Increasing Activity Post-Kidney Transplant with SystemCHANGE

摘要 不活动是老年肾移植受者(KRR)的常见问题，与他们的 肥胖和心血管问题的高发病率是KDR的主要死亡原因。 然而，SystemCHANGETM+活动跟踪器的组合有望增加活跃度。这个 这项以患者为导向的导师研究职业发展奖(K23)的短期目标是 实施这些干预措施，并获得有关老年人KRR的初步数据。60名65岁及以上的KRR 将从中南部移植中心招募，以确定：(I)感知(可用性、可持续性和 活动跟踪器使用的可接受性)对于参与系统变更干预的老年人KRR来说是不同的 与对照组在1、2、3、6和12个月时进行比较，以及(Ii)系统变化™+的程度 活动跟踪器干预改善了体力活动(每天的步数)、功能能力、健康结果(血液 血压、心率、腰围和体重指数)和生活质量 与仅使用活动跟踪器的对照组相比，基线为3、6和12个月。长期目标是 将候选人培养为独立研究员，准备领导专注于以下方面的随机临床试验 最大限度地增加老年慢性病患者的体力活动。拟议的培训符合NINR- 支持倡议，代表候选人之前的研究培训的合乎逻辑的进步。职业生涯 发展目标是：(1)通过基于理论的系统变化™干预获得专业知识 并与信息学专家合作，(2)为负责任的行为开发更强大的知识库 在科学研究和肾移植领域，(3)培养熟练使用统计学 分析连续监测的数据的技术(即，每天采取的步骤)，(4)在 在拟议研究的核心进行随机临床试验(RCT)，(5)积极参与 正在进行的对导师的随机对照试验研究称为考虑到个人变化的药物依从性(魔术)和 在移植诊所观察病例经理，(6)实施拟议的K23研究项目，以及 (7)分析及使用K23先导研究的初步数据，以准备“R01”拨款，以测试 多点随机对照试验中针对体力活动的个性化移动健康干预。职业目标将是 通过授课课程完成；参加国家会议和研究所；以及实践 在肾脏领域一支经验丰富的科学家团队的指导下进行研究培训 移植(Hathaway和Russell)，系统改变(Moore和Russell)，老年人的体力活动 成人(Resnick)、移动活动跟踪器和大型监测数据集的整合(ERTIN)、临床试验 (Russell)和定量方法(Hathaway)。从这份职业中获得的技能、经验和数据 发展奖将定位候选人推进专注于行为自我管理的干预措施 关于最大限度地增加老年慢性病患者的体力活动。

Abstract Inactivity is a common problem among older kidney transplant recipients (KTRs) and is associated with their high incidence of obesity and cardiovascular problems which are the leading cause of death for KTRs. However, the combination of SystemCHANGETM + activity trackers holds promise for increasing activity. The short-term goals of this Mentored Patient-Oriented Research Career Development Award (K23) are to implement these interventions and obtain preliminary data on older adult KTRs. Sixty KTRs age 65 and older will be recruited from a Mid-South transplant center to determine: (I) if perceptions (usability, sustainability, and acceptability) of activity tracker use differ for older adult KTRs participating in a SystemCHANGETM intervention compared to a control group at 1, 2, 3, 6, & 12 months and (II) the degree to which a SystemCHANGE™ + activity tracker intervention improves physical activity (steps per day), functional ability, health outcomes (blood pressure, heart rate, waist circumference, and body mass index) and quality of life for older adult KTRs from baseline to 3, 6, & 12 months compared to a control group using only activity trackers . The long-term goal is to develop the candidate as an independent investigator prepared to lead randomized clinical trials focused on maximizing physical activity among older chronically ill adults. The proposed training is in line with NINR- supported initiatives and represents a logical progression from the candidate's prior research training. Career development objectives are to: (1) gain expertise with the theoretically-based SystemCHANGE™ intervention and work with informatics experts, (2) develop a stronger knowledge base for the responsible conduct of scientific research and the field of kidney transplantation, (3) develop proficiency in the use of statistical techniques for the analysis of continuously monitored data (i.e., daily steps taken), (4) develop skills in the conduct of randomized clinical trials (RCT) at the core of the proposed study, (5) actively engage in the ongoing RCT study of mentors called the Medication Adherence Given Individual Change (MAGIC) and observe the case manager at the transplant clinic, (6) implement the proposed K23 research project, and (7) analyze and use preliminary data from the K23 pilot study to prepare an “R01”grant to test the efficacy of personalized mobile health interventions for physical activity in a multi-site RCT. Career objectives will be accomplished through didactic courses; participation in national conferences and institutes; and hands-on research training under the mentorship of an accomplished team of scientists in the field of kidney transplantation (Hathaway and Russell), SystemCHANGETM (Moore and Russell), physical activity in older adults (Resnick), mobile activity trackers and the integration of large monitoring data sets (Ertin), clinical trials (Russell), and quantitative methods (Hathaway). The skills, experience, and data gained from this career development award will position the candidate to advance behavioral self-management interventions focused on maximizing physical activity for older chronically ill adults.