Phase III Trial of Pocket PATH: A Computerized Intervention to Promote Self-Care

Pocket PATH 第三阶段试验：促进自我保健的计算机干预

• 批准号: 7810485
• 负责人: ANNETTE J DE VITO DABBS
• 金额: $ 29.75万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-18 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7810485
• 关键词: American; Behavior; Caring; Chronic Disease; Clinical; Collaborations; Communication; Computer software; Contract Services; Data; Databases; Decision Making; Devices; Early Diagnosis; Evaluation; Funding; Future; Goals; Grant; Health; Health Promotion; Health Resources; Health Technology; Human Resources; Impairment; Individual; Institute of Medicine (U.S.); Internet; Intervention; Lead; Life; Link; Lung; Lung Transplantation; Medical; Modification; Monitor; Morbidity - disease rate; National Institute of Nursing Research; Online Systems; Organ; Organ Donor; Organ Transplantation; Outcome; Participant; Patients; Persons; Phase III Clinical Trials; Prevention; Quality of life; Randomized Controlled Trials; Recovery; Relative (related person); Reporting; Research; Resources; Respiratory physiology; Self Care; Self Management; Services; Software Engineering; Solid; Specialist; Sum; Technology; Testing; Translational Research; Translations; Transplant Recipients; Transplantation; Treatment Protocols; United States National Institutes of Health; Voice; Work; clinical practice; collaborative care; comparative efficacy; computer human interaction; computerized; data sharing; design; disorder prevention; efficacy testing; end stage disease; experience; handheld equipment; improved; innovation; mortality; new technology; novel; parent grant; prevent; programs; public health relevance; research study; response; standard care; success; therapy design; trend; usability; user centered design; virtual; web based interface

DESCRIPTION (provided by applicant): This Competitive Revision to the current grant (Phase III Trial of Pocket PATH: A Computerized Intervention to Promote Self-Care (NR010711) is being submitted in response to Notice NOT-OD-09-058 supported by the American Recovery and Reinvestment Act of 2009. Lung transplant recipients experience more transplant-related complications, higher health resource utilization and mortality than recipients of other solid organs. Prevention and detection of early complications is known to reduce the likelihood of future impairments in lung function and therefore morbidity and mortality. Despite the scarce donor organs and financial resources expended to support individuals throughout the lung transplant experience, few trials have tested interventions designed to promote self-care behaviors and patient-clinician collaboration with the aim of improving transplant-related health and reducing resource utilization after lung transplant. The purpose of the current trial is to compare the efficacy of a novel intervention, Pocket PATH (Personal Assistant for Tracking Health) for promoting self-care and improving health outcomes relative to standard care after lung transplantation. Pocket PATH provides lung transplant recipients a handheld device with customized data recording, trending and decision-support programs to promote their self-care behaviors. The overall purpose of this competitive revision is to extend the scope of the currently funded PocketPATH project beyond patient behaviors to also support the clinician behaviors known to promote better health outcomes through collaboration and partnership with patients (e.g., support of patient activation, timely data review for evaluation of condition changes and proactive communication). We now propose to design and test a web-based clinician interface (Pocket PATH Link) to support remote data sharing and communication between patients using the Pocket PATH device and their clinician partners. We will then combine the current Pocket PATH features for patients with the new Pocket PATH Link features for clinicians to create a fully integrated application called Pocket PATH Synergy, so that the combination of patients and clinicians working together will lead to health outcomes that are better than the sum of each working separately. Pocket PATH Synergy melds the latest interactive health technologies with the evidence regarding the benefits of patients' being active participants in their care, and the link between patient-clinician collaboration and shared clinical decision making on better health outcomes. The proposal is innovative and well matched to the scientific priorities of NINR-supported competitive revisions including health promotion, disease prevention, self-management and integrating technology into clinical practice. As in the parent grant, while our work is targeted to the needs of lung transplant recipients, it has the potential to inform interventions to promote shared clinician management for individuals living with other chronic illnesses. This competitive revision will allow us to contribute to the aims of the ARRA in the following ways: 1. Stimulate the economy by hiring additional personnel (a usability specialist/human computer interaction specialist and programmer/data base specialist, and trainer/data collector), procuring additional equipment (handheld devices, voice and data service plans, virtual private server, and web-screen capture software), and increasing contracted services (software engineer/programmer). 2. Accelerate the tempo of scientific research by increasing the value of the current project goals and accelerating the rate of evaluation and translation of scientific research. Since completion of the revision period coincides with the final year of the R01, we will have all requisite preliminary work to propose a full-scale translational research study to evaluate the success of Pocket PATH Synergy in promoting shared management of post-transplant health and hence better health outcomes. PUBLIC HEALTH RELEVANCE: The purpose of this revision is to extend the scope of the currently funded Pocket PATH project beyond patient behaviors to also support the clinician behaviors known to promote better health outcomes through collaboration and partnership with patients (e.g., support of patient activation, timely data review for evaluation of condition changes and proactive communication). Although Pocket PATH is being designed and tested with lung transplant recipients, with little modification this intervention has the potential to have a broader impact by promoting self-care behaviors, and thus improving health outcomes, in recipients of other solid organs and in persons with other chronic illnesses. The proposed revision fits well with the goals of the ARRA (NOT -OD-09-058) and the following initiatives and priorities: 1) National Institute of Nursing Research's emphasis on generating and testing new technologies to improve self-management, 2) the NIH Roadmap initiative to build collaborative, interdisciplinary teams to promote health, and 3) the recent Institute of Medicine report to involve patients in the design of health technologies.

