RecruitingNot ApplicableNCT06033924

Telehealth Delivered Home-based Walking for Vets With Peripheral Artery Disease

Telehealth Delivered Home-based Walking for Vets With Peripheral Artery Disease (TREK-PAD)


Sponsor

VA Office of Research and Development

Enrollment

225 participants

Start Date

Jul 1, 2024

Study Type

INTERVENTIONAL

Conditions

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.


Eligibility

Min Age: 21 Years

Inclusion Criteria8

  • 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 Criteria11

  • Life expectancy of less than six months
  • Comorbidities that limit walking to a severe degree (i.e., wheelchair-bound)
  • Resident of a nursing home
  • Recent enrollment in an exercise program or performing 150 minutes per week or more of exercise
  • Planned revascularization or amputation in the next two months
  • Recent CVD events (< 3 months) including stroke/TIA, MI, UA, PCI/CABG
  • Unstable cardiac conditions (severe valve disease, NYHA class III-IV heart failure, untreated complex congenital heart disease, or complex arrhythmias)
  • Current substance abuse
  • Psychiatric disorder which limits the patient's ability to follow the study protocol
  • Pregnancy
  • Inability to speak and read English

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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, AL

Birmingham, Alabama, United States

VA Palo Alto Health Care System, Palo Alto, CA

Palo Alto, California, United States

Rocky Mountain Regional VA Medical Center, Aurora, CO

Aurora, Colorado, United States

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NCT06033924


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