权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Mindful Steps: A Web-Based Mind-Body Exercise Intervention to Promote Physical Activity in Chronic Cardiopulmonary Disease

正念步骤：基于网络的身心运动干预，促进慢性心肺疾病的体力活动

基本信息

批准号：
10732824
负责人：
GLORIA Y YEH
金额：
$ 86.6万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-05 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10732824
关键词：
Activities of Daily Living Address Adherence Adverse event Anxiety Area Awareness Behavior Behavioral Breathing Exercises Cardiac rehabilitation Cardiopulmonary Chronic Chronic Disease Chronic Obstructive Pulmonary Disease Chronic lung disease Chronic pulmonary heart disease Cognitive Congestive Heart Failure Coupled Coupling Data Data Collection Development Disease Disease Management Dose Dyspnea Education Educational process of instructing Exercise Fatigue Feasibility Studies Fostering Frequencies Functional disorder Funding Goals Grant Habits Health Health Promotion Health behavior change Heart Diseases Heart failure Home Hospitalization Hospitals Instruction Internet Intervention Interview Literature Logistics Measures Mediating Mental Depression Mind-Body Intervention Moods Motivation Movement Musculoskeletal National Center for Complementary and Integrative Health Online Systems Outcome Outpatients Patients Personal Satisfaction Persons Physical activity Pilot Projects Population Procedures Pulmonary Heart Disease Quality of life Research Self Efficacy Self-Examination Social support Syndrome Tai Ji Technology Theoretical model Time Transportation Travel United States National Institutes of Health Walking Work acceptability and feasibility adverse event risk behavior change behavior measurement behavioral construct clinical center comorbidity curriculum enhancement efficacy evaluation efficacy testing efficacy trial empowerment exercise capacity exercise intervention exercise intolerance exercise program experience fitbit health related quality of life high risk improved improved outcome individualized feedback interest intrinsic motivation mind/body mindfulness modifiable behavior multi-component intervention multimodality novel novel strategies online community patient oriented pedometer physical conditioning primary outcome programs pulmonary rehabilitation recruit remote delivery risk minimization sedentary sedentary lifestyle standard of care success symptomatology treatment as usual web platform web-based intervention

项目摘要

Physical activity (PA) is an important modifiable behavior that has enormous impacts on chronic cardiopulmonary health. Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are similar systemic syndromes where patients are often deconditioned and suffer exercise intolerance and dyspnea. Importantly, these patients share a dramatically high risk of sedentary behavior that portend poor outcomes. While PA is paramount in disease management (with improvements in exercise capacity, quality-of-life, and hospitalizations) available exercise programs are underutilized and inaccessible, and long-term adherence to PA is universally problematic. Novel strategies to increase PA in these populations are greatly needed. In recent years, there is rapidly emerging interest in use of internet/technology-mediated interventions to promote health behavior change in chronic disease populations. Our prior work investigated a web-based PA platform with motivational and educational content coupled with a wearable step tracker with individualized step goals that demonstrated increases in PA in patients with cardiopulmonary disease in the short term. At the same time, there is also a growing and robust literature on the benefits of mind-body exercise for health behavior change. In HF and COPD, we have shown improvements in quality-of-life, exercise capacity, and PA, with data suggesting that self-efficacy may be an important factor to facilitate long-term behavior change. In a previously funded NIH developmental grant (R34AT009354) we leveraged our experience in web- based PA interventions together with our expertise in mind-body therapies to develop a novel multi-modal intervention (Mindful Steps) for patients with COPD and HF to foster longer-term PA adherence. Our theoretical model posits that the integration of a mind-body curriculum enhances key behavioral constructs in the existing intervention and also targets new areas that will lead to enhanced self-efficacy and increased, sustained PA. In a pilot study, we have demonstrated study feasibility (recruitment, retention, all-remote data collection), and intervention feasibility/acceptability (including online, synchronous mind-body classes). In this R01, we propose the next step RCT (N=136) to test the efficacy of Mindful Steps, compared to usual care, to promote PA (objectively measured by daily step counts) in patients with COPD and/or HF (primary aim). Secondary aims will examine cognitive-behavioral measures within our theoretical model (self- efficacy for exercise and for disease management, intrinsic motivation, mindfulness, interoceptive awareness) and patient-centered clinical outcomes (disease-specific quality of life, exercise engagement, dyspnea, fatigue). Coupling technology with traditional mind-body exercise principles, Mindful Steps emphasizes a whole person approach that aligns well with NCCIH’s strategic priorities. Based on a compelling rationale and rigorous feasibility data, a larger-scale remotely-delivered efficacy trial is the next step in evaluating this accessible, web-based PA intervention that may provide broader reach in COPD and HF.

体育活动（PA）是一种重要的可改变行为，对慢性疾病有巨大的影响