PROJECT SUMMARY/ ABSTRACT
Chronic Obstructive Pulmonary Disease (COPD) is an increasingly prevalent and costly chronic health
condition, and is the third major cause of morbidity and mortality in the United States. Self-management
treatment programs for COPD are shown to improve health-related quality of life and prevent COPD-related
hospitalizations. Despite their clinical benefits, these programs are typically multi-component and time- and
resource-intensive. To date, no study has been conducted to isolate the role of individual self-management
treatment components in contributing to improved COPD outcomes. The current application proposes to
establish the feasibility of using the Multiphase Optimization Strategy (MOST) framework to optimize COPD
self-management treatment delivered by the American Lung Association (ALA) Helpline. Treatment
components to be evaluated include duration of self-management education, ground-based walking training,
peer support, and caregiver support. The primary outcome is health-related quality of life, with secondary
outcomes of COPD symptom burden, self-management behaviors, and hospitalization. Specific aims are: Aim
1. Design a factorial experiment and develop operational procedures (i.e., screening/ recruitment,
randomization, and database management) for successful implementation. Aim 2. Establish feasibility and
acceptability by pilot testing the study design with an initial sample of 48 individuals with COPD. Resulting
values will provide estimates of recruitment and retention rates, outcome measure variability, treatment fidelity,
and acceptability of treatment components to inform a subsequent fully-powered optimization trial. The
proposed project will also establish the PI as one of the few researchers employing optimization methods
within the field of COPD self-management. Dr. Mathew is currently completing an NHLBI K23 award (K23
HL138165) to develop and test a tailored smoking cessation intervention for individuals with COPD. The
proposed R03 will extend her treatment development work to additional behavioral health targets addressed by
COPD self-management treatment, such as dyspnea management, medication adherence, physical activity,
and diet. Public Health Impact: The proposed study is an initial step to address a critical research gap
regarding identifying effective elements of COPD self-management treatment. The long-term goal of this line of
research is to optimize the effectiveness of multi-component COPD self-management interventions, and
reduce COPD-related disease burden.