Background: End-stage renal disease (ESRD) is associated with decreased physical function and health-related quality of life, high rates of mortality, and elevated healthcare costs.
Hemodialysis (HD) is a life-saving treatment but depends critically on patient adherence to HD sessions, medications, dietary restrictions, and physical activity. Positive psychology- motivational interviewing (PP-MI) interventions have the potential to reduce distress and improve wellbeing, which in turn may increase engagement in critical health behaviors for this high-yield population. In this proof-of-concept trial, we aim to examine the feasibility, acceptability, and preliminary efficacy of a 12-week, phone-based PP-MI intervention (INSPIRED) in adults with ESRD treated with HD.
Methods: Participants enrolled in the INSPIRED intervention will complete weekly PP exercises (e.g., writing a letter of gratitude) and work towards one or more goals related to physical activity, diet, and diabetes self-care, then will complete weekly phone sessions with a study trainer. During these sessions, the trainer will (1) review of the previous week’s PP exercise and assign a new PP exercise for completion, and (2) review of the previous week’s health behavior goal, introduce a new health behavior topic, and create a new weekly goal. For feasibility and acceptability (primary outcomes), we will assess the % of total phone sessions completed and participant ratings of the ease and utility of each session (0-10 ratings). We will explore the intervention’s impact on health behavior adherence and psychological, functional, and medical outcomes.
Results: Nine participants have enrolled since October 2020. We hypothesize that >70% of all sessions will be completed and that mean ease and utility ratings will be > 7.0/10. Finally, we expect participants to have pre-post improvements in health behavior adherence and other key outcomes, warranting further testing in a well-powered efficacy trial.
Conclusion: If effective, we will examine the efficacy of this program in a larger, randomized controlled trial.
Regina M. Longley, BA, Alba Carillo Vega, PhD, Christina Massey, PhD, Wei-Jean Chung, PhD, Juliana Zambrano, MD, Abraham Cohen Bucay, MD, Emily Feig, PhD, Rachel Millstein, PhD, Christopher Celano, MD
Christopher Celano, MD