A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care
增强心房颤动自我护理的移动关系代理
基本信息
- 批准号:10831234
- 负责人:
- 金额:$ 21.24万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-04-27 至 2024-03-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAdvisory CommitteesAnticoagulantsAnticoagulationAtrial FibrillationBenchmarkingBlack raceCardiovascular DiseasesCardiovascular systemCaringCellular PhoneChronicChronic DiseaseClinicComplementComplexComputer LiteracyComputersCuesDataEducationEducational CurriculumElectronic Health RecordEmergency SituationFacial ExpressionGesturesGuidelinesHandHealthHealth Care RationingHealth EducatorsHealth PromotionHealth StatusHealth behavior and outcomesHealth educationHealth systemHeart RateHeart failureHospitalizationIncidenceIncomeIndividualInformation SystemsInternationalInterventionLow incomeMeasurementMeasuresMedical Care CostsMedical centerModificationMonitorMorbidity - disease rateMyocardial InfarctionOutcomeParticipantPatient CarePatient Outcomes AssessmentsPatient Self-ReportPatient-Centered CarePatient-Focused OutcomesPatientsPharmaceutical PreparationsPharmacy facilityPhasePrevalencePreventive treatmentProblem SolvingPublic HealthQuality of lifeRandomizedResearchResourcesSelf CareSelf EfficacySpeechStrokeStroke preventionSymptomsSystemTerminologyTestingUniversitiesVisitVoiceVulnerable Populationsanimationarmclinical infrastructurecohortcomparison controlcostdiariesdisabling symptomefficacy evaluationefficacy testingethnic minorityexperiencegazehealth applicationhealth care service utilizationhealth literacyhealth related quality of lifeheart rhythmhigh riskimprovedinnovationintervention effectintervention participantslow health literacymHealthmedical specialtiesmembermortalitynovelnovel strategiesoptimal treatmentsparticipant interviewpatient orientedprimary outcomeprogramsracial minorityrandomized, clinical trialsrecruitsecondary outcomeskillssocialsocial determinantssocial factorssocial health determinantssocioeconomicsstandard carestroke risksuccess
项目摘要
PROJECT SUMMARY
Atrial fibrillation (AF) is a common, morbid condition. Symptoms, complex management, and significant
adversity contribute to poor health-related quality of life (HRQoL). Social determinants of health exacerbate
morbidity in AF, and limited health literacy compounds the poor patient experience of AF. We propose a single-
center parallel group randomized clinical trial to test the efficacy of an embodied conversational agent (ECA) to
improve patient-centered care in AF. The ECA is a computer character that simulates face-to-face
conversation using voice, hand gesture, and gaze cues to provide education, monitoring and problem-solving.
We have used the ECA in multiple health contexts for self-care and demonstrated its success to improve
health behaviors and outcomes in individuals with limited computer and health literacy. Here we propose to
expand our successful 30-day pilot (n=31) of the ECA and the AliveCor Kardia smartphone heart rate and
rhythm monitor in order to evaluate the effect of a 4-month self-care curriculum and assess its 12-month
sustainability. We will further test the integration of ECA/Kardia results in the electronic health record (EHR)
and monitor alerts and resulting modifications to care. We will randomize 240 patients with AF who are
receiving anticoagulation to either (1) the ECA/Kardia intervention, provided by smartphone, and
accompanying EHR alerts, or (2) the control, consisting of an AF educational session, diary for recording
symptoms and adherence, and a smartphone with a general health application for self-care (WebMD). Our trial
will leverage the clinical infrastructure of the University of Pittsburgh Medical Center (UPMC) by recruiting at 8
UPMC clinics that share a common electronic health record. We will focus recruitment on individuals with
limited socioeconomic resources, low health literacy, or racial/ethnic minorities. Our aims are: (1) To examine
the effect of the ECA/Kardia intervention on patient-centered outcomes. We will evaluate HRQoL with the AF-
specific AF Effect on QualiTy of life (AFEQT) measure and general HRQoL with the Patient-Reported
Outcomes Measurement Information System-29 Profile at baseline, 4, and 12 months. (2) To evaluate the
effect of the ECA/Kardia and EHR alert intervention on anticoagulant adherence. We will quantify adherence
using medication possession ratio and pharmacy contact at 12 months, and complementary measures of self-
reported non-adherence at baseline, 4, and 12 months. (3) To determine the effect of the intervention on health
care utilization at 4 and 12 months using participant interview and the common EHR. Our trial will engage an 8-
member patient advisory committee comprised of individuals with chronic AF to guide the intervention's cultural
acceptability, recruitment, and presentation of results. Expected Results: In this project we will evaluate a
scalable patient-centered intervention to improve HRQoL, improve anticoagulation adherence, and reduce
health care utilization in vulnerable individuals with chronic AF. If proven successful, this intervention can be
broadly disseminated to improve the care of patients with AF.
