Development of a Values-Affirmation Intervention Targeting Medication Adherence in Older Adults with Heart Failure Completing Cardiac Rehabilitation

制定针对完成心脏康复的心力衰竭老年人的药物依从性的价值观肯定干预措施

• 批准号: 10824842
• 负责人: Emily Claire Gathright
• 金额: $ 7.56万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10824842
• 关键词: Activities of Daily Living; Adherence; Adult; Aging; Behavior; Behavior Therapy; Behavioral; Behavioral Medicine; Biometry; Cardiac rehabilitation; Cardiology; Chronic Disease; Clinical; Clinical Trials Design; Cognition; Complex; Control Groups; Development; Diagnosis; Disease; Disease Management; Education; Elderly; Environment; Evaluation; Face; Focus Groups; Foundations; Funding; Goals; Health behavior change; Heart failure; Hospitals; Human; Individual; Intervention; K-Series Research Career Programs; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Motivation; Patients; Pharmaceutical Preparations; Pharmacoepidemiology; Preventive; Preventive Medicine; Prognosis; Psychiatry; Qualitative Methods; Randomized, Controlled Trials; Research; Research Personnel; Role; Scientist; Self Management; Structure; Survival Rate; Training; Universities; acceptability and feasibility; biopsychosocial; comparison intervention; efficacy evaluation; experience; hospital readmission; improved; improved outcome; innovation; medical schools; medication compliance; novel; participant enrollment; psychosocial; skills; theories; therapy development; tool; trial design

PROJECT SUMMARY/ABSTRACT Aging adults, particularly those managing a chronic illness, face numerous challenges navigating changing roles and functional abilities. Heart failure (HF) is prevalent among older adults and requires complex, long- term disease management. Rehospitalizations are common, and often result from inadequate medication ad- herence. Encouraging a connection between medication-taking and an individual’s core values may reframe medication use as a self-guided effort to engage in personally meaningful living. Values-affirmation (e.g., inviting patients to reflect on important core values) can promote openness to health behavior change, and may be a powerful motivational tool to enhance education and behavior skills adherence interventions. This application proposes to develop a novel values-affirmation intervention to improve medication adherence in HF patients enrolled in cardiac rehabilitation. The proposed Mentored Patient-Oriented Research Career Develop- ment Award (K23) will provide Dr. Emily Gathright critical training in the development and evaluation of behavioral self-management interventions for older adults with HF. Training in (1) biopsychosocial as- pects of aging, (2) use of qualitative methods to guide theory-driven intervention development, (3) randomized controlled trial (RCT) design and execution, (4) RCT analysis, and (5) professional development will bridge prior training in psychosocial and behavioral determinants of prognosis in HF to interventions that improve out- comes for older adults with chronic illness. Dr. Gathright will benefit from the support of a robust mentorship team with complementary strengths and extensive experience leading federally-funded research. Expert men- torship will be provided by leading scientists in the fields of aging and cognition, preventive cardiology, biosta- tistics and methodology, behavioral interventions, qualitative methods, and pharmacoepidemiology. The Cen- ters for Behavioral and Preventive Medicine at The Miriam Hospital (a Center of Excellence at the Alpert Medi- cal School of Brown University) and Alpert Medical School’s Department of Psychiatry and Human Behavior offer an impressive training environment with a strong record of successful completion of K awards. Dr. Gath- right will develop a values-affirmation medication adherence intervention through three aims: (1) Focus groups (6-8; N = 30-48) will be conducted to identify core values most relevant to HF medication adherence, and to guide the development of a combined values-affirmation and skills-building intervention; (2) Intervention feasi- bility and acceptability will be evaluated and refined following a small, open trial (N = 12); and (3) Intervention feasibility, acceptability, and preliminary efficacy will be examined using a pilot RCT (N = 50) comparing the intervention to a no-treatment control group. The project will lay the foundation for a subsequent RCT to evalu- ate efficacy and mechanisms of action. The K23 proposal provides clear and achievable training and research plans that will move Dr. Gathright toward her goal of becoming an independent, clinical researcher developing novel and innovative approaches to improve disease management for older adults with chronic illness.

项目总结/文摘

项目成果

Promoting Social Connectedness among Cardiac Rehabilitation Patients During the COVID-19 Pandemic and Beyond.

在 COVID-19 大流行期间及之后促进心脏康复患者的社会联系。

• 发表时间: 2020
• 期刊: Rhode Island medical journal (2013)
• 作者: Scott-Sheldon,LoriAJ;Gathright,EmilyC;Wu,Wen-Chih
• 通讯作者: Wu,Wen-Chih

Important Personal Values of Veterans Enrolled in Home-Based Cardiac Rehabilitation.

• 发表时间: 2020-11
• 期刊: Rhode Island medical journal
• 作者: E. Gathright;L. Scott-Sheldon;Jeannie Ursillo;Elizabeth Medbury;Wen‐Chih Wu

Meta-Analysis of Antidepressant Pharmacotherapy in Patients Eligible for Cardiac Rehabilitation: ANTIDEPRESSANT AMBIVALENCE.

• DOI: 10.1097/hcr.0000000000000699
• 发表时间: 2022-11-01
• 期刊: Journal of cardiopulmonary rehabilitation and prevention
• 影响因子: 3.8