[K23] Development and Pilot testing of a Theory-informed, Implementation Science Behavioral Modification Intervention supporting Care Planning in Patients with End-stage Liver Disease

Ente: National Institute of Diabetes and Digestive and Kidney Diseases

Scadenza: 2031-04-30

Importo max: 187.398 EUR

Paese: US

Descrizione

PROJECT SUMMARY Dr. Brown, an Assistant Professor of Medicine in the Division of Gastroenterology and Hepatology at UT Austin Dell Medical School, is a transplant hepatologist with a long-term career goal of being a leader in care planning intervention development supporting improvement in the quality of life of all patients with end-stage liver disease (ESLD) including those with limited health literacy. This K23 award will provide training and mentored research in 1. Recruiting strategies in people with limited health literacy 2. Implementation Science 3. Human-centered design and 4. Randomized Behavioral clinical trials to transition Dr. Brown to investigator independence. Dr. Brown has assembled an exceptional mentoring team with extensive experience in health literacy, care planning interventions and clinical trials. This team will be led by Dr. Paul Mueller, an internationally recognized bioethicist focused on ethical use of life-sustaining therapies and Dr. Rebecca Sudore, internationally recognized for successful care planning interventions in a wide range of health literacy levels, serving as Dr. Brown’s co-primary mentors. Dr. Brown’s proposal focuses on the development and pilot testing of a theory-informed, implementation science behavioral intervention supporting increased patient engagement in care planning for patients with ESLD. ESLD is increasing in incidence and is the 9th leading cause of death in the US with a median survival of 2 years. Patients with ESLD receive intensive care, particularly in the last year of life, without corresponding improvements in quality of life. Goal concordant care (care that aligns a patient’s values with the care that is received) has been demonstrated to improve quality of life in cancer and other chronic illnesses but has not been rigorously tested in patients with ESLD. Care planning is an iterative process of provider-patient conversations aiming to provide disease knowledge, elicit patient values and align future medical care with the patient’s stated values that supports goal concordant care. Currently, care planning is lacking in patients with ESLD, occurring < 10% in outpatient settings. Patients with limited health literacy are 50% less likely to undergo care planning compared to those with adequate health literacy. PREPARE for Your Care program is a literacy-appropriate care planning online program validated in older primary care patients developed by Dr. Sudore but has not been tested in patients with ESLD. The research aims of this K23 proposal are co-developing an ESLD-specific module for PREPARE using ESLD patient perspectives, including patients with limited health literacy, and creating a behavioral intervention that is appropriate for a large, heterogeneous population of patients with ESLD. Aim 1 will conduct qualitative interviews of patients with ESLD and caregivers, including those with limited health literacy, to determine the content needs for the PREPARE-ESLD module. These p Istituzione: UNIVERSITY OF TEXAS AT AUSTIN PI: Cristal Latanza Brown Progetto: 1K23DK146187-01A1

Settori: National Institute of Diabetes and Digestive and Kidney Diseases

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