项目概要
心房颤动 (AF) 是一种常见的病态。症状、管理复杂且意义重大
逆境会导致健康相关的生活质量 (HRQoL) 较差。健康的社会决定因素加剧
房颤的发病率和有限的健康素养加剧了房颤患者的不良体验。我们提出一个单一的
中心平行组随机临床试验,测试实体对话代理 (ECA) 的功效
改善以患者为中心的 AF 护理。 ECA是一个模拟面对面的计算机角色
使用声音、手势和目光线索进行对话,以提供教育、监控和解决问题。
我们已在多种健康环境中使用 ECA 进行自我保健,并证明其成功改善
计算机和健康素养有限的个人的健康行为和结果。在此我们建议
扩大我们成功的 30 天 ECA 和 AliveCor Kardia 智能手机心率试点 (n=31)
节律监测器,以评估 4 个月的自我护理课程的效果并评估其 12 个月的效果
可持续性。我们将进一步测试 ECA/Kardia 结果在电子健康记录 (EHR) 中的集成
并监控警报和由此产生的护理修改。我们将随机抽取 240 名 AF 患者,他们是:
接受抗凝治疗 (1) 通过智能手机提供的 ECA/Kardia 干预,以及
随附的 EHR 警报,或 (2) 控制,包括 AF 教育课程、记录日记
症状和依从性,以及带有一般健康自我护理应用程序 (WebMD) 的智能手机。我们的审判
将利用匹兹堡大学医学中心 (UPMC) 的临床基础设施,在 8 日进行招募
共享共同电子健康记录的 UPMC 诊所。我们将重点招聘具有以下特点的个人:
社会经济资源有限、健康素养低或种族/族裔少数。我们的目标是: (1) 检验
ECA/Kardia 干预对以患者为中心的结果的影响。我们将使用 AF- 来评估 HRQoL
特定 AF 对生活质量的影响 (AFEQT) 测量和一般 HRQoL 与患者报告
结果测量信息系统-29 基线、4 个月和 12 个月的概况。 (2) 评估
ECA/Kardia 和 EHR 警报干预对抗凝治疗依从性的影响。我们将量化遵守情况
使用 12 个月时的药物持有率和药房接触情况,以及自我管理的补充措施
报告在基线、4 个月和 12 个月时未遵守规定。 (3) 确定干预措施对健康的影响
使用参与者访谈和通用 EHR 评估 4 个月和 12 个月时的护理利用情况。我们的试验将涉及 8-
由慢性房颤患者组成的患者咨询委员会成员,指导干预措施的文化
可接受性、招募和结果的呈现。预期结果:在这个项目中,我们将评估
可扩展的以患者为中心的干预措施,以改善 HRQoL、提高抗凝依从性并减少
患有慢性房颤的弱势个体的医疗保健利用。如果证明成功,这种干预措施可以
广泛传播以改善 AF 患者的护理。
项目成果
期刊论文数量(11)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Design, rationale, and baseline characteristics of a randomized controlled trial evaluating a mobile relational agent to enhance atrial fibrillation self-care.
一项随机对照试验的设计、原理和基线特征,该试验评估移动关系代理以增强房颤自我护理。
- DOI:10.1016/j.cct.2022.107015
- 发表时间:2023
- 期刊:
- 影响因子:2.2
- 作者:Althouse,AndrewD;Abebe,KaleabZ;Paasche-Orlow,MichaelK;Lalama,ChristinaM;Ferry,Danielle;Lancet,Michelle;Swabe,Gretchen;Bickmore,Timothy;Magnani,JaredW
- 通讯作者:Magnani,JaredW
Disparities in Anticoagulant Therapy Initiation for Incident Atrial Fibrillation by Race/Ethnicity Among Patients in the Veterans Health Administration System.
退伍军人健康管理系统中不同种族/族裔患者因房颤事件开始抗凝治疗的差异。
- DOI:10.1001/jamanetworkopen.2021.14234
- 发表时间:2021-07-01
- 期刊:
- 影响因子:13.8
- 作者:Essien UR;Kim N;Hausmann LRM;Mor MK;Good CB;Magnani JW;Litam TMA;Gellad WF;Fine MJ
- 通讯作者:Fine MJ
Association of income and educational attainment in hospitalization events in atrial fibrillation.
- DOI:10.1016/j.ajpc.2021.100201
- 发表时间:2021-09
- 期刊:
- 影响因子:4.1
- 作者:Tertulien T;Chen Y;Althouse AD;Essien UR;Johnson A;Magnani JW
- 通讯作者:Magnani JW
Separate and Unequal: The Cost of Coronavirus Disease 2019 on Childhood Health and Well-Being.
- DOI:10.1089/heq.2020.0080
- 发表时间:2021
- 期刊:
- 影响因子:2.7
- 作者:Magnani JW;Kinloch V;Essien UR
- 通讯作者:Essien UR
A qualitative crossroads of rhythm and race: Black patients' experiences living with atrial fibrillation.
