remains limited due to poor short- as well as long-term adherence. This proposed study will examine the effectiveness of the Heart Exercise And Resistance Training – Peer Lead ActivitY (HEART–PLAY) intervention to significantly sustain exercise adherence in HF patients, as compared to a more standard exercise intervention. The HEART–PLAY intervention will be adapted from previous NHLBI-funded R01 work shown to have a sustained impact on moderate physical activity in the elderly. This proposed study will adapt the intervention to be safe for HF patients, deliver the intervention in cardiology clinics, and test adherence to the program over 18 months. Clinic staff and HF patients who are appropriate role models will be trained to teach the intervention activities with trained health educators. They will then be responsible for maintaining the program in the cardiology clinics. The HEART–PLAY program and behavior change will be sustainable because of the presence of peer and staff leadership and because it employs proven strategies from social cognitive theory and ecological models including self monitoring, social support, role modeling, and relapse prevention. In contrast to exercise classes that have a fixed schedule and limited evidence for adherence, HEART-PLAY teaches patients how to accumulate meaningful physical activity across the day and provides a supportive social infrastructure to maintain motivation. In a rigorous cluster randomized controlled trial at cardiology clinics at the University of California, San Diego (UCSD) hospitals and at the VA San Diego Healthcare System (VASDHS), we will develop and assess the HEART–PLAY intervention program in 264 socioeconomically and ethnically diverse women and men 60+ years old with either HF with preserved Ejection Fraction (HFpEF) or HF with reduced Ejection Fraction (HFrEF). Participants in the HEART–PLAY and in the STANDARD exercise programs will receive self-monitoring tools for aerobic plus resistance training as well as group education and materials. Participants in HEART–PLAY will additionally receive peer and staff leadership. We will demonstrate that the peer-led HEART–PLAY program based in the clinic setting will significantly enhance the primary study endpoint of adherence to 150 min/week of moderate physical activity/week over an 18-month follow up. We envision the study’s findings will provide a successful intervention model that will be exportable to the clinic environment.!

项目总结/文摘

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Systemic Inflammation and Cognitive Decrements in Patients With Stage B Heart Failure.

B 期心力衰竭患者的全身炎症和认知能力下降。

DOI：
10.1097/psy.0000000000001033
发表时间：
2022
期刊：
Psychosomatic medicine
影响因子：
3.3
作者：
Redwine,LauraS;Hong,Suzi;Kohn,Jordan;Martinez,Claudia;Hurwitz,BarryE;Pung,MeredithA;Wilson,Kathleen;Pruitt,Christopher;Greenberg,BarryH;Mills,PaulJ
通讯作者：
Mills,PaulJ

Is Belonging to a Religious Organization Enough? Differences in Religious Affiliation Versus Self-ratings of Spirituality on Behavioral and Psychological Variables in Individuals with Heart Failure.

加入宗教组织就足够了吗？

DOI：
10.3390/healthcare8020129
发表时间：
2020
期刊：
Healthcare (Basel, Switzerland)
影响因子：
0
作者：
Saiz,Jesús;Pung,MeredithA;Wilson,KathleenL;Pruitt,Christopher;Rutledge,Thomas;Redwine,Laura;Taub,PamR;Greenberg,BarryH;Mills,PaulJ
通讯作者：
Mills,PaulJ

Cardiac Rehab in the COVID Era and Beyond: mHealth and Other Novel Opportunities.