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MIGHTIER: Movement in Heart Transplant patients: the Impact of Environmental factoRs

Award Number: K23HL169833
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 06/01/2024
PERIOD OF PERFORMANCE END DATE: 05/31/2029

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MIGHTIER: Movement in Heart Transplant patients: the Impact of Environmental factoRs - PROJECT SUMMARY/ABSTRACT Long term survival of pediatric heart transplant (HT) patients remains unacceptably low and is driven in part by modifiable cardiovascular risk factors. Children with HT engage in low levels of moderate to vigorous physical activity (MVPA), which is a major health problem for a population already at increased cardiovascular risk and further contributes to their morbidity and mortality. Increasing MVPA may be a critical way to improve cardiovascular health, quality of life, and survival in this population. While environmental exposures are associated with physical activity in children without HT, their effects in those with HT are unknown, and likely different. To design effective, generalizable, and sustainable interventions to increase MVPA, we need to recognize the environmental determinants of MVPA and involve stakeholders in intervention development. Jonathan Edelson, MD, is a pediatric cardiologist and physician-scientist passionate about understanding how physical activity can improve outcomes of children after HT. With a mentoring team specializing in implementation science, Dr. Edelson will 1) develop expertise in mobile health technology and accelerometry; 2) hone the skills to design, launch, oversee, and complete a multisite, prospective interventional study; and 3) gain methodologic expertise in geospatial and qualitative methodology. This study proposes to leverage an existing mobile health study of pediatric HT patients to evaluate the macro and micro environmental determinants of MVPA in pediatric HT and to pilot an exercise intervention using the Multiphase Optimization Strategy (MOST). Specific Aims are to 1) Determine the association of the macro-environment with MVPA in a heterogenous cohort of children after HT; 2) Use qualitative methodology to identify micro-environmental determinants of participation in physical activity in pediatric HT patients; 3) Determine the feasibility and preliminary efficacy of a digital exercise program in pediatric HT patients. Dr. Edelson will map participant addresses to neighborhood-level built and natural environmental exposures to estimate the association of MVPA patterns with macro environmental factors. He will then conduct semistructured interviews informed by the COM-B (Capability, Opportunity, Motivation, Behavior) implementation science framework with patients and their families to identify determinants of physical activity and desirable components of a mobile health exercise intervention. Finally, he will apply the knowledge gained to the development and implementation of a prospective pilot longitudinal exercise intervention using MOST, a strategy for developing multi-component intervention which has successfully informed physical activity interventions. This K23 award will support Dr. Edelson’s pathway to becoming an independent investigator in the interventional space with skills that will support future R level proposals using exercise in a large multisite cohort to improve long-term outcomes. This work will provide a novel framework for exercise interventions that will be applicable to a range of populations, further highlighting the public health significance of this proposal.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $160,053 )
2026	2026	THE CHILDREN'S HOSPITAL OF PHILADELPHIA	3401 CIVIC CENTER BLVD	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	001	3	6/11/2026	NON-COMPETING CONTINUATION	$160,053
2026	2025	THE CHILDREN'S HOSPITAL OF PHILADELPHIA	3401 CIVIC CENTER BLVD	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	000	2	5/26/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $160,053

Issue Date FY: 2025 ( Subtotal = $160,622 )
2025	2025	THE CHILDREN'S HOSPITAL OF PHILADELPHIA	3401 CIVIC CENTER BLVD	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	000	2	8/5/2025	NON-COMPETING CONTINUATION	$160,622
														Subtotal = $160,622

Issue Date FY: 2024 ( Subtotal = $161,175 )
2024	2024	THE CHILDREN'S HOSPITAL OF PHILADELPHIA	3401 CIVIC CENTER BLVD	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	000	1	5/30/2024	NEW	$161,175
														Subtotal = $161,175

Grand Total All Awards = $481,850

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MIGHTIER: Movement in Heart Transplant patients: the Impact of Environmental factoRs

Award Number: K23HL169833

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 06/01/2024

PERIOD OF PERFORMANCE END DATE: 05/31/2029

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