节律和种族的定性十字路口:黑人患者患有房颤的经历。
- DOI:10.1016/j.ahjo.2023.100293
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Mann,Harnoor;Johnson,AmberE;Ferry,Danielle;deAbrilCameron,Flor;Wasilewski,Julia;Hamm,Megan;Magnani,JaredW
- 通讯作者:Magnani,JaredW
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Jared W. Magnani其他文献
Integrating Digital Coaching into Cardiac Practice: Strategies to Advance Health Equity
- DOI:
10.1007/s12170-024-00743-8 - 发表时间:
2024-08-09 - 期刊:
- 影响因子:1.800
- 作者:
Erin M. Schikowski;Arinze Bosah;Anisha Reddy;Sam Younes;Jared W. Magnani - 通讯作者:
Jared W. Magnani
The mobile health intervention for rural patients with atrial fibrillation a randomized controlled trial
针对农村房颤患者的移动健康干预:一项随机对照试验
- DOI:
10.1016/j.ijcard.2025.133575 - 发表时间:
2025-11-01 - 期刊:
- 影响因子:3.200
- 作者:
Jared W. Magnani;Keri Plevniak;Danielle Ferry;Deborah Martin;Maria M. Brooks;Everlyne Kimani;Stefán Ólafsson;Bruce L. Rollman;Michael K. Paasche-Orlow;Samar R. El Khoudary;Timothy Bickmore - 通讯作者:
Timothy Bickmore
EPIDEMIOLOGY OF P WAVE INDICES IN HEALTHY POST-MENOPAUSAL WOMEN: THE WOMEN’S HEALTH INITIATIVE
- DOI:
10.1016/s0735-1097(10)60126-x - 发表时间:
2010-03-09 - 期刊:
- 影响因子:
- 作者:
Eiran Z. Gorodeski;Jared W. Magnani;Ronald J. Prineas;Mara Z. Vitolins;Mary J. O’Sullivan;Elsayed Z. Soliman;Lisa W. Martin;Marian C. Limacher;J. David Curb;Barbara B. Cochrane;Eugene H. Blackstone;Michael S. Lauer - 通讯作者:
Michael S. Lauer
A mobile relational agent to enhance atrial fibrillation self-care: Primary and secondary outcomes of a randomized controlled trial
一种用于增强房颤自我护理的移动关系代理:一项随机对照试验的主要和次要结果
- DOI:
10.1016/j.ahj.2025.06.009 - 发表时间:
2025-12-01 - 期刊:
- 影响因子:3.500
- 作者:
Jared W. Magnani;Christina M. Lalama;Kaleab Z. Abebe;Danielle Ferry;Bruce L. Rollman;Michelle Q. Lancet;Everlyne Kimani;Stefán Ólafsson;Timothy Bickmore;Michael K. Paasche-Orlow - 通讯作者:
Michael K. Paasche-Orlow
The barbershop paradigm: Community engagement for cardiovascular prevention
理发店范式:社区参与预防心血管疾病
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:0
- 作者:
Ruxandra Ionescu;Jared W. Magnani - 通讯作者:
Jared W. Magnani
Jared W. Magnani的其他文献
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{{ truncateString('Jared W. Magnani', 18)}}的其他基金
Mentoring in patient-oriented research in social determinants and atrial fibrillation
指导以患者为中心的社会决定因素和心房颤动研究
- 批准号:
10687127 - 财政年份:2022
- 资助金额:
$ 21.24万 - 项目类别:
Mentoring in patient-oriented research in social determinants and atrial fibrillation
指导以患者为中心的社会决定因素和心房颤动研究
- 批准号:
10523302 - 财政年份:2022
- 资助金额:
$ 21.24万 - 项目类别:
A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care
增强心房颤动自我护理的移动关系代理
- 批准号:
10377942 - 财政年份:2020
- 资助金额:
$ 21.24万 - 项目类别:
A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care
增强心房颤动自我护理的移动关系代理
- 批准号:
10611982 - 财政年份:2020
- 资助金额:
$ 21.24万 - 项目类别:
A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care
增强心房颤动自我护理的移动关系代理
- 批准号:
10610784 - 财政年份:2020
- 资助金额:
$ 21.24万 - 项目类别:
Diversity Supplement for geocoding in the parent grant "A Mobile Relational Agent to Enhance Atrial Fibrillation self-care"
家长补助金中地理编码的多样性补充“增强心房颤动自我护理的移动关系代理”
- 批准号:
10164339 - 财政年份:2020
- 资助金额:
$ 21.24万 - 项目类别:
A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care
增强心房颤动自我护理的移动关系代理
- 批准号:
10153869 - 财政年份:2020
- 资助金额:
$ 21.24万 - 项目类别:
Mobile Health intervention for rural atrial fibrillation
农村房颤的移动健康干预
- 批准号:
10240320 - 财政年份:2019
- 资助金额:
$ 21.24万 - 项目类别:
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