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:10610784
- 负责人:
- 金额:$ 21.16万
- 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 LiteracyComputersCuesDataDisease OutcomeEducationEducational CurriculumElectronic Health RecordEmergency SituationFacial ExpressionGesturesGuidelinesHandHealthHealth EducatorsHealth PromotionHealth StatusHealth behavior outcomesHealth educationHealth systemHeart RateHeart failureHospitalizationIncidenceIncomeIndividualInformation SystemsInternationalInterventionInterviewLow incomeMeasurementMeasuresMedical Care CostsMedical centerModificationMonitorMorbidity - disease rateMyocardial InfarctionOutcomeOutcome MeasureParticipantPatient CarePatient Outcomes AssessmentsPatient Self-ReportPatient-Centered CarePatient-Focused OutcomesPatientsPharmaceutical PreparationsPharmacy facilityPhasePrevalencePreventive treatmentProblem SolvingPublic HealthQuality of lifeRandomizedRandomized Clinical TrialsResearchResourcesSelf CareSelf EfficacySpeechStrokeStroke preventionSymptomsSystemTerminologyTestingUniversitiesVisitVoicearmbaseclinical infrastructurecohortcomplex chronic conditionscostdiariesdisabling symptomefficacy evaluationefficacy testingethnic minorityexperiencegazehealth applicationhealth care service utilizationhealth literacyhealth related quality of lifeheart rhythmhigh riskimprovedinnovationintervention effectintervention participantsmHealthmedical specialtiesmembermortalitynovelnovel strategiesoptimal treatmentspatient orientedprimary outcomeprogramsracial and ethnicrecruitsecondary outcomeskillssocialsocial determinantssocial factorssocial health determinantssocioeconomicsstandard carestroke risksuccesssymptom treatment
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.
项目总结
房颤(房颤)是一种常见的病态疾病。症状、复杂的管理和重要的
逆境会导致与健康相关的生活质量(HRQOL)下降。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糟糕的经历。我们提议一个单一的-
中心平行组随机临床试验,以测试一种具体化对话制剂(ECA)对
改善房颤以病人为中心的护理。ECA是一个模拟面对面的计算机角色
使用语音、手势和凝视提示进行对话,以提供教育、监控和解决问题。
我们已经在多种健康情况下使用ECA进行自我护理,并证明了其成功地改善了
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
扩展我们的ECA和AliveCor Kardia智能手机成功的30天试点(n=31)心率和
节律监测,以评估4个月自我护理课程的效果,并评估其12个月的效果
可持续发展。我们将进一步测试ECA/Kardia结果在电子健康记录(EHR)中的整合情况
并监控警报和由此产生的修改以进行护理。我们将随机选择240名房颤患者
接受抗凝治疗(1)由智能手机提供的ECA/Kardia干预,以及
伴随的EHR警报,或(2)对照组,由房颤教育课程、用于记录的日记组成
症状和依从性,以及带有一般自我保健健康应用程序(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
UPMC诊所共享共同的电子健康记录。我们将重点招聘具有以下条件的个人
社会经济资源有限,健康素养低,或少数族裔。我们的目标是:(1)审查
ECA/Kardia干预对以患者为中心的结果的影响。我们将与AF一起评估HRQOL-
房颤对患者生活质量(AFEQT)测量和总体HRQL的影响--报道
结果衡量信息系统-29基线、4个月和12个月的概况。(2)评估
Eca/Kardia和EHR警报干预对抗凝剂粘附性的影响我们将量化遵守情况
12个月时使用药物拥有率和药房接触情况,并辅以自我管理措施
报告在基线、4个月和12个月时未遵守。(3)确定干预对健康的影响
在4个月和12个月时,使用参与者访谈和普通电子病历进行护理利用。我们的审判将使用8-
由慢性房颤患者组成的成员患者咨询委员会指导干预的文化
可接受性、招聘和结果的展示。预期结果:在这个项目中,我们将评估一个
可扩展的以患者为中心的干预,以改善HRQL,提高抗凝依从性,并降低
慢性房颤易感个体的卫生保健利用情况。如果被证明成功,这种干预可能会
广泛传播以改善房颤患者的护理。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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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:
$ 21.16万 - 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:
$ 21.16万 - 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:
$ 21.16万 - 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:
$ 21.16万 - 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:
$ 21.16万 - 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:
$ 21.16万 - 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:
10831234 - 财政年份:2020
- 资助金额:
$ 21.16万 - 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:
$ 21.16万 - 项目类别:
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