Increasing Activity Post-Kidney Transplant with SystemCHANGE

摘要 不活动是老年肾移植受者（KTR）的常见问题，并与他们的 肥胖和心血管问题的高发病率是KTR死亡的主要原因。 然而，SystemCHANGETM +活动跟踪器的组合有望增加活动。的 该指导性患者导向研究职业发展奖（K23）的短期目标是 实施这些干预措施，并获得关于老年人幼儿园和幼儿园的初步数据。60名65岁及以上的幼儿园教师 将从中南移植中心招募，以确定：（一）如果感知（可用性，可持续性， 参与SystemCHANGETM干预的老年KTR的活动跟踪器使用的可接受性）不同 在1、2、3、6和12个月时与对照组相比，以及（II）SystemCHANGE™ + 活动跟踪器干预改善身体活动（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）和老年KTR的生活质量 基线至3、6和12个月，与仅使用活动跟踪器的对照组相比。长期目标是 培养候选人作为一个独立的研究者准备领导随机临床试验，重点是 最大限度地增加老年慢性病患者的身体活动。建议的培训符合国家核研究所的要求- 支持的倡议，并代表了从候选人的先前的研究培训的逻辑进展。职业生涯 开发目标是：（1）获得基于理论的SystemCHANGE™干预的专业知识 并与信息学专家合作，（2）为负责任地开展 科学研究和肾移植领域，（3）熟练使用统计学 用于分析连续监测数据的技术（即，（4）发展日常生活技能; 开展以随机临床试验（RCT）为核心的拟议研究，（5）积极参与 正在进行的导师RCT研究称为药物依从性鉴于个人变化（MAGIC）， 观察移植诊所的病例经理，（6）实施拟议的K23研究项目，以及 (7)分析和使用K23试点研究的初步数据，以准备“R 01”赠款，以测试 在多中心随机对照试验中对身体活动进行个性化的移动的健康干预。职业目标将是 通过教学课程完成;参加国家会议和研究所;和动手实践 在肾脏领域一个有成就的科学家团队的指导下进行研究培训 移植（海瑟薇和罗素），系统CHANGETM（摩尔和罗素），老年人的体力活动 成人（Resnick）、移动的活动跟踪器和大型监测数据集的集成（Ertin）、临床试验 （Russell）和定量方法（海瑟薇）。从这一职业中获得的技能、经验和数据 发展奖将定位候选人，以推进行为自我管理干预的重点 最大限度地增加老年慢性病患者的身体活动。

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.