Developing feasible, effective and scalable interventions to improve health among people with multiple chronic conditions is urgent. However, research gaps hinder intervention development. Most interventions do not consider co-occurring functional limitations, family caregivers' perspectives or contextual factors that define social determinants of health. Moreover, interventions commonly focus on deficits rather than strengths. These limitations are compounded by lack of communication among practitioners and people experiencing multiple chronic conditions about their goals, values, and preferences. The proposed Hopkins Center to Promote resilience in persons and families living with multiple chronic conditions (the PROMOTE Center) is poised to address these gaps. The PROMOTE Center will leverage a unique combination of interdisciplinary expertise in 1) behavioral intervention research 2) research and statistical methodology and 3) physiological processes including cytokines found in sweat. Early, mid-career and senior researchers, persons and families experiencing multiple chronic conditions, and key translational stakeholders will work together to advance the science of improving health among those with multiple chronic conditions using our innovative ecological resilience framework. This framework conceptualizes resilience as a life-long process impacted by cumulative interaction of multiple inter-related factors, such as society, community, and family, individual, physiologic and genomic factors. The PROMOTE Center will advance science to improve health and care of adults with multiple chronic conditions by providing expertise, mentorship and resources for the development, implementation and evaluation of theory-driven interdisciplinary research through three Aims.
Aim 1 : Establish a community-informed, sustainable infrastructure with dedicated resources to advance interdisciplinary nursing science that improves the health of vulnerable adults with multiple chronic conditions and their family caregivers:
Aim 2 : Foster a new generation of nursing scholars with skills to lead interdisciplinary research that improves the resilience of adults with multiple chronic conditions.
Aim 3 : Leverage unique environmental strengths to enhance dissemination and translation of evidence-based multiple chronic condition interventions through established partnerships with key stakeholders. Key innovations of the PROMOTE Center include: 1) Use of Society to Cells Resilience Framework that supports focus on health phases in which people are most likely to be open to new information and habits; 2) Integration of exploratory aims in pilot studies measuring bio- markers of resilience with non-invasive sweat measures developed at NINR; and 3) User-centered strengths- based co-design approaches at each phase of pilot development leading to enhanced participant uptake and higher likelihood of sustainability and translation to other settings.
Developing feasible, effective and scalable interventions to improve health among people with multiple chronic conditions is urgent. The proposed Hopkins Center to Promote resilience in persons and families living with multiple chronic conditions (the PROMOTE Center) can advance the science of multiple chronic conditions through a sustainable infrastructure to test innovative multidisciplinary interventions co-designed with persons and families experiencing these conditions. Using a framework of resilience, measuring biomarkers with sweat patches, and co-design will increase the relevance, uptake and sustainability of the interventions.
