2019 Pilot Grant Recipients
Basic Biomedical Sciences, USD
Project: Impact of transcranial direct current stimulation on motor-induced cognitive fatigue in a stroke population
Post-stroke central fatigue is a common and debilitating symptom that has a severe impact on stroke survivor’s quality of life and results in a higher risk of death, making it a top research priority to improve life after stroke. Despite how common this symptom is, currently there is no effective treatment of post-stroke fatigue, due to our limited understanding of the conditions that cause it to occur. If our understanding of post-stroke fatigue is not further advanced, our ability to increase the quality of life, and ultimately the survival of up to three-quarters of stroke survivors will continue to be hampered. The central objective of the proposed research is to determine the effects of upper extremity motor deficits on the development of post-stroke fatigue in order to advance the understanding and treatment of this debilitating and widespread phenomenon. To accomplish this objective, first, the investigators will determine whether fatigue is dependent on performance of skilled object manipulation in which post-stroke deficits are present. Next the investigation team will identify the role that errors in anticipatory control of object manipulations plays in subjective and physiological indices of workload and development of cognitive fatigue. Lastly, the research team will determine whether a novel treatment utilizing transcranial direct current stimulation (tDCS) is effective at reducing post-stroke fatigue symptoms. Collectively, the results of the proposed research will substantially advance our understanding of the relationship between stroke and fatigue, providing a new avenue to identify and treat this common post-stroke symptom by monitoring and potentially altering the conditions that lead to its instantiation, improving the lives of up to 75% of stroke survivors. Further, the completion of this research will advance the field of motor control by determining the relationship between errors in prediction and the development of fatigue, an important stepping-stone to future research aimed at combating this debilitating consequence of a variety of brain pathologies.
Department of Gerontology, UNO
Project: Age-Related Differences in Food Choices and Appetite Regulation in the Context of Exercise
Maintaining a healthy lifestyle requires the implementation of behavioral choices in diet and exercise, which can interact to promote weight loss and long-term weight control. Exercise, for instance, can suppress appetite and food intake over the short term, but the long-term consequences vary considerably among individuals: While some successfully lose weight through exercise, others may use exercise to justify poor food choices. Possible sources of this variation are endocrine and neural mechanisms underlying reward, appetite, and self-regulation. Our long-term goal is to integrate biological and behavioral perspectives to develop precision medicine strategies that can be used to improve food and exercise choices and promote long-term health. The goals of this project are to assess the influence of exercise on food choices (Specific Aim 1), and to identify neuroendocrine factors that explain inter-individual differences in food choices in the post-exercise state (Specific Aim 2) in younger and older adults. Because exercise is important for overall health, including cognitive, psychological, and physical well-being throughout the lifespan, it is essential for life-long health promotion to determine whether the beneficial impact of exercise on food intake regulation is altered with aging. Exercise improves appetite control, which impacts food intake. This effect is beneficial for the prevention of unhealthy weight gain during adulthood and midlife, though less is known about how exercise impacts food intake in the context of aging, which is associated with decreased food intake. This age-related decline in food intake can lead to accelerated weight loss and malnutrition. Nutritional deficiencies can exacerbate non-normative cognitive changes with age and impair decision making. If, as suggested by preliminary data, exercise can improve age-related neurological declines such as sensing of food intake signals and executive control in older adults, it could serve as a simple, non-invasive tool to improve appetite and satiety control and ultimately increase and/or maintain food intake. Researchers, clinicians, and the general population need to be aware of these changes to continue to reap the physical and neurological benefits of exercise.
Department of Psychology, UNL
Project: The Role of the Early Family Environment in Child Behavioral Health
The long-term goal of our research is to understand the role of the multifaceted family system in mental and physical health. Guided by family systems theory, the objective of this project is to conduct a comprehensive, multimethod investigation of the family system during pregnancy and the first two years of life to identify the family processes having the greatest impact on child health outcomes during preschool age. It is essential to identify modifiable factors affecting the earliest stages of child development to inform novel interventions for mitigating long-term risk for negative mental and physical health outcomes There are three specific aims to the proposed research. Aim 1: Explore preliminary associations between the family environment and early childhood executive control (EC) in an existing longitudinal sample. We hypothesize that greater parental depression and interparental discord during pregnancy will predict poorer quality parent-child relationships (insecure, adversarial) and maladaptive co-parenting (limited support and greater conflict) during the first two years of the child’s life which, in turn, will predict EC at preschool age. Aim 2: Explore preliminary associations between the family environment and childhood obesity in an existing longitudinal sample. We hypothesize that greater parental depression and interparental relationship discord during pregnancy will predict poorer quality parent-child relationships and maladaptive co-parenting dynamics during the first two years of the child’s life which, in turn, will predict indicators of childhood obesity at preschool age. Aim 3: Establish the feasibility of novel paradigms and technologies to assess features of the family environment that we expect will have particular relevance for understanding risk for poor EC and obesity.
Department of Psychology, UNL
Project: Using VR to Assess the Efficacy of a Motivational Interviewing Intervention to Increase Bystander Behaviors
During young adulthood, an estimated one in five women experience sexual assault (Elliott, Mok, & Briere, 2004). We seek reduce this violence by motivating young adults to intervene with their peers to prevent sexual assault—an approach known as bystander intervention. Current bystander training is conducted in group sessions involving education about how to recognize and intervene in response to sexual risk situations (e.g., Banyard, Noynihan, Plante, 2007). Although successful in changing knowledge and attitudes about sexual assault prevention, these programs have had limited success in changing actual bystander behaviors. Thus, the present RCT will test a new motivational interviewing intervention—Motivate-the-Bystander (MