Building on the successful infrastructure of our current Center of Excellence: Self-Management Advancement through Research and Translation (SMART) Center, the purpose of the Pilot Projects Core is to support the development, implementation and dissemination of self-management intervention research examining the brain-behavior connections underpinning effective self-management behavior.
The aims of the Pilot Projects Core are: 1). Mentor pilot investigators in developing and examining the brain-behavior connections of self- management interventions for specific populations;2). Provide common measures, measurement training and analyses for Center studies;3) Select new pilot projects;4). Monitor the progress of the pilot projects, assisting as needed to ensure successful completion of projects;and 5). Educate SMART Center and university investigators and external collaborators in brain-behavior frameworks, processes, and research, and support synthesis of findings and dissemination of results. Using our Model of Brain-Behavior Connections in Self- Management of Health and Illness, we will achieve these aims through a series of five pilot studies designed to extend previous self-management intervention research by focusing on brain-behavior connections and examining neural processing, Hypothalamus-Pituitary-Adrenal (HPA) function and stress, and cognitive mediators that influence self-management behaviors and outcomes. Drawing on cutting-edge brain-behavior science, our premise is that self-management interventions that target both analytic components and emotional components of self-management will be most effective in helping individuals achieve desirable self- management outcomes. All of our SMART Center self-management interventions will target both analytic and emotional components of self-management, and all studies will examine the mediators hypothesized to facilitate the learning and performance of self-management behaviors: neural processing, specifically brain activation and function and cortical neural networks;HPA function and stress (systemic inflammatory effects), and cognitive mediators (self-efficacy, decision-making, motivation, patient activation and perceived stress). In addition, we will evaluate if contextual factors modify the effects of interventions on proximal (self-management behaviors) and distal outcomes (health status, quality of life and functional health, and cost). Our Pilot Projects Core proposal includes plans to support our investigators in carrying out these innovative neuroscience studies, ensure common measurement and analysis strategies, and collaborate with other NINR Self- Management Centers in education and dissemination efforts, and through data harmonization using Common Data Elements (CDEs) and joint biomarker analyses. By examining brain-behavior mechanisms that are hypothesized to drive each intervention's success, we will build knowledge about the neurobiological basis of self-management, to add to the current, predominantly behavioral, paradigm of self-management science.
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