teleABLE: Adapting a Behavioral Activation-Based Intervention to Reduce Post-Stroke Sedentary Behavior Using Telehealth

项目摘要/摘要 这份K23申请书提出了一项职业发展计划，以帮助艾米丽·克林格尔博士建立一个独立的 研究计划，重点是优化中风相关残疾成年人和其他人的健康 神经性残疾。她将在一个由资深科学家组成的跨学科小组的指导下接受培训 在行为临床试验、利益相关者参与的干预开发、定性方面的研究专长 研究方法、人际交往理论和方法。她将继续使用她目前的T32 导师马骏博士和梅根·刘易斯博士，他们都有指导学员的丰富经验。这将是 由贝瑟尼·巴隆·吉布斯博士、伊丽莎白·斯基德莫尔博士提供的内容和指导专业知识补充， 还有迪利普·潘迪。总体而言，这个团队将提供一个出色的培训环境，使Dr。 Kringle填补了她在与生活方式干预和研究相关的知识和技能方面的关键空白 影响中风后久坐行为和生活质量的人际社会动态。她所受的训练 目标是培养以下技能：(1)传统和现代行为临床的设计和分析 试验，(2)利益相关者参与度数据的定性分析，(3)理论、测量和分析 人际关系(二元)对卒中后健康行为的影响；(4)跨学科专业技能 团队科学和科学领导。实现这些目标将加强她的学术活动，建立 重要的合作，并获得关键数据，以确保她成功过渡到独立。至 为此，Kringle博士提出的研究计划直接建立在她之前开发激活 持久参与(能够)干预的行为。Enable使用行为激活来减少中风后 久坐的行为。减少久坐行为对促进健康尤为重要 中风相关的残疾。即使损伤(运动、认知、感觉)完全消失，中风幸存者也不能 随着损伤的减少，自动重新从事非久坐的活动。此外，剩余减值， 社会影响(保护性护理提供者)和环境因素(交通、可获得性) 参与对个人有意义的非久坐的日常活动的障碍。这项建议的目的是 为了适应远程医疗(TeleABLE)，目标是中风后第一年，并评估其可接受性， 保真度，以及先导性随机临床试验的潜在影响。我们还将探索有潜力的因素 干预结果的调解人或理论上驱动的调解人。这项试验中嵌入的是数据 收集卒中幸存者社会支持人员资料，探讨人际(二元)对卒中后生活质量的影响 中风久坐的行为。这项研究的发现，与职业发展计划相结合，将 使Kringle博士能够启动一项独立的研究计划，旨在1)开发干预措施 减少中风后的久坐行为，以提高健康和生活质量，以及2)阐明 中风相关残疾成人的健康、行为和生活质量中的人际社会动力学。

PROJECT SUMMARY/ABSTRACT This K23 application proposes a career development plan to help Dr. Emily Kringle establish an independent research program that focuses on optimizing health among adults with stroke-related disability and other neurological disabilities. She will train under the mentorship of a transdisciplinary group of senior scientists with research expertise in behavioral clinical trials, stakeholder-engaged intervention development, qualitative research methods, and interpersonal theories and methods. She will continue working with her current T32 mentors, Drs. Jun Ma and Megan Lewis, both of whom have extensive experience mentoring trainees. This will be complemented by content and mentoring expertise from Drs. Bethany Barone Gibbs, Elizabeth Skidmore, and Dilip Pandey. Collectively, this team will provide an outstanding training environment that will allow Dr. Kringle to fill critical gaps in her knowledge and skill set relating to the study of lifestyles interventions and interpersonal social dynamics that influence post-stroke sedentary behavior and quality of life. Her training goals are to develop skills in (1) design and analyses of conventional and contemporary behavioral clinical trials, (2) qualitative analyses of stakeholder engagement data, (3) theory, measurement, and analyses of interpersonal (dyadic) influences on post-stroke health behaviors, and (4) professional skills in interdisciplinary team science and scientific leadership. Achieving these goals will strengthen her scholarly activities, establish important collaborations, and acquire critical data that will ensure her successful transition to independence. To this end, Dr. Kringle’s proposed research plan that builds directly on her prior work developing the Activating Behavior for Lasting Engagement (ABLE) intervention. ABLE uses behavioral activation to reduce post-stroke sedentary behavior. Reducing sedentary behavior is particularly important for promoting health in the context of stroke-related disability. Even if impairments (motor, cognitive, sensory) fully resolve, stroke survivors do not automatically re-engage in non-sedentary activities as impairments diminish. Further, residual impairments, social influences (protective care providers), and environmental factors (transportation, accessibility) create barriers to engagement in personally meaningful non-sedentary daily activities. The purpose of this proposal is to adapt ABLE to telehealth (teleABLE), targeting the first year post-stroke, and evaluate its acceptability, fidelity, and potential effects in a pilot randomized clinical trial. We will also explore factors that are potential moderators or theoretically driven mediators of intervention outcomes. Embedded within this trial is data collection from stroke survivors’ social support person to explore interpersonal (dyadic) influences on post- stroke sedentary behavior. Findings from this study, in combination with the career development plan, will enable Dr. Kringle to launch an independent program of research that aims to 1) develop interventions that reduce post-stroke sedentary behavior to enhance health and quality of life, and 2) elucidate the role of interpersonal social dynamics in health behaviors and quality of life among adults with stroke-related disability.