Digital Health Physical Activity Program for Older Family Care Partners of Patients with Heart Failure

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PROJECT SUMMARY/ABSTRACT My career goal is to establish an independent aging research program focused on designing and evaluating high quality, technology-based behavioral health interventions to improve self-management and quality of life (QoL) of community-dwelling older adults, particularly older family care partners (FCPs). More than 17 million FCPs, including family, friends, and relatives, provide care for older adults with chronic illness in the US. High caregiving burden places FCPs at risk for physical function decline, psychological distress, and poor health status. Specifically, older FCPs are more vulnerable than younger FCPs because of greater physical and psychological burden, more age-related health care needs, and less emotional and social support. Physical activity (PA) has the potential to promote the health and well-being of older FCPs. Because caregiving duties limit FCPs to the home and preclude face-to-face interactions (more so during the COVID-19 pandemic), using digital health technologies is an effective way to engage older FCPs in home-based PA interventions. However, there is a gap in research for digital health PA interventions targeting older FCPs; I intend to fill this gap. This K23 award will provide me with the protected time to acquire advanced skills and knowledge in (1) design and implementation of clinical trials in older adults, (2) physical activity behavior change, (3) expansion of health informatics, and (4) professional development for a successful independent research career. The research environment at the University of Colorado, the interdisciplinary mentorship team I have assembled, and support from the College of Nursing provide an exceptional training opportunity. The overall objective of the proposed study is to rigorously design and test a tailored PA coaching program using digital health technologies, TPA4You, and conduct a pilot RCT to assess feasibility of TPA4You and its effects on health outcomes among older FCPs. Older FCPs of patients with heart failure (HF-FCPs) will be the focus of this study because HF-FCPs are an understudied population that is vulnerable to their own health-related issues. The specific aims of this proposal are to: (1) develop the TPA4You intervention by evaluating its technology features (n=15; Year 1), (2) conduct field-testing of TPA4You to optimize usability and acceptability (n=20; Year 2), and (3) conduct a pilot RCT to assess feasibility and preliminary effects of the TPA4You intervention (n=62; Years 3-5). For Aim 1, using scenario-based design methods, we will elicit HF-FCPs' perceptions about the integrated technology components in one-on-one interviews. For Aim 2, we will iteratively enhance TPA4You to meet HF-FCPs' PA needs and optimize usability and acceptability. For Aim 3, older HF-FCPs will be randomized to receive the TPA4You program or attention control for 12 weeks. This proposed study's novel TPA4You program has the potential to increase PA, and improve physical function, psychological outcomes, and QoL among older HF-FCPs. This proposal will provide the foundation for an R01 efficacy study of the TPA4You program in a larger, more diverse population of older HF-FCPs.