Newsletter

Research Study by Kavita Radhakrishnan, PhD, RN (PI)

The Problem: Heart Disease

• Heart disease is the leading cause of death in the United States accounting for 25.4% of total deaths.
• Roughly 5.1 million people in the US have heart failure (HF).
• HF costs the nation an estimated $32 billion each year, according to data from the Healthy Communities Institute.
• Travis County averages over 850 deaths/year due to heart disease related complications.

Interactive Digital E-Health Game for Heart Failure Self-management

Dr. Kavita Radhakrishnan is finishing up a transdisciplinary pilot study using a casino style slot game to teach self-management skills to patients with HF. Dr. Radhakrishnan contends that because poor outcomes in patients with HF are often due to lack of knowledge or motivation to change behavior, her study was designed to address this problem by providing a scalable platform to motivate, inform, and educate patients on what they could be doing to improve their health. Because HF is most common among aging adults, this game was one of the first designed for people aged 55+. The interface is simple. The player starts with a number of chips and then “spins” the reel. When you hit a winning combination, chips will be added to the credit meter. However, every three spins or so the player is given a mixture of HF related content in the form of questions, facts, and reminders about taking medications and dietary guidelines. If the player answers correctly they are rewarded with additional chips to play. The game has a built-in mechanism that reports how many spins each player has completed; enabling the research team to draw factual correlations between how much time the patient has played the game with their improvement in scores.

Transdisciplinary Team 

Dr. Radhakrishnan admits that a study like this could not have functioned without a transdisciplinary team. Paul Toprac, Ph.D. and Matthew O’Hair, M.ED. of the University of Texas at Austin Computer Science Department and the Game and Mobile Media Applications (GAMMA) Program worked on improving the feasibility of how to incorporate typical disease knowledge into a game format while Michael Mackert, Ph.D. from the Moody College of Communication contributed with programing, content management, usability testing, and health literacy. Working together, they were able to merge clinical and technical knowledge to create a more effective interface.

Community Impact

What’s the best way to recruit patients into a study? Engage local treatment providers! Members of the health care community such as St. David’s Heart Failure Clinic, Texas Heart and Vascular, and Austin Heart Hospital have shown tremendous interest in the implications this study has for treatment and prevention of life threatening symptoms of heart failure. Eliciting their “buy-in” was a crucial step in gaining their active support for enrolling their patients into this pilot study.

Tips from the Principal Investigator

When asked for advice on working with a transdisciplinary team, Dr. Radhakrishnan recommends the following:

• Start with an open dialogue about the constraints that each group has, so that expectations are realistic when considering time frame, logistics, and budget.
• Objectively ask yourself “can this platform solve this problem?”
• When working with technology, try to build upon what already exists, rather than starting from scratch. This will save a lot of time and money, both of which are precious resources for up and coming researchers.

Furthering its mission to establish and participate in interprofessional education on the UT Austin campus, the School of Nursing recently received a $2.4 million grant from the National Institutes of Health to launch the Center for Trans-Disciplinary Collaborative Research in Self-Management Science (TCRSS). With a goal of fostering trans-disciplinary research to solve complex health problems, the center is quickly becoming a national model for improving the lives of people with chronic health conditions by helping them learn to better manage their illness.

To help meet this goal, the School of Nursing has provided funds to support two scholars who, in addition to working on their doctoral degree, will assist Dr. Miyong Kim, the center’s director, in promoting meetings and events, preparing materials and announcements, and providing input into the content and design of the TCRSS website. The first scholars are Nicole Murry and Ya-Ching Huang.

As a neo-natal nurse for 10 years, Nicole became interested in health literacy and helping patients gain access to tools and resources for good health care as they move from the hospital to home.

“The transition from hospital to home is very stressful for most patients, Nicole said. “I wanted to explore how organizations are using health literacy to prepare patients to manage their care and how they might do a better job of making this change less stressful and more successful. But that meant I needed to learn how to conduct research, and that’s where the TCRSS Center came in. It is helping me build the skill set I need to conduct this research.”

On the other side of the spectrum is Ya-Ching, whose experience has been to help individuals with chronic illness learn how to better manage their symptoms in the community. In the case of patients with diabetes, for example, she helps them learn how to control their diet, schedule exercise time and understand glucose levels. Her patients often are confronted by limited resources and barriers, such as travel and accessibility, for which she attempts to find solutions.

“People with chronic illnesses suffer a lot, but nurses can help with that,” she said. “We can help them learn coping strategies in order to obtain a better quality of life.”

In addition to her other tasks, Nicole’s role as liaison with the Center for Health Communication, another new center on the campus at UT Austin, has been eye-opening. That center, designed to bring together researchers and experts in many diverse areas of health communication into one unit where they can collaborate, share ideas and innovations, and advance scholarship to improve health, is a natural complement to the TCRSS Center.

“I’ve learned a lot about the value of communication from this group, and, because of my back- ground, I believe I’ve helped them understand which proposed projects are more likely to work in a hospital setting and which won’t,” Nicole said. “You can have what looks like a great idea to help patients, but implementing it in a hospital might be difficult. These are things that need to be discussed and worked through. This is where nursing experience can be so valuable.”

Welcome to the first newsletter from our Center for Transdisciplinary Collaborative Research in Self-Management Science (TCRSS). Since we first received a 2.4 million dollar grant from the National Institute of Nursing Research in September 2014, we have been hard at work to achieve our core mission. Our efforts have focused on two main areas: 1. fostering transdisciplinary collaborations amongst the community and academic departments and 2. supporting TCRSS pilot projects that are developing and testing innovative strategies to enhance self-management knowledge and behaviors to improve outcomes of chronic conditions.

To date, we have created numerous partnerships across The University of Texas at Austin campus that include the various health disciplines, such as School of Social Work, College of Pharmacy, Department of Nutritional Sciences and Dell Medical School, in addition to the Department of Computer Science and Moody College of Communication, to name a few.

We have sponsored and co-sponsored numerous networking and community events to foster new and sustainable partnerships between community organizations and UT academic partners and have hosted several skills-building events on grant writing, informatics and technologic interventions. More information about these events is described in this issue.

In addition, we are currently supporting four pilot studies that incorporate transdisciplinary collaborations to promote patient self-management and improve health outcomes in people with chronic conditions such as heart failure, chronic kidney disease, diabetes, HIV and cancer.

Lastly, we are establishing our Center as a local resource to offer editorial guidance, self-management related grant reviews, and general health promotion within the School of Nursing and throughout the community.

We hope you enjoy this first edition of our TCRSS Newsletter, and that you use this opportunity to get to know our TCRSS staff and the work we are doing. Please feel free to contact us with ideas for collaboration or resources you might find helpful related to transdisicplinary and self-management science. On behalf of our TCRSS team, we wish you a healthy and happy start to 2016!

Warm regards,
Miyong Kim