Harvard Catalyst Profiles

NIH/NCCIH

Tai Chi Exercise and Wearable Feedback Technology to Promote Physical Activity in ACS Survivors

Role Description: Physical activity (PA) is a cornerstone of secondary prevention after an acute coronary syndrome (ACS) with associated improvements in cardiovascular risk, morbidity, and mortality. Unfortunately, over 80% of these cardiovascular patients remain sedentary after an event. Participation in cardiac rehabilitation programs is poor, and long-term adherence to PA remains problematic. There is a critical need for the development of novel exercise programs to improve PA in this high-risk patient population. Tai Chi (TC) is a multi-dimensional intervention that integrates low-moderate intensity physical exercise with meditative components that have been shown to improve important self-regulatory skills and cognitive- behavioral determinants of behavior change, such as self-efficacy, motivation, and emotional health. Because it is delivered in a class format, TC also fosters social support. Preliminary evidence suggests that TC may positively impact PA and selected cardiovascular risk factors. TC is an attractive exercise option for ACS survivors, who are often sedentary or deconditioned. There is also growing evidence supporting the use of wearable technology (e.g., Fitbit) as an effective behavioral strategy to promote PA. Wearable devices can utilize evidence-based techniques such as individualized goal setting and feedback in increasing motivation and self-efficacy for exercise. In patients with cardiometabolic disease, the addition of wearable technology to structured exercise has been promising to increase moderate-vigorous PA and improve cardiovascular risk. This application leverages our prior work with TC to promote PA among sedentary ACS survivors, experience with remote delivery of group-based TC, and experience combining mind-body exercise with wearables (Fitbit). We propose a multi-site feasibility study as a necessary step in preparation for a future, fully-powered trial investigating the efficacy of a multi-modal intervention (TC+Wearable) that combines virtual, group TC classes with an individual wearable device to support overall PA, and thus impact downstream cardiometabolic risk. The specific aims are: 1) To assess feasibility of a multi-site randomized controlled trial of TC+Wearable plus enhanced usual care (with cardiovascular risk factor education materials) vs. enhanced usual care alone among inactive ACS survivors. Feasibility measures will include recruitment and retention; intervention acceptability, adherence, and fidelity; and coordination/management of multi-site data collection. Patient- centered outcomes will include accelerometry-assessed PA and sedentary time, cognitive-behavioral constructs (self-efficacy, intrinsic motivation, awareness, anxiety/depression, stress), and cardiometabolic measures (exercise capacity, weight, lipids, blood pressure, glucose). 2) To obtain qualitative feedback from multiple stakeholders to inform future study conduct. We will engage patients, providers, and TC instructors in interviews/focus groups on acceptability of TC+Wearable (content, facilitators/barriers, integration of TC and device); technical aspects of remote delivery; and openness for future provider and TC instructor engagement.

Role: Co-Investigator qualitative aspects

Department of Defense

Boston Biorepository, Recruitment, and Integrative Network (BBRAIN) for GWI

Role Description: Our research group has taken a team approach to solving the mystery of Gulf War Illness (GWI) and we are well-poised to design and implement an important and necessary GWI Biorepository Network of experienced and dedicated GWI researchers to tackle and solve this problem of devising more definitive diagnostic markers of GWI. The “Boston Biorepository, Recruitment and Innovative Network (BBRAIN) for GWI” will be based on the infrastructure of our currently funded and extremely productive Boston GWI consortium (GW120037; Sullivan, Principal Investigator [PI]). As part of this nine-site GWI consortium (GWIC), we have created a large multi-site dataset with cognitive, brain imaging, health symptom data, and biorepository blood and saliva specimens for several hundred GW Veterans and cerebrospinal fluid (CSF) and PET imaging data on a smaller group of Veterans. GWIC funds also allowed us to create a core biorepository of blood, saliva, and human-induced pluripotent stem cells (hiPCS) that our Veteran participants agreed to share for research collaborations. It has been stated that the success of a biorepository is not in how many samples are collected but in how many are shared that lead to important new results.

Role: Co-Investigator

Department of Defense

Veterans with Gulf War Illness: Understanding the spectrum of experiences related to aging and demographics

Role Description: Many Veterans who served in the 1990-1991 Gulf War developed chronic symptoms that could not be explained by established medical diagnoses or standard laboratory tests. The main research questions for the study are as follows: What are the perceptions and experiences of Veterans with GWI regarding symptoms of physical health, cognitive functioning, quality of life, as well as the quality of care they receive? In addition, the study will explore experiences related to the natural process of aging; differences in experiences across demographic characteristics (e.g., gender, race/ ethnicity, type of exposure, etc.) as well as capture the perceptions and experiences of healthcare providers who serve Veterans with GWI. Data for the study will include narrative interviews as well as collage self-portraits of Veterans’ experiences of living with GWI. This research will lead to the development of an educational resource for healthcare providers, namely, a Massive Online Open Access Course (MOOC) that will include recent research on GWI and qualitative perspectives from a range of Veterans living with the illness.

Role: Co-Investigator

Army

Designing a Successful Acupuncture Treatment Program for Gulf War Illness

Role Description: The goals of this current application are:1) Gather follow up data from our veteran participants (from our completed parent study The Effectiveness of Acupuncture in the Treatment Of Gulf War Illness) on current symptom levels and use of services to explore the long-term effects of an acupuncture treatment program, 2) Develop suggestions for how an acupuncture program may be implemented using the viewpoints of multiple stakeholders, 3) Develop a treatment manual for acupuncture practitioners explaining the most effective methods of treating the symptoms of GWI.

Role: PI

NIH

Efficacy of Open-Label Placebo, Double-Blind Placebo, and Peppermint Oil in IBS

Role: Co-Investigator, Director of Qualitative Aspects