Better Living After Stroke through Technology (BLAST)

 描述(申请人提供)中风是美国残疾、认知障碍和死亡的主要原因，造成巨大的经济和个人负担。中风的后遗症影响到许多传统康复治疗无法解决的生活方面。特别是，轻度中风患者通常被定义为无或轻度运动障碍，在日常生活的基本活动中高度独立，通常会经历情绪问题，轻微但严重的认知障碍，以及参与生产性、社会活动和休闲活动的减少。尽管存在这些问题，但患有轻度疾病的人 中风患者通常会出院回家，除了向初级保健医生进行后续治疗外，不会进一步转诊至健康或康复服务。这是一款快速跟踪SBIR应用程序，基于Baum和Edwards博士在开发和测试活动参与(活动卡片分类)和支持简单和复杂功能任务表现的认知技能(功能行为概况，FBP)的可靠和有效测量方法方面的广泛研究成果。这些措施已被用于指导治疗，以帮助轻度认知障碍患者及其家人支持功能独立。这些措施和其他研究的结果将被用来建立一个动态的在线自我管理工具，旨在帮助轻度中风患者制定支持最佳康复的个性化策略。我们建议中风后通过技术(BLAST)更好地生活，通过主动帮助幸存者和照顾者设定他们的活动目标来帮助中风幸存者和家人回到他们富有成效和有意义的生活 这些活动包括：1)使用ACS；2)使用FBP识别和解决幸存者的行为/功能能力；3)识别和管理指示二次中风风险的中风症状；4)从在线和社区资源中获得支持；5)使用循证策略提供量身定制的自我管理建议，以帮助他们实现活动目标。使用我们的BLAST系统的中风幸存者和护理者预计会有更好的幸存者自我效能感和更少的护理者担忧。此外，两者都会有更好的 生活满意度和活动增加，中风幸存者将有更好的解决问题的能力， 任务表现和社会互动。第一阶段的具体目标是：1)通过焦点小组收集利益攸关方对系统功能、感知的有用性和采用障碍的意见；2)开发基于网络的移动友好原型，以用户为中心的设计过程；3)评估系统的可用性/有用性/可接受性。第二阶段的目标是：1)增强和改进第一阶段的原型系统；2)对138对中风幸存者和照顾者进行随机对照试验，以证实我们的研究假设。

 DESCRIPTION (provided by applicant) Stroke, the leading cause of disability, cognitive impairment and death in the US, imposes significant financial and personal burden. The residual effects of stroke affect many aspects of life not addressed by traditional rehabilitation treatments. In particular, persons with mild stroke, typically defined as a stroke with no or sligh motor impairment and a high level of independence in basic activities of daily living, often experience emotional problems, subtle but significant cognitive impairment and decreased participation in productive, social and leisure activity. Despite these problems, persons with mild stroke are typically discharged to home without further referral to health or rehabilitation services other than follow-up with primary care physicians. This is a Fast-Track SBIR application based on the extensive research results from Drs. Baum and Edwards on developing and testing reliable and valid measures of activity participation (Activity Card Sort, o ACS) and cognitive skills supporting performance of simple and complex functional tasks (Functional Behavior Profile, or FBP). These measures have been used to guide treatments to help persons with mild cognitive impairment and their families support functional independence. These measures and the results of other studies will be used to build a dynamic online self-management tool designed to help persons with mild stroke develop individualized strategies that will support optimal recovery. We propose Better Living After Stroke through Technology (BLAST) to help stroke survivors and family members return back to their productive and meaningful lives by proactively 1) helping both the survivor and caregiver set their activity goals using ACS; 2) identifying and addressing the survivors behavioral/functional capabilities using FBP; 3) recognizing and managing stroke symptoms indicative of secondary stroke risks; 4) for both engaging support from online and community resources; and 5) offering tailored self-management recommendations using evidence-based strategies to help them both achieve their activity goals. Stroke survivors and caregivers using our BLAST system are expected to have better survivor self-efficacy and fewer caregiver concerns. In addition, both will have better life satisfaction and increased activity, and the stroke survivor will have better problem solving, task performance and social interaction. Specific Phase I Aims: 1) collect input from stakeholders on system features, perceived usefulness and adoption barriers via focus groups; 2) develop the Web-based mobile-friendly prototype with a user-centric design process; 3) evaluate system usability/usefulness/acceptability. Phase II Aims: 1) enhance and improve the Phase I prototype system; and 2) conduct a randomized controlled trial with 138 dyads of stroke survivors and caregivers to confirm our study hypotheses.