Bailey Submits NIH Grant Application

Kudos to Chip Bailey, associate professor, and his entire team for the resubmission of his NIH R01 application entitled "Trajectories of Caregiver Self-Management and Health (TRAC-SM)" This proposal requests funds for a 5-year period with a start date of July 1, 2020.

Family caregivers of the nearly 400,000 people suffering from end stage liver disease (ESLD) experience stress, poor health and a reduced quality of life. They often are younger and also caring for children or aging parents when compared to caregivers of other end stage conditions. Caregiving stress leads to unemployment, financial difficulty, unfulfilled professional goals which may result in poor health, increased mood disturbance, strain and illness uncertainty. Caregivers put their lives on hold, limiting their ability to self-manage their own health. Self-management is a process by which caregivers use knowledge, skills and beliefs to improve or maintain their health while at the same time supporting self-management of a loved one. There is emerging evidence on the impact of ESLD patient symptoms on caregiver health and quality of life. The proposed 5-year descriptive study will fill this critical gap in caregiver self-management science. We will collect prospective longitudinal data for 24 months on 240 dyads consisting of family caregivers of patients who are undergoing evaluation for liver transplant. We will measure caregiver self-management in relation to their health behaviors, stress, and quality of life; we will also examine self-management in relationship to patient demographics, clinical characteristics, symptoms and stress. Our long-term goal is to develop a self-management intervention targeted to the stress and resulting challenges that effect health and quality of life that family caregivers endure while caring for patients with an unpredictable and uncertain illness course. Our objectives in this application and our immediate next steps toward achieving this goal, are to (1) identify trajectories of change over 24-months in caregiver self-management and (2) determine the extent the trajectory classes predict proximal and distal caregiver outcomes. We anticipate at least two classes, maintainers and decliners. We examine the influence of caregiver and patient contextual characteristics on caregiver self-management over time to determine who needs intervention. This project has four aims: 1) Identify distinct caregiver self-management trajectory classes across the 24 months among caregivers of patients with ESLD, covarying for caregiver contextual characteristics; 2) Determine the patient contextual characteristics that are associated with caregiver self-management trajectory classes across the 24 months; 3) Determine the extent to which the caregiver self-management trajectory classes predict proximal and distal outcomes across the 24 months among caregivers of patients with ESLD; and 4) Explore the self-management strategies caregivers use to manage stress and enhance their health.