mGlide-Care: A mHealth Partnership with Care Givers to Improve HTN Management in Patients with Cognitive Impairment

mGlide-Care：与护理人员建立 mHealth 合作伙伴关系，以改善认知障碍患者的 HTN 管理

• 批准号: 10661238
• 负责人: KAMAKSHI LAKSHMINARAYAN
• 金额: $ 17.32万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10661238
• 关键词: Acceleration; Address; Adult; Age; Aging; Agreement; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Atherosclerosis Risk in Communities; Behavioral; Biometry; Blood Pressure Monitors; Blood Vessels; Cardiovascular Diseases; Caregiver Burden; Caregivers; Caring; Cellular Phone; Chronic Disease; Clinical Pharmacists; Clinical Research; Clinical Trials; Collaborations; Communities; Community Health; Community Health Systems; Data; Dementia; Disease Management; Economics; Elderly; Environment; Epidemiology; Evidence based intervention; Faculty; Family Caregiver; Focus Groups; Funding; Goals; Grant; Guidelines; Health; Health Policy; Health Resources; Health Services; Health Technology; Health system; Healthcare; Home; Hypertension; Impaired cognition; Institution; Intervention; K-Series Research Career Programs; Leadership; Low income; Measures; Mediating; Medical; Medical Care Team; Medication Management; Mentors; Minnesota; Modeling; Monitor; Neurocognitive; Neurology; Nursing Faculty; Outcome; Participant; Patient Education; Patients; Persons; Pharmaceutical Preparations; Population; Prevention; Principal Investigator; Provider; Public Health Schools; Recommendation; Recovery; Reporting; Research; Research Personnel; Research Support; Resources; Risk Factors; Role; Scientific Advances and Accomplishments; Self Care; Site; Stroke; Stroke prevention; Technology; Testing; Time; Training Programs; Underrepresented Populations; United States National Institutes of Health; Universities; Work; cardiovascular disorder prevention; cardiovascular risk factor; career; cohort; cost; dementia risk; design; disorder risk; disparity reduction; evidence base; graduate student; health care disparity; health equity; health management; hypertension control; hypertension treatment; implementation science; improved; innovation; investigator training; mHealth; medical schools; member; middle age; mild cognitive impairment; overtreatment; pilot trial; primary care patient; primary care provider; primary outcome; satisfaction; side effect; skills; social; stroke cognitive outcome; stroke risk; stroke survivor; transmission process; treatment as usual

Project Summary The principal investigator Dr. Lakshmi’s goal is to develop evidence-based technology interventions that support chronic disease care in older persons including those with mild cognitive impairment (MCI) and early stage Alzheimer’s disease and Alzheimer’s Disease Related Dementia (AD/ADRD). This K24 application will provide her with protected time to: 1) build skills in implementation science, aging research and the conduct of research with persons with cognitive impairment and their family caregivers; 2) accelerate mentoring of early career clinical faculty in the Department of Neurology particularly on K-awards and transition to the 1st R01; 3) obtain pilot feasibility and effect size data for a larger clinical trial of a mobile health technology (mHealth) intervention to improve hypertension (HTN) care in persons with MCI and early stage AD/ADRD. Dr. Lakshmi is a tenured faculty in the Division of Epidemiology and Community Health, School of Public Health (SPH) at the University of Minnesota and in the Department of Neurology. Her rich institutional environment includes partnerships with the Divisions of Biostatistics and Health Policy and Management, Medical School departments and community health systems. Dr. Lakshmi is a member of the Center for Health Aging and Innovation, a collaboration that aims to advance interdisciplinary aging research. The research focus of this K24 is improving the management of uncontrolled HTN in persons with MCI and early stage AD/ADRD. HTN is the most significant stroke, cardiovascular disease and dementia risk factor and is substantially under-treated especially in older persons. Dr. Lakshmi has worked on mHealth interventions since 2011, with a successful record of multiple funded grants. Her clinical trial, mGlide RCT, is implementing a mHealth-based care model for HTN care in community health systems serving diverse, low-income patients. In this K24, Dr. Lakshmi will develop mGlide-Care – an adaptation of mGlide – to address uncontrolled HTN in people with MCI and early AD/ADRD. Aim 1 will engage stakeholders to study the acceptability of mHealth mediated HTN care and will use their input to develop mGlide-Care. Stakeholders are persons with early stage AD/ADRD and MCI, unpaid family caregivers, primary care providers, geriatricians and clinical pharmacists. Aim 2 is a feasibility pilot to test mGlide-Care vs. usual care in 75 participants with uncontrolled HTN and early stage AD/ADRD or MCI. Caregivers will assist participants. Outcomes will include HTN control and participant and caregiver reported measures. Dr. Lakshmi is the site-PI for two NIH research networks, StrokeNet and DISCOVERY (Determinants of Incident Stroke Cognitive Outcomes and Vascular Effects on RecoverY). She also has access to rich cohort data including Atherosclerosis Risk in Communities-Neurocognitive study (ARIC-NCS) and others. Dr. Lakshmi will leverage the substantial resources from her health technology grants, StrokeNet, DISCOVERY, and cohorts including ARIC-NCS to mentor junior investigators in NIA priority areas. Her goal is to prepare her mentees for their own major scientific advances and independent research careers.