描述（由申请人提供）：本竞争性修订，以目前的赠款（第三阶段试验的口袋路径：计算机化干预，以促进自我保健（NR 010711）正在提交，以回应通知NOT-OD-09-058支持的美国复苏和再投资法案2009年。 肺移植受者比其他实体器官受者经历更多的移植相关并发症，更高的卫生资源利用和死亡率。已知预防和检测早期并发症可降低未来肺功能受损的可能性，从而降低发病率和死亡率。 尽管在整个肺移植过程中用于支持个人的供体器官和财政资源稀缺，但很少有试验测试旨在促进自我护理行为和患者-临床医生合作的干预措施，旨在改善移植相关的健康状况并减少肺移植后的资源利用。 本试验的目的是比较一种新的干预措施，口袋路径（跟踪健康的个人助理）的有效性，以促进自我护理和改善肺移植后相对于标准护理的健康结果。Pocket PATH为肺移植受者提供了一个手持设备，该设备具有定制的数据记录、趋势和决策支持程序，以促进他们的自我护理行为。这项竞争性修订的总体目的是将目前资助的PocketPATH项目的范围扩展到患者行为之外，以支持已知的临床医生行为，通过与患者的合作和伙伴关系促进更好的健康结果（例如，支持患者激活，及时审查数据以评估病情变化和主动沟通）。我们现在建议设计和测试一个基于网络的临床医生界面（Pocket PATH Link），以支持使用Pocket PATH设备的患者与其临床医生合作伙伴之间的远程数据共享和通信。然后，我们将联合收割机将当前针对患者的Pocket PATH功能与针对临床医生的新Pocket PATH Link功能相结合，以创建一个名为Pocket PATH Synergy的完全集成的应用程序，这样患者和临床医生的联合工作将带来比各自单独工作的总和更好的健康结果。 Pocket PATH Synergy融合了最新的交互式健康技术，以及患者积极参与其护理的益处，以及患者与临床医生合作与共享临床决策之间的联系，以获得更好的健康结果。该提案具有创新性，与NINR支持的竞争性修订的科学优先事项相匹配，包括健康促进，疾病预防，自我管理和将技术融入临床实践。与父母补助金一样，虽然我们的工作是针对肺移植受者的需求，但它有可能为干预措施提供信息，以促进患有其他慢性病的个人的共享临床医生管理。 这一竞争性修订将使我们能够通过以下方式为ARRA的目标做出贡献： 1.通过雇佣额外的人员（可用性专家/人工计算机）来刺激经济 此外，还将增加服务（软件工程师/程序员），包括：培训人员/数据收集员（互动专家和程序员/数据库专家），采购更多设备（手持设备、语音和数据服务计划、虚拟专用服务器和网络屏幕捕捉软件），以及增加订约服务（软件工程师/程序员）。 2.通过提高当前项目目标的价值和加快科学研究的评估和转化速度来加快科学研究的克里思。由于修订期的完成恰逢R 01的最后一年，我们将开展所有必要的前期工作，提出一项全面的转化研究，以评估Pocket PATH Synergy在促进移植后健康的共同管理方面的成功，从而获得更好的健康结果。 公共卫生关系：此次修订的目的是将目前资助的Pocket PATH项目的范围扩展到患者行为之外，以支持已知通过与患者的合作和伙伴关系促进更好健康结果的临床医生行为（例如，支持患者激活，及时审查数据以评估病情变化和主动沟通）。虽然口袋路径正在设计和测试与肺移植受者，很少修改，这种干预措施有可能通过促进自我保健行为，从而改善健康结果，在其他实体器官的接受者和其他慢性疾病的人有更广泛的影响。拟议的修订与ARRA的目标非常吻合（NOT -OD-09-058）以及以下举措和优先事项：1）国家护理研究所的重点是产生和测试新技术，以改善自我管理，2）国家卫生研究院路线图倡议，建立协作，跨学科团队，以促进健康，3）最近医学研究所报告说，让病人参与卫生技术的设计。