Existing models of self-management are predominately behavioral in nature and do not address the biological processes underlying self-management, such as the influence of brain and hormonal activity. Despite the fact that many of the proposed mediating processes of self-management interventions are cognitive in nature (e.g., self-efficacy, motivation, decision-making), brain activity associated with these mechanisms has been little studied. Exciting new findings in neuroscience and advances in technology now create the opportunity to identify the brain-behavior connections that underlie the acquisition and performance of self-management. Building on our successful current Center of Excellence: Self-Management Advancement through Research and Translation (SMART) Center, the purpose of this project is to provide targeted research resources to foster the development, implementation and dissemination of self-management intervention research examining the brain-behavior connections underpinning effective self-management of health and illness.
The aims of the SMART Center are to: (1) Expand the success of the SMART Center by advancing science related to brain-behavior connections specific to the self-management of health and illness; (2) Expand the number of research projects aimed at improving our scientific understanding of the brain-behavior connections specific to the self-management of health and illness; (3) Increase the number of investigators conducting research targeted at the brain-behavior connections specific to self-management of health and illness; and (4) Promote interdisciplinary collaborations and partnerships to develop and support programs of research regarding the brain-behavior connections specific to the self-management of health and illness. Working with early-career investigators, five pilot studies will be conductd over the next 5 years testing promising new self-management interventions (two of which are described in this application). All studies will use a common framework to explore the brain-behavior connection in self-management and a set of common data elements will be used across all projects. Collaborations among investigators from the current SMART Center, the Cognitive Science Department, the CWRU Imaging Research Center, and the School of Nursing Neuroscience Lab provide a rich set of resources and mentorship to SMART Center investigators. We also will enhance development of self-management science through formal collaborations with other proposed self- management centers of excellence at Columbia University and University of Florida. The infrastructure support services offered by the SMART Center are organized in three Cores: (1) Administrative, (2) Neuroscience, and (3) Pilot Studies. A thorough evaluation of process and outcomes will assist us to measure our success and promote sustainability of the expanded SMART Center.

Public Health Relevance

With the aging of the population and the expansion of chronic disease, there is an increased need to develop interventions that help patients to better manage their own health conditions. However, despite significant progress in self-management science, we remain unclear on who will benefit and from what type of interventions to motivate people to take action on behalf of themselves. Given recent advancements in neuroscience about the brain and motivation to take action, we plan to identify the brain- behavior connections that underlie the acquisition and performance of self-management.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Center Core Grants (P30)
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Special Emphasis Panel (ZNR1)
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Kehl, Karen
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Case Western Reserve University
Schools of Nursing
United States
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