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Pre-transplant health coaching to improve patient-reported outcomes in lung transplant candidates

Award Number: R33HL158811
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/15/2022
PERIOD OF PERFORMANCE END DATE: 04/30/2027

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Pre-transplant health coaching to improve patient-reported outcomes in lung transplant candidates - PROJECT SUMMARY/ABSTRACT Self-management abilities reflect patients’ capacity to manage emotions, social roles, and chronic medical conditions. In fact, self-management abilities are strongly associated with lung transplant candidates’ emotional health. Both self-management abilities and emotional health while waiting for lung transplant predict post- transplant quality of life. Additionally, a candidate’s self-management abilities and emotional health pre- transplant are associated with post-transplant adherence to immunosuppressive medications. Given the important role of these pre-transplant factors, the objective of this study is to optimize pre-transplant self- management abilities and emotional health with the long-term objective of improving post-transplant quality of life and transplant outcomes. Health coaching is an effective strategy to improve emotional health and self- management abilities in other populations and in non-transplant candidates with chronic obstructive pulmonary disease. We used semi-structured, qualitative interviews of lung transplant stakeholders to develop a relevant health coaching intervention for adult lung transplant candidates on the waiting list. In our small, single-center pilot trial we showed telephonic health coaching demonstrated improved pre-transplant self-management abilities, emotional health, and quality of life in comparison to usual care. In this application, we propose a randomized trial of a 30-minute telephonic health-coaching intervention once weekly for 12 weeks (compared to usual care) in 230 lung transplant candidates on the waiting list at the Mayo Clinic in Florida or Minnesota or at UW Medicine in Washington state. Patient-reported outcome instruments measuring emotional health, self- management, and quality of life will be measured at baseline, 12-16 weeks following enrollment, and post- transplant. Our primary outcomes will be differences between groups in Chronic Respiratory Questionnaire (CRQ) domains of Mastery (a measure of self-management) and Emotional function adjusted for baseline values. Secondary outcomes will compare the differences between groups of other psychometric questionnaire scores, adjusted for baseline, as well as short-term post-transplant outcomes. The long-term goal of this application is to optimize post-transplant outcomes through effective pre-transplant interventions. Our central hypothesis is that health coaching will improve lung transplant patients’ self-management abilities, emotional health, and quality of life pre-transplant. We further hypothesize that future studies will demonstrate that these pre-transplant improvements in self-management abilities and emotional health will translate into improved post- transplant quality of life. The results of this study will be used to refine the intervention and plan for a larger, multi-center trial designed to optimize dissemination and implementation in diverse settings. This proposal supports the NIH mission by striving to improve outcomes in lung disease patients while supporting a new investigator in her to transition to research independence.


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 = $492,749 )
2026	2026	MAYO CLINIC	200 1ST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	000	5	5/7/2026	NON-COMPETING CONTINUATION	$492,749
														Subtotal = $492,749

Issue Date FY: 2025 ( Subtotal = $550,101 )
2025	2025	MAYO CLINIC	200 1ST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	001	4	9/11/2025	NON-COMPETING CONTINUATION	$55,010
2025	2025	MAYO CLINIC	200 1ST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	000	4	4/30/2025	NON-COMPETING CONTINUATION	$495,091
														Subtotal = $550,101

Issue Date FY: 2024 ( Subtotal = $802,749 )
2024	2024	MAYO CLINIC	200 1ST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	001	3	5/8/2024	NON-COMPETING CONTINUATION	$539,598
2024	2023	MAYO CLINIC	200 1ST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	000	2	12/29/2023	EXTENSION WITH OR WITHOUT FUNDS	$263,151
														Subtotal = $802,749

Issue Date FY: 2023 ( Subtotal = $543,034 )
2023	2023	MAYO CLINIC	200 FIRST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	001	2	3/31/2023	EXTENSION WITH OR WITHOUT FUNDS	$7,065
2023	2023	MAYO CLINIC	200 FIRST ST SW	ROCHESTER	MN	55905	OLMSTED	USA	Lung Diseases Research	000	2	3/27/2023	EXTENSION WITH OR WITHOUT FUNDS	$535,969
														Subtotal = $543,034

Grand Total All Awards = $2,388,633

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Pre-transplant health coaching to improve patient-reported outcomes in lung transplant candidates

Award Number: R33HL158811

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 05/15/2022

PERIOD OF PERFORMANCE END DATE: 04/30/2027

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