This K23 award will provide an opportunity for Dr. Prieto-Centurion to achieve his long-term goal of becoming an independently-funded physician scientist with a focus on improving outcomes for patients with Chronic Obstructive Pulmonary Disease (COPD). The proposed project builds on his previous work investigating gaps in the care of patients with COPD, particularly following hospital discharge. Through this project, Dr. Prieto-Centurion will attain expertise in clinical trial design, behavioral intervention methods, rehabilitation research methods, and qualitative research. This will be accomplished through an integrated career development plan consisting of formal coursework, guidance from highly skilled mentors, and protected time to gain practical research experience. Environment: The rich academic environment at the University of Illinois at Chicago (UIC) is an ideal place for Dr. Prieto-Centurion's continued training. The UIC Division of Pulmonary, Critical Care, Sleep and Allergy Medicine prides itself on a collegial environment in which investigators are encouraged to collaborate with one another. UIC also offers a broad range of educational and research resources, including the School of Public Health and the Center for Clinical and Translational Science (UIC's Clinical and Translational Science Awards institution). In addition, Dr. Prieto-Centurion has assembled a mentoring team with the expertise required to guide him through the proposed project, strong records of funding and publication, and success in training early-stage investigators who have gone on to have careers as physician scientists at major academic medical centers. Research: In the proposed patient-oriented research proposal, Dr. Prieto-Centurion will examine physical activity patterns in patients recovering from COPD exacerbations following hospital discharge and evaluate the feasibility of a home-based objectively-monitored behavioral intervention to increase physical activity. He has already successfully pilot tested remote physical activity monitoring in patients with COPD and has designed an intervention that is integrated into the post- discharge care structure at the University of Illinois Hospital & Health Sciences System and Jesse Brown VA Medical Center. Dr. Prieto-Centurion will: 1) conduct a cohort study to estimate time-related changes in functional capacity, objectively-measured physical activity, and patient-generated outcomes in patients recovering from COPD exacerbations following hospital discharge; 2) perform a pilot clinical trial to evaluate the feasibility of a home-based behavioral intervention to promote physical activity; and 3) identify participant and caregiver barriers and facilitators to the intervention to guide the development of a future R01-funded clinical trial to examine the efficacy of the intervention. The proposed project is innovative in that it leverages technological tools to assist in the delivery of a behavioral intervention with the overall goal of improving outcomes in this vulnerable population. This study has the potential to lead to further studies to examine the efficacy of the intervention in other patient populations as well as different intervention delivery methods.
Despite well-established evidence of the benefits of physical activity, especially in the post-hospitalization setting, few patients recovering from Chronic Obstructive Pulmonary Disease (COPD) exacerbations are able to complete an outpatient pulmonary rehabilitation program. This project will aid in better understanding time- related changes in physical activity and patient-generated outcomes in patients recovering from COPD exacerbations following hospital discharge and evaluate the feasibility of a home-based, objectively-monitored behavioral intervention to promote physical activity. Knowledge gained from this study will serve as the basis for a future R01-funded clinical trial designed to evaluate the efficacy of the intervention, and additional studies to examine its efficacy in other patient populations as well as different intervention delivery methods.