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StepNet-Adapt: A SMART Mobile Health Intervention to Promote Physical Activity in Hemodialysis Patients

Award Number: R01DK147813
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/09/2026
PERIOD OF PERFORMANCE END DATE: 02/28/2031

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StepNet-Adapt: A SMART Mobile Health Intervention to Promote Physical Activity in Hemodialysis Patients - PROJECT SUMMARY Physical activity is a modifiable behavior that significantly influences morbidity, mortality, and quality of life in patients with advanced kidney disease. Despite its clinical importance, individuals receiving hemodialysis often exhibit persistently sedentary behavior, and scalable, sustainable interventions to promote physical activity in this population remain lacking. To address this gap, we propose StepNet-Adapt, a Sequential Multiple Assignment Randomized Trial (SMART) designed to evaluate a personalized, adaptive mobile health (mHealth) intervention to increase physical activity in individuals undergoing hemodialysis. The intervention combines wearable activity trackers, automated personalized text messaging, and stepwise behavioral support, including online or in-person coaching for non-responders. Participants will be randomized to receive either a wearable tracker alone or a tracker plus weekly personalized text messages incorporating behavioral strategies such as goal-setting and self-monitoring. The 6-month intervention will be followed by a 6-month observational period. Participants who do not meet their step goals for four consecutive weeks will be re-randomized to receive additional support via online or in-person coaching, enabling real-time adaptation based on individual response. The primary outcome is change in average weekly step count from baseline to 6 months. Secondary outcomes include intervention engagement, hospitalizations, cardiovascular events, all-cause mortality, and cost- effectiveness. This project is significant in its aim to move from a one-size-fits-all approach to a dynamic and personalized framework for physical activity promotion in hemodialysis care. By identifying non-responders in real time and delivering tailored adaptive augmentation, the StepNet-Adapt intervention has the potential to improve physical activity levels, clinical outcomes, and long-term health in this high-risk population.


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 = $796,998 )
2026	2026	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	7/10/2026	NEW	$796,998
														Subtotal = $796,998

Grand Total All Awards = $796,998

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StepNet-Adapt: A SMART Mobile Health Intervention to Promote Physical Activity in Hemodialysis Patients

Award Number: R01DK147813

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/09/2026

PERIOD OF PERFORMANCE END DATE: 02/28/2031

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