ADAPT Center Reflects on First Two Years

This summer marks an important milestone for the ADAPT Center at Duke University School of Nursing. July is the second anniversary of the Center’s founding in 2012. Named a Center of Excellence by the National Institutes of Health/National Institute of Nursing Research, the ADAPT Center, which stands for Adaptive Leadership for Cognitive/Affective Symptom Science, supports symptom science research and the study of cognitive/affective symptoms and interventions that promote patients’ and their caregivers’ adaptive abilities for self-management.

At the heart of the Center’s work is the idea that chronic illnesses are complex and often require patients and their families to make behavioral changes in order to manage illnesses and improve the patients overall quality of life. Often, these changes may require resources that test the limits of a family’s ability to adapt to the challenges of managing one or more chronic health conditions. Furthermore, these challenges are often outside the scope of a healthcare provider’s knowledge or understanding, which is often focused on the technical aspect of the chronic illness, like medications or possible surgeries to help alleviate symptoms.

Dr. Ruth Anderson and Dr. Sharron Docherty, the co-directors of the ADAPT Center, want to bridge the gap between the healthcare provider and patient and family, where all sides are collaborating on strategies and methods for managing chronic illnesses

 “The Center directors work closely with researchers to help them conceptualize patient challenges, a critical step to developing tailored approaches and interventions that can be tested in research,” said Dr. Anderson.

As part of their goals, Center investigators share and disseminate new knowledge, participate in interdisciplinary research collaboration to advance the field of symptom science and assist other investigators to conceptualize and study cognitive/affective symptoms and interventions that promote patients’ and their family caregivers’ adaptive abilities.

Additionally, the Center directors are also mentoring junior investigators in their pursuit of research and funding, disseminating new knowledge through publications and workshops and collaborating with other Duke University centers and institutes, such as the Duke Institute on Brain Sciences, Center for the Study of Aging and Human Development, Geriatric Research, Education and Clinical Center (GRECC), Duke Center for Palliative Care and the Center on Biobehavioral Disparities Research.

The Center is currently funding research, in areas of:

  • Physiologic Mechanisms in Pediatric Traumatic Brain Injury. Project Director: Karin Reuter-Rice. Prospective descriptive study explores a genetic variation associated with cerebral vasospasm and neurocognitive outcomes in pediatric traumatic brain injury. Thirty TBI pediatric patients currently enrolled.
  • Trajectory of Symptom Experiences Post-Ablation in Patients with Atrial Fibrillation. Project Director: Kathryn Wood. This study will help identify symptom trajectories of atrial fibrillation (AF) patients who benefit most from ablation and those at higher risk of poorer affective and physical outcomes from this therapy.
  • Careful Hand Feeding Dementia Feeding Skills Training Program for Nursing Home Staff. Project Director: Melissa Batchelor-Aselage. Beginning on July 1, 2014, this study proposes that providing dementia feeding skills training that combines adaptive and technical approaches to nursing home staff will increase feeding knowledge/skills and self-efficacy; increase time spent providing feeding assistance; improve feeding assistance behaviors.
  • Cognitive Status Changes Among Stroke Patients Receiving Acute Rehabilitation. Project Director: Janet Prvu Bettger. Beginning July 2015, this retrospective study of stroke patients receiving inpatient rehabilitation is designed to address knowledge gaps related to cognitive status changes that influence stroke rehabilitation outcomes, and to identify opportunities for adaptive approaches that could lead to improved outcomes.

During the past two years, two new pilot projects were funded by the ADAPT Center using funds contributed to the Center by the Office of the Dean at Duke School of Nursing. Those new projects include:

  • The Adaptive Leadership Framework in Mobile Health: A Pilot Study for Weight Loss. Project Director/Pilot Investigator: Ryan Shaw. This study, in which the adaptive leadership framework is used as a lens to enable collaboration and adaptive processes between patients and clinicians to facilitate weight loss using mobile health, also known as “mHealth.”
  • Establishing Inter-rater Reliability for Video Coding of Hand-Feeding Techniques for Persons with Dementia in the Nursing Home. Project Director/Pilot Investigator: Melissa Batchelor-Aselage. This study will establish inter-rater reliability of the coding of video recordings of mealtime interactions using three hand feeding techniques (direct hand feeding, hand-over-hand feeding, and hand-under-hand feeding) that were collected in preliminary pilot studies sponsored by Duke University School of Nursing Office of Research Affairs and John Hartford Foundation.

“As we enter the third year for the Center, some of our researchers are moving toward completion of their projects and that means there is increased opportunity and support for them to report their outcomes,” said Dr. Docherty. “We plan to fund two more pilots during the next year using School of Nursing funds. One of the pilots will be co-sponsored by the Office of Research Affairs and will focus on international collaboration.”

Collaboration has been an important component for the ADAPT Center. In fact, more than eighty-five Center investigators have used ADAPT Center Resources. These investigators represent nine different institutions, including Duke University, East Carolina University, University of North Carolina, Emory University, University of Texas Medical Branch, Winston-Salem University, University of South Florida, University of Texas Health Sciences and Billings Clinic in Montana. Areas of expertise and focus were from nursing, medicine, public health, psychiatry, ethics, palliative care, public policy and neuroscience, among many other disciplines.

The ADAPT Center held eight journal club meetings and six research seminars and also hosted the first-ever Clipp Symposium on Trajectory Science in 2013.

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