The aim of the proposed work is to conduct a randomized controlled trial (RCT) evaluation of a behavior change intervention designed to enhance fluid-intake adherence (compliance) among hemodialysis patients. Patient non-adherence (non-compliance) with fluid-intake restrictions is a highly pervasive problem in the hemodialysis population with substantial consequences in terms of increased patient morbidity and mortality. Given the prevalence and clinical importance of adherence among ESRD patients, the design and evaluation of interventions to improve patient adherence is critically important. Surprisingly, however, little such empirical work has been conducted in this area. The proposed RCT involves testing the efficacy of a behaviorally based, group-administered, """"""""behavioral self regulation"""""""" intervention designed to increase adherence to fluid intake restrictions among hemodialysis patients. This structured intervention is designed to be delivered by healthcare providers in a clinical setting to groups of 4-10 patients over seven, one-hour weekly sessions. A randomized control group research design will be used in the proposed work to investigate the effect of the self-regulation intervention versus an attention placebo control on fluid-intake adherence in a sample of approximately 200 fluid non-adherent center hemodialysis patients over a 26-week follow-up period. Both clinical (interdialysis session weight gain) and self-report indices of fluid-intake adherence will be examined. We believe that the proposed research is of potentially very high impact given the high prevalence and clear clinical consequences of hemodialysis patient nonadherence and the potential for a relatively low-cost, structured intervention to significantly reduce this type of maladaptive patient behavior in the hemodialysis treatment context. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK072325-03
Application #
7459677
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Eggers, Paul Wayne
Project Start
2006-07-15
Project End
2011-06-30
Budget Start
2008-07-01
Budget End
2011-06-30
Support Year
3
Fiscal Year
2008
Total Cost
$195,853
Indirect Cost
Name
University of Iowa
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
062761671
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Howren, M Bryant; Kellerman, Quinn D; Hillis, Stephen L et al. (2016) Effect of a Behavioral Self-Regulation Intervention on Patient Adherence to Fluid-Intake Restrictions in Hemodialysis: a Randomized Controlled Trial. Ann Behav Med 50:167-76
Kellerman, Quinn D; Christensen, Alan J; Baldwin, Austin S et al. (2010) Association between depressive symptoms and mortality risk in chronic kidney disease. Health Psychol 29:594-600