Improving Overactive Bladder Treatment Access and Adherence Through Personalized Behavioral Modifications and Mobile Technology-Based Interventions

通过个性化行为改变和基于移动技术的干预措施改善膀胱过度活动症治疗的可及性和依从性

• 批准号: 10682476
• 负责人: Ekene Enemchukwu
• 金额: $ 19.38万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10682476
• 关键词: Adherence; Affect; American; Award; Behavior Therapy; Caring; Chronic; Clinical; Data; Development; Diagnosis; Disease; Evidence based intervention; Evidence based treatment; Female; Funding; Goals; Health; Health Personnel; Health Services Accessibility; Improve Access; Increased frequency of micturition; International; Intervention; Interview; Knowledge; Lead; Low income; Methods; Minority Groups; Outcome; Overactive Bladder; Patient Education; Patients; Perception; Pharmacotherapy; Pilot Projects; Population; Positioning Attribute; Procedures; Process; Provider; Publishing; Quality of life; Randomized; Research; Research Personnel; Risk; Role; Stigmatization; Structure; Symptoms; Syndrome; Testing; Treatment Efficacy; Underserved Population; Urinary Incontinence; Veterans; Vulnerable Populations; Woman; Women' s Group; barrier to care; care seeking; cost; cost effective; design; efficacy trial; empowerment; ethnic diversity; evidence base; expectation; future implementation; health care delivery; improved; innovation; mHealth; micturition urgency; minimally invasive; mobile application; mobile computing; multidisciplinary; patient engagement; patient expectation; patient oriented; pilot test; pilot trial; provider-level barriers; racial diversity; satisfaction; side effect; social health determinants; therapy adherence; therapy duration; therapy outcome; tool; treatment adherence; treatment as usual; treatment planning; urinary; usability

PROJECT SUMMARY/ABSTRACT Poor access and insufficient patient education regarding OAB chronicity, expected outcomes, costs, and potential side effects lead to unrealistic patient perceptions about therapy and suboptimal therapy duration, particularly in vulnerable populations. This thus leads to poor treatment access, adherence, and undertreatment. My long-term goal is to develop as an independently funded investigator and international leader who will pioneer interventions that improve OAB therapy access, adherence and outcomes, thereby reducing the burden of this chronic condition. The overall objective for this K23 proposal is to design an innovative, stakeholder-informed strategy that incorporates barriers to treatment (such as social determinants of health) and improves patient access to therapy options and therapy adherence. The central hypothesis is that unmet patient expectations and knowledge due to lack of access and suboptimal provider-to-patient OAB healthcare delivery are a barrier to treatment adherence. This central hypothesis will be tested pursuing two specific aims: 1. Evaluate an adapted UI mobile health tool for use in a diverse, multicultural population of women with OAB and identify barriers and facilitators to access, treatment adherence and engagement from multiple key stakeholders. 2. Conduct a pilot study to evaluate the usability and feasibility of using a mobile health tool to improve OAB knowledge, engagement and treatment plan adherence in a diverse group of women with OAB. The rationale for the proposed research is that its completion is expected to provide a strong evidence-based framework for the continued development and future implementation of cost-effective, evidence-based interventions to improve OAB therapy access and adherence. Combined these results are expected to have an important positive impact by positioning me to submit a competitive R01 application proposing a randomized controlled efficacy trial for improving therapy access, adherence, and OAB outcomes during the fourth year of this award.

项目摘要/摘要 获得机会较少，对OAB慢性病、预期结果、成本和患者教育不足 潜在的副作用导致患者对治疗和次优治疗时间的不切实际的看法， 特别是在弱势群体中。因此，这导致治疗的可获得性、依从性和 不适当的治疗。我的长期目标是发展成为一名独立资助的调查员和国际 领导者，他将率先采取干预措施，改善OAB治疗的可及性、依从性和结果，从而 减轻这一慢性病的负担。这项K23提案的总体目标是设计一个 创新的、利益相关者知情的战略，纳入了治疗障碍(如社会决定因素 健康)，并改善患者获得治疗选择和治疗依从性的机会。中心假设是 由于缺乏渠道和次优的提供者对患者的OAB而未满足患者的期望和知识 医疗服务的提供是坚持治疗的障碍。这一核心假说将在两个月内得到检验 具体目标：1.评估适用于多元化、多文化人群的用户界面移动健康工具 并确定障碍和促进者，从以下方面获得、遵守治疗和参与 多个关键利益相关者。2.开展试点研究，评估使用手机的可用性和可行性 健康工具，在不同的人群中提高OAB知识、参与度和治疗计划的遵守情况 患有OAB的女性。拟议研究的理由是，它的完成预计将提供一个强有力的 以证据为基础的框架，以继续开发和今后执行成本效益高的方案， 循证干预，以改善OAB治疗的可及性和依从性。综合这些结果是 通过让我提交竞争性的R01申请，预计会产生重要的积极影响 提出一项改善治疗可获得性、依从性和OAB结果的随机对照疗效试验 在该奖项的第四个年头。