项目摘要 首席研究员Lakshmi博士的目标是开发基于证据的技术干预措施， 支持老年人的慢性病护理，包括轻度认知障碍（MCI）和 阶段性阿尔茨海默病和阿尔茨海默病相关性痴呆（AD/ADRD）。K24应用程序将 为她提供受保护的时间：1）建立实施科学，老龄化研究和开展 对认知障碍者及其家庭照顾者的研究; 2）加快对早期儿童的指导 神经病学系的职业临床教师，特别是K奖和过渡到第一R 01; 3） 为移动的医疗技术（mHealth）的大型临床试验获得试点可行性和效应量数据 干预改善MCI和早期AD/ADRD患者的高血压（HTN）护理。拉克希米博士 是公共卫生学院流行病学和社区卫生系的终身教职员工， 明尼苏达大学和神经病学系。其丰富的制度环境包括 与医学院生物统计学和卫生政策与管理系建立伙伴关系 部门和社区卫生系统。Lakshmi博士是健康老龄化中心的成员， 创新，旨在推进跨学科老龄化研究的合作。本研究的重点是 K24正在改善MCI和早期AD/ADRD患者中不受控制的HTN的管理。HTN是 最重要的中风、心血管疾病和痴呆症风险因素， 尤其是老年人。Lakshmi博士自2011年以来一直致力于移动健康干预措施， 多项赠款的记录。她的临床试验mGlide RCT正在实施一种基于移动医疗的护理模式 为社区卫生系统的HTN护理服务多样化，低收入患者。在K24中，拉克希米博士将 开发mGlide-Care-mGlide的一种改进-以解决MCI患者和早期 AD/ADRD。目标1将使利益相关者参与研究移动健康介导的HTN护理的可接受性，并将 利用他们的意见来开发mGlide-Care。利益相关者是早期AD/ADRD和MCI患者，无报酬 家庭护理人员、初级保健提供者、老年病学家和临床药剂师。目标2是一个可行性试点， 在75名患有不受控制的HTN和早期AD/ADRD或MCI的参与者中测试mGlide-Care与常规护理的对比。 护理人员将协助参与者。结果将包括HTN控制以及参与者和护理人员报告 措施Lakshmi博士是两个NIH研究网络StrokeNet和DISCOVERY的网站PI （突发性卒中认知结果的决定因素和血管对恢复的影响）。她也有 获得丰富的队列数据，包括社区动脉粥样硬化风险-神经认知研究（ARIC-NCS） 等人拉克希米博士将利用她的卫生技术赠款，中风网， DISCOVERY，以及包括ARIC-NCS在内的队列，以指导NIA优先领域的初级研究人员。她的目标是 为她的学员准备自己的重大科学进步和独立的研究生涯。