Research

Janet Larson, PhD , RN, FAAN, Funded Projects

Nurse Managed Upper Body Strength Training in COPD

Funding Source: National Institute of Nursing Research

Dates: 9/30/02 – 6/30/07

Co-Investigators: Charles Alex, Michael Berbaurn, Margaret K. Covey

View Poster: PowerPoint File

Abstract: People with moderate to severe chronic obstructive pulmonary disease (COPD) experience intense symptoms of dyspnea when they use their arms and shoulders. To control the dyspnea people avoid the use of their upper extremities and ultimately experience a significant loss of upper body (UB) strength and a decrease in functional performance, reflected by a decrease in the level of activities performed on a daily basis. The purpose of this research is to examine the effects of UB strength training with a self-efficacy intervention to enhance adherence. This is an experimental study with random assignment of subjects to one experimental and two control groups: (a) UB strength training and self-efficacy intervention for adherence (experimental), (b) UB strength training with health education (control 1) and (c) armchair fitness exercises with health education (control 2). The intervention is four months in duration with three booster sessions scheduled during a 12 month follow-up period. Each subject will be studied for a total of 16 months. The primary specific aims are to compare the short (4 months) and long term (12 months after termination of structured training) effects of the above interventions in terms of the following dependent variables: UB strength (one-repetition maximum), dyspnea during physical activities (Chronic Respiratory Disease Questionnaire) and functional performance ((a) Functional Performance Inventory, (b) Upper Body Functional Performance Test, a performance-based test, and (c) level of physical activity measured with accelerometers). Secondary aims are to examine the effects in terms of inspiratory muscle strength, exercise-related self-efficacy, and adherence to UB strength training. Additionally dual energy x-ray absorptiometry will be used to document changes in UB muscle mass (fat free soft tissue). The sample will be 135 people with moderate to severe COPD who experience dyspnea with UB activities, 45 per group. Researchers performing strength tests will be blinded to group assigrunent.

This research is innovative in that it examines the effects of a comprehensive upper body strength training with weight lifting (8 exercises) and combines it with a theory-based self-efficacy intervention to promote adherence to training. This is important because people with COPD experience exacerbations that adversely affect adherence.

Center for Reducing Risks in Vulnerable Populations (CRRVP)

Funding Source: National Institute of Nursing Research

Dates: 9/17/04 – 7/31/09

Associate Directors: JoEllen Wilbur, Karen Kavanaugh, Julie Zerwic, Barbara Berger, Margaret Covey, Barbara Dancy, Alicia Matthews, Beverly McElmurry, Arlene Miller, Dorie Schwertz, Marie Talashek, Edward Wang

Abstract: The overall purpose of the Center for Reducing Risks in Vulnerable Populations (CRRVP) is to (a) advance the science of biobehavioral health for vulnerable populations, emphasizing issues associated with vulnerability related age (very young and elderly), minority status, and lower socioeconomic status; (b) reduce disparities in disease/illness; and (c) support research training by providing core services and resources to investigators. The work of the CRRVP will be accomplished through three research cores (a) Multi-ethnic Emphasis Core, (b) Biobehavioral Methods Core and (c) Development and Dissemination Core. The CRRVP will sponsor research to advance the science in biobehavioral health for vulnerable populations and in the first year four novice investigators will be funded to conduct pilot studies. The science of the CRRVP is organized by a biobehavioral and health-related quality of life framework. Key elements in this framework include person (individual) factors, environmental factors, physiological and psychological variables, symptom status, functional status, general health perception, and quality of life. Studies supported by the CRRVP will (a) reduce disparity and promote healthy life styles for vulnerable populations, (b) elucidate underlying physiological and psychological mechanisms that contribute to symptoms, functional status, perceived health status and quality of life, (c) test interventions to minimize symptoms, enhance functional status, perceived health status and quality of life. The research supported by the CRRVP will have a strong biobehavioral orientation with an emphasis on potential/real health problems experienced by people who are very young, elderly, minorities and/or lower socioeconomic status. In addition, the CRRVP will have a strong emphasis on facilitating multi-ethnic research and reducing disparity in health through research. The combining of research related to vulnerable populations under the umbrella of a single center is, a strength due to overlaps in the science that have not been explored. The interaction of investigators with expertise in diverse groups of subjects will move the science forward in new directions.

Training in Biobehavioral Nursing Research (III)

Funding Source: National Institute of Nursing Research

Dates: 8/1/04 – 5/31/09

Abstract: The overall objective of this training program is to prepare investigators with the understanding and skill to advance knowledge in the biological and biobehavioral basis of nursing care. Specific objectives relate to the development of pre- and postdoctoral fellows in substantive knowledge of biological and biobehavioral science, technical laboratory skills, research methodology, data analysis, and knowledge dissemination. The research interests of program faculty relate to (1) exercise and nutrition in health and disease, (2) neurobehavioral functioning in health and disease, and (3) cardiovascular functioning in health and disease. Highly qualified candidates will be chosen who are closely matched to expertise of program faculty. The training program includes coursework in specified areas of nursing, biological science, research methodology and statistics. Students will learn research techniques in the laboratories of faculty sponsors, and participate in weekly departmental research seminars and colloquia. Trainees will develop and implement research projects that may encompass studies at various levels of biological and biobehavioral functioning, such as intracellular signals and processes in animal models and integrated responses in the biological and biobehavioral domains in human subjects. This proposal requests funds for eight predoctoral and four postdoctoral trainees over a five-year period. The duration of training will be three years for each trainee. It is expected that this training program will prepare outstanding investigators who will advance knowledge of the biological and biobehavioral basis of nursing care.