# 2/2 Self-directed mobile adaptive coping skills intervention to improve psychological distress symptoms among cardiorespiratory failure survivors: the Blueprint RCT

> **NIH NIH U24** · OREGON HEALTH & SCIENCE UNIVERSITY · 2024 · $555,597

## Abstract

Project Summary
Cardiorespiratory conditions such as the acute respiratory distress syndrome (ARDS), congestive heart failure,
COVID pneumonia, and sepsis are among the most common causes of mortality and morbidity. They are also
notable for high rates of persistent psychological distress symptoms including depression, anxiety, and PTSD that
worsen quality of life and outcomes of the underlying conditions. Yet there are few effective strategies able to
overcome barriers of limited access to mental health care. Even less is known about distress management among
people from structurally disadvantaged backgrounds such as racially and ethnically minoritized populations
because of their suboptimal representation in relevant clinical trials.
To fill this gap, we developed Blueprint, an adaptive coping skills training intervention, and have optimized it over
years of research. We conducted a multicenter RCT (PCORI PFA 195) of a telephone- and web-based version
among those recently hospitalized with serious cardiorespiratory conditions, finding that it reduced depression
symptoms and improved quality of life among those with elevated baseline distress. Informed by lessons learned
about intervention delivery and eligibility criteria, we next conducted a single-center pilot RCT (R34 HL145387)
that targeted a broader population and tested a completely automated, self-guided, symptom-responsive mobile
app version of Blueprint. We found excellent adherence and a strong effect on depression, anxiety, PTSD, and
quality of life compared to control.
Given these promising findings, a formal test of the Blueprint adaptive coping skills training intervention’s efficacy
is needed. Therefore, we propose a 5-year multicenter RCT with 6-month follow up in which 400 cardiorespiratory
failure survivors with elevated symptoms of psychological distress post-discharge are randomized to either
Blueprint or an Education Program control, both delivered through similar mobile app platforms. Our specific aims
will: (1) Test Blueprint vs. control on symptoms of depression, anxiety, PTSD, and quality of life; (2) Determine
patient-level characteristics associated with a great treatment response among sociodemographic subgroups of
interest, also applying a heterogeneity of treatment effects analysis to identify other groups of clinical relevance;
and (3) Ensure off-the-shelf intervention readiness for implementation by using an exploratory mixed-methods
hybrid type 1 implementation framework analysis that integrates semi-structured interviews with trial participants
and quantitative trial data from Aims 1 and 2. This DCC proposal will provide the data management infrastructure
and will maintain study integrity. Innovative elements include a fully automated mobile health delivery system that
personalizes content in response to changes in symptom trajectories, a focus on racially and ethnically minoritized
persons, the integration of a Spanish language intervention version, and strong...

## Key facts

- **NIH application ID:** 10805733
- **Project number:** 1U24HL168491-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Catherine Lee Hough
- **Activity code:** U24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $555,597
- **Award type:** 1
- **Project period:** 2024-02-15 → 2029-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10805733

## Citation

> US National Institutes of Health, RePORTER application 10805733, 2/2 Self-directed mobile adaptive coping skills intervention to improve psychological distress symptoms among cardiorespiratory failure survivors: the Blueprint RCT (1U24HL168491-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10805733. Licensed CC0.

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