RESP-FIT: A Respiratory Muscle Strength Training Intervention for COPD

About This Grant

Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the U.S. (3rd worldwide) and disproportionately affects individuals living in rural areas. Poor COPD outcomes are influenced by exposures common in rural settings, such as wood smoke, dust, and agricultural byproducts known to adversely affect respiratory health. There is a critical need for accessible COPD interventions that can be delivered in rural communities. Respiratory muscle strength training (RMST) is an empirically validated therapy that can improve ventilation and airway defenses and reduce dyspnea symptoms in patients with COPD. Few studies have evaluated the effects of RMST on respiratory function, respiratory quality of life (R-QOL), dyspnea, and dyspnea-related kinesiophobia in patients with COPD in rural areas. Our multicomponent, mHealth-delivered COPD intervention, Respiratory Muscle Strength Training and Fitness Program (RESP-FIT) is feasible and acceptable. RESP-FIT incorporates home-based RSMT using a portable training device, mHealth, and behavior theory. Integration of remote spirometry and ecological momentary assessment (EMA) allows measurement of lung function and symptoms (including dyspnea) in real-time in a remote setting. This integrated design (RMST + mHealth + EMA) addresses three key areas: 1) COPD-related physical deconditioning and associated symptoms; 2) health behaviors, including dyspnea-related kinesiophobia; and 3) accessibility (i.e., a portable respiratory intervention enhanced by mHealth/remote technology) for intervention delivery in rural areas. In Aim 1, we will conduct a RCT to evaluate efficacy of RESP-FIT on dyspnea, dyspnea-related kinesiophobia, and R-QOL in adults with COPD. Participants will be randomized to the RESP-FIT intervention or enhanced usual care (control) study arms. In Aim 2, we will identify barriers, facilitators, and contextual factors (e.g., environmental exposures, age, distance from healthcare provider, social support, access to care, income) that may moderate intervention engagement, adherence, and outcomes. RESP-FIT has high potential for scalability. Successful completion of these aims will lay the groundwork for subsequent implementation initiatives that support positive health outcomes and respiratory health for patients with COPD.