# Leveraging the dyad: mechanisms of an intervention for psychological distress in chronic lung disease

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $792,484

## Abstract

PROJECT SUMMARY
Patients with chronic obstructive pulmonary disease (COPD), a debilitating lung disease affecting over 16
million Americans, experience a high burden of chronic symptoms. Patients with COPD and their caregivers
identify patients’ high burden of psychological distress (e.g., symptoms of depression and anxiety) as their top
palliative care priority. Psychological distress is also strongly associated with poor clinical outcomes in COPD.
Yet, patients with COPD rarely receive care for psychological distress. Family caregivers are uniquely
positioned to facilitate the delivery of palliative care interventions due to their longitudinal contact with the
patient and because social relationships provide direct health benefits and buffer against health stressors. A
critical evidence gap that prevents effective and efficient palliative care delivery is an understanding of how
palliative care interventions may best leverage these existing relationships to meet the dyad’s needs. This
application proposes a two-arm mechanistic randomized trial comparing the effect of the Coping Skills Training
(CST) program and a minimally enhanced usual care attention control arm on improving patients’ and
caregivers’ outcomes. Over 12 remotely delivered, weekly sessions, the patient-caregiver dyad learns and
practices coping skills tailored to COPD. CST’s content focuses on (1) improving patients’ abilities to cope with
stress and illness and (2) teaching caregivers both how to cope and how to be an effective coping skills coach.
In prior testing, CST improved patients’ psychological quality of life and functional abilities, yet the mechanisms
of action remain unknown and the prior study population did not reflect the health disparities populations most
affected by COPD. The primary objective of the proposed trial is to apply behavioral science theories to identify
key mechanisms through which the CST program reduces patients’ psychological distress through caregiver
support. The project will also assess heterogeneity in the efficacy of CST at reducing distress among patients
who differ by key characteristics and identify patient, caregiver, and contextual factors associated with program
uptake and completion, both emphasizing modifiable, structural barriers to participation and relevancy. A
stakeholder advisory committee will continue to collaborate with investigators. The trial will enroll 375 dyads of
outpatients with COPD experiencing psychological distress and their caregivers recruited from University of
Pennsylvania and Henry Ford Health Systems’ outpatient clinics that primarily serve patients identifying as
Black, low-income, and/or living in rural communities. The study will identify the novel mechanisms through
which a palliative care intervention that includes and leverages patients’ caregivers can reduce the burden of
chronic illness carried by the dyad. Completing this project will provide the knowledge necessary to refine and
(1) develop scalab...

## Key facts

- **NIH application ID:** 10933390
- **Project number:** 5R01NR020819-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Joanna Lee Hart
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $792,484
- **Award type:** 5
- **Project period:** 2023-09-22 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10933390

## Citation

> US National Institutes of Health, RePORTER application 10933390, Leveraging the dyad: mechanisms of an intervention for psychological distress in chronic lung disease (5R01NR020819-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10933390. Licensed CC0.

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