Engaging Medically Complex Veterans in Tele-Rehabilitation Using a Biobehavioral Approach: A Pilot Study of Feasibly and Acceptability

使用生物行为方法让医学复杂的退伍军人参与远程康复:可行性和可接受性的试点研究

基本信息

项目摘要

Older Veterans with multiple comorbidities or medically complexities represent one of the most vulnerable patient populations. This large and growing proportion of Veterans Health Administration (VHA) beneficiaries are more likely to live in rural areas, experience social isolation and loneliness, and be physically inactive. Thus, medically complex older Veterans are at greater risk for progressive declines in function, lower quality of life, and frequent care needs. While the VHA has established outpatient programs to address rehabilitation needs, these programs tend to serve disease-specific populations (e.g. cardiac, stroke). Moreover, these programs often do not meet the needs of medically complex older Veterans, as they typically 1) require in- person attendance, 2) under-dose the physiologic intensity of rehabilitation, and 3) lack self-management approaches for preservation of function. Telehealth platforms offer a solution to redesign rehabilitation models of care for medically complex older Veterans and can aid in overcoming access barriers (rurality, transportation), while also integrating technologies to augment biobehavioral interventions and provide social support. Novel, scalable telerehabilitation approaches targeting medically complex older Veterans are urgently needed to 1) address physiologic impairments using progressive, high-intensity rehabilitation, 2) increase physical inactivity with biobehavioral interventions which promote self-management, and 3) reduce social isolation and loneliness via social support. Therefore, we propose a pilot, two-arm randomized trial using a crossover study design to determine the feasibility, acceptability, and safety (AIM 1) of a 12-week multicomponent telerehabilitation program. We will also measure Veterans’ clinical outcomes to explore the preliminary response to the program and to determine variability estimates for outcomes (AIM 2) in preparation for a larger investigation. This study will enroll 50 medically complex older Veterans who are designated as “high-need, high-risk” using a definition provided by the Geriatrics & Extended Care Data & Analysis Center. Veterans will be randomized to GROUP1 or GROUP2 (25 participants in each group); GROUP1 will receive the 12-week intervention, and GROUP2 will receive attention control consisting of 1-hour education sessions delivered every 2 weeks (6 total). GROUP2 will then crossover to the intervention at the completion of 12- weeks. Outcomes will be assessed at baseline (pre-intervention), 6 weeks (intervention mid-point), 12 weeks (end of intervention), and 24 weeks. Achievement of the proposed aims will establish feasibility and preliminary response of a novel, multicomponent telerehabilitation program that critically addresses the multitude of interrelated complexities unique to older Veterans who are currently underserved by traditional rehabilitation paradigms. This work will directly translate to other medically complex and underserved populations who will benefit from innovative telerehabilitation care approaches. Study findings will have immediate clinical impact as they will guide implementation of safe and effective telerehabilitation programs as alternatives to in-person rehabilitation for medically complex older Veterans.
患有多种合并症或医学复杂性的老年退伍军人是最脆弱的群体之一

项目成果

期刊论文数量(0)
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会议论文数量(0)
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Jennifer E. Stevens-Lapsley其他文献

Mixed-Method Evaluation to Understand Clinician Perspectives of a Program to Implement High-Intensity Resistance Rehabilitation Into Skilled Nursing Facilities
混合方法评估以了解临床医生对一项在专业护理机构中实施高强度抗阻康复项目的看法
  • DOI:
    10.1016/j.apmr.2024.09.006
  • 发表时间:
    2025-01-01
  • 期刊:
  • 影响因子:
    3.700
  • 作者:
    Lauren A. Hinrichs-Kinney;Janell Pisegna;Mattie E. Pontiff;Emma H. Beisheim-Ryan;Rebecca Altic;Heather Coats;Jennifer E. Stevens-Lapsley
  • 通讯作者:
    Jennifer E. Stevens-Lapsley
Functional Capacity at Rehabilitation Discharge Predicts Physical Activity Characteristics 24 Weeks Later for People With Total Knee Arthroplasty: A Secondary Analysis of a Randomized Controlled Trial
康复出院时的功能能力可预测全膝关节置换术后 24 周患者的身体活动特征:一项随机对照试验的二次分析
  • DOI:
    10.1016/j.apmr.2025.01.416
  • 发表时间:
    2025-06-01
  • 期刊:
  • 影响因子:
    3.700
  • 作者:
    Paul W. Kline;Shawn L. Hanlon;Vanessa L. Richardson;Rashelle M. Hoffman;Edward L. Melanson;Elizabeth Juarez-Colunga;Jennifer E. Stevens-Lapsley;Cory L. Christiansen
  • 通讯作者:
    Cory L. Christiansen
Saving Shared Decision-Making
  • DOI:
    10.1007/s11606-025-09410-z
  • 发表时间:
    2025-02-14
  • 期刊:
  • 影响因子:
    4.200
  • 作者:
    Douglas J. Opel;Maya T. Gerstein;Adam C. Carle;Alaina K. Fournier;Ian Hargraves;Jennifer E. Lafata;Ellen A. Lipstein;Trudy Mallinson;Nathalie Moise;Heather B. Neuman;Mary Nix;Christina Papadimitriou;Laura Scherer;Karen Sepucha;Matthew Simpson;Alan Schwartz;Jennifer E. Stevens-Lapsley;Neal W. Dickert
  • 通讯作者:
    Neal W. Dickert

Jennifer E. Stevens-Lapsley的其他文献

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{{ truncateString('Jennifer E. Stevens-Lapsley', 18)}}的其他基金

Improving Rehabilitation for Veterans After Total Knee Arthroplasty Using Individualized Recovery Trajectories
使用个性化恢复轨迹改善退伍军人全膝关节置换术后的康复
  • 批准号:
    10615821
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Improving Rehabilitation for Veterans After Total Knee Arthroplasty Using Individualized Recovery Trajectories
使用个性化恢复轨迹改善退伍军人全膝关节置换术后的康复
  • 批准号:
    10424875
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities
推进熟练护理机构中老年人的康复模式
  • 批准号:
    10439772
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities
推进熟练护理机构中老年人的康复模式
  • 批准号:
    10226727
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities
推进熟练护理机构中老年人的康复模式
  • 批准号:
    10768215
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities
推进熟练护理机构中老年人的康复模式
  • 批准号:
    10659131
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Engaging Medically Complex Veterans in Tele-Rehabilitation Using a Biobehavioral Approach: A Pilot Study of Feasibly and Acceptability
使用生物行为方法让医学复杂的退伍军人参与远程康复:可行性和可接受性的试点研究
  • 批准号:
    10447060
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Engaging Medically Complex Veterans in Tele-Rehabilitation Using a Biobehavioral Approach: A Pilot Study of Feasibly and Acceptability
使用生物行为方法让医学复杂的退伍军人参与远程康复:可行性和可接受性的试点研究
  • 批准号:
    10909790
  • 财政年份:
    2021
  • 资助金额:
    --
  • 项目类别:
Novel Strategies for Personalized Clinical Decisions in Knee Arthroplasty
膝关节置换术个性化临床决策的新策略
  • 批准号:
    10454171
  • 财政年份:
    2018
  • 资助金额:
    --
  • 项目类别:
Novel Strategies for Personalized Clinical Decisions in Knee Arthroplasty
膝关节置换术个性化临床决策的新策略
  • 批准号:
    10227895
  • 财政年份:
    2018
  • 资助金额:
    --
  • 项目类别:

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