Telehealth Delivered Home-based Walking for Vets With Peripheral Artery Disease (TREK-PAD)
VA Office of Research and Development
Summary
Walking is beneficial for adults with peripheral arterial disease. Benefits include the ability to walk for longer periods and general well being (quality of life). This study will look at two types of delivery methods for a home-based walking program. The walking program includes step count goals, information on healthy walking and motivational messages. The two delivery methods include a web-based delivery and an telehealth delivery. Participants are randomized to either one of the delivery methods or usual care. After 12 weeks participants in the web based or telehealth based groups maybe re-randomized to receive a combination of both web-based and telehealth for a second 12 week period. After 24 weeks, everyone is followed for an additional 12 weeks, so the total time a participant is in the study is 36 weeks. At baseline, 12, 24 and 36 weeks the investigators ask participant to walk (slowly) on a treadmill, perform a six-minute walk test, and several questionnaires on quality of life. Vouchers are provided at each study visit. All participants who complete the study also keep their pedometer.
Description
The objective of this study is to evaluate two delivery methods of home-based walking among Veterans with PAD. The investigators will use an innovative sequential multiple assignment, randomized trial (SMART) design to compare a web-based delivered (WBD) walking program and a video telehealth delivered (VTD) walking program versus usual care among 225 Veterans with peripheral arterial disease (PAD) in three sites (Birmingham AL, Palo Alto CA, and Aurora CO). This trial has two study aims and one exploratory aim. Aim 1 is to evaluate the efficacy of two remote delivery methods to increase maxi…
Eligibility
- Age range
- 21+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Men and women * Diagnosis of lower extremity PAD due to atherosclerosis * Claudication with walking defined as stage 1-3 on the Rutherford Scale * Medical clearance from the patient's primary care provider or vascular care provider * Ability to walk at least one city block * Self-reported sedentary behaviors defined as \< 150 minutes per week of physical activity * Access to a phone and/or email \& Internet * Competent to provide informed consent Exclusion Criteria: * Life expectancy of less than six months * Comorbidities that limit walking to a severe degree (i.e., w…
Interventions
- BehavioralWalking Program: Internet-based
Internet pages allow participants to see step-count goals, progress over time and access to walking tips for 12 weeks. Among participants who do not increase their step counts (\>15%), these non-responders will be rerandomized to received the combination of internet and telehealth or either along for an additional 12-weeks (total intervention time is 24-weeks). A follow-up phase of 12-weeks will be completed for a total participant duration of 36 weeks.
- BehavioralWalking Program: Telehealth-based
Telehealth sessions allow participants review step-count goals, progress over time and access to walking tips with the study coordinator for 12 weeks. Among participants who do not increase their step counts (\>15%), these non-responders will be rerandomized to received the combination of internet and telehealth or either along for an additional 12-weeks (total intervention time is 24-weeks). A follow-up phase of 12-weeks will be completed for a total participant duration of 36 weeks.
Locations (3)
- Birmingham VA Medical Center, Birmingham, ALBirmingham, Alabama
- VA Palo Alto Health Care System, Palo Alto, CAPalo Alto, California
- Rocky Mountain Regional VA Medical Center, Aurora, COAurora, Colorado