# A Pilot, Feasibility Randomized Controlled Trial of a Behavioral Activation and Rehabilitation Intervention to Improve Psychological and Physical Impairments in Acute Respiratory Failure Survivors

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2020 · $153,310

## Abstract

A growing number of Acute Respiratory Failure (ARF) survivors are burdened by depressive symptoms
and physical impairments that last for years after intensive care unit discharge. Notably, depressive symptoms
are independently associated with subsequent development of new impairments in physical functioning. There
are no randomized controlled trials (RCT), in ARF survivors, evaluating any intervention for depression. To
improve mental and physical health outcomes in ARF survivors, the following gaps within existing patient-
oriented research must be addressed: 1) interventions to improve depressive symptoms and associated
physical functioning impairments, 2) evaluation of modifiable psychosocial risk factors for depressive
symptoms, and 3) validation of screening instruments to assess depressive symptoms. This K23 application,
by Ann Parker, MD, aims to address these gaps by designing and conducting a pilot RCT (Aim 1) of an
intervention combining Behavioral Activation and physical rehabilitation (delivered via telephone and 2 home
visits over 12-weeks) versus a “usual care” control group, and evaluating its feasibility (primary outcome) and
efficacy to reduce depressive symptoms and improve physical functioning (secondary outcomes). Behavioral
Activation, as proposed for this pilot RCT, is an evidence-based psychological treatment for depression, which
increases adaptive behaviors to achieve patient-valued goals. Using the combined patient cohort from the
intervention and control groups of the RCT, Dr. Parker also will evaluate modifiable psychosocial risk factors
for depressive symptoms in ARF survivors and the association between the intervention and these modifiable
factors (Aim 2), and the measurement properties of two commonly used depression screening instruments in
ARF survivors versus a “gold standard” clinician diagnostic interview that she will be trained to perform (Aim 3).
 Dr. Parker, an Instructor in Pulmonary and Critical Care Medicine at Johns Hopkins University, has the
long-term career goal of becoming an independent, NIH-funded patient-oriented researcher in ARF, focused
on the intersection of mental and physical health and multidisciplinary behavioral interventions, consistent with
the most recent NHLBI Strategic Vision. This award will allow Dr. Parker to achieve the following training goals:
1) obtain practical experience designing and conducting a pilot RCT; 2) undertake didactic and mentored
training in psychosocial research and related behavioral interventions; 3) establish local and national
collaborations with experts in mental and physical outcomes of ARF survivors; and 4) obtain preliminary data
and experience to submit a successful R-level grant. Via this award, Dr. Parker will expand on her prior
coursework in biostatistics and epidemiology and expand her existing mentorship team to include additional
national leaders with a strong track record of fostering successful academic careers, to allow her to establish
ind...

## Key facts

- **NIH application ID:** 9983160
- **Project number:** 5K23HL138206-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Ann Marie Parker
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $153,310
- **Award type:** 5
- **Project period:** 2017-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9983160

## Citation

> US National Institutes of Health, RePORTER application 9983160, A Pilot, Feasibility Randomized Controlled Trial of a Behavioral Activation and Rehabilitation Intervention to Improve Psychological and Physical Impairments in Acute Respiratory Failure Survivors (5K23HL138206-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9983160. Licensed CC0.

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