# Activation for Self-Care Needs in Older Adults with Chronic Kidney Disease: ACTIVE SENIORS with CKD

> **NIH NIH K23** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $175,716

## Abstract

PROJECT SUMMARY/ABSTRACT
Dr. Devika Nair is an Assistant Professor of Medicine in the Division of Nephrology at Vanderbilt University
Medical Center. With this K23, she will advance the precision, personalization, and scalability of behavioral
interventions for older adults with chronic kidney disease (CKD) by developing and iteratively refining a novel,
multicomponent, adaptive behavioral intervention able to be dosed in real-time. Dr. Nair will gain 1) new
proficiency in behavioral science research, including analyzing cohort data containing patient-reported
assessments, recruiting and retaining a new, longitudinal cohort, and developing adaptive behavioral
interventions; 2) new knowledge in areas of geriatrics relevant to CKD (cognition and physical function); and 3)
new competency in implementation science and mixed-methods design. An invested, integrated, and
established team will support Dr. Nair's transition to independence. Dr. Kerri Cavanaugh will provide instruction
in behavioral science. Dr. Warren Taylor will provide instruction in geriatrics and experiential learning in
neurocognitive assessment. Dr. Daniel Cukor will provide instruction in behavioral interventions. Dr. Russell
Rothman will provide instruction in implementation science. Dr. David Schlundt will provide guidance in mixed-
methods design. Poor engagement in disease self-care behaviors (i.e., physical activity) leads to adverse
cardiovascular events and death in older adults with CKD, the fastest growing kidney disease population.
Existing interventions to improve self-care behaviors in this group are `one-size-fits-all' and do not result in
durable behavior change due to inadequate tailoring and dose adjustment. Patient Activation, a modifiable
measure of self-efficacy, knowledge, problem-solving skill, and level of need for behavioral support, is under-
investigated in CKD despite its inclusion in CKD legislative policy. Cognitive function, the neurobiological
processes requisite of goal-directed behavior and problem-solving skill, is often impaired in CKD yet its impact
on engagement in disease self-care behaviors is unknown. To elucidate neurobiological and behavioral
mechanisms of self-care behaviors, identify new intervention targets, and develop a novel, adaptive behavioral
intervention, Dr. Nair will 1) test whether self-efficacy, Patient Activation and cognitive function associate with
frequency of engagement in CKD self-care behaviors; 2) define how Patient Activation levels and CKD self-
care behaviors change over time to inform intervention dosing, amount of support, and frequency; 3) identify
patients' behavioral goals and triggers for ineffective self-care to inform timing and intervention component
selection; 4) identify patient preferences for behavioral monitoring frequency and intervention delivery mode; 5)
identify barriers and facilitators to intervention implementation into the health system; and 6) iteratively refine
the prototype with usability tes...

## Key facts

- **NIH application ID:** 10449657
- **Project number:** 1K23DK129774-01A1
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Devika Nair
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $175,716
- **Award type:** 1
- **Project period:** 2022-09-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10449657

## Citation

> US National Institutes of Health, RePORTER application 10449657, Activation for Self-Care Needs in Older Adults with Chronic Kidney Disease: ACTIVE SENIORS with CKD (1K23DK129774-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10449657. Licensed CC0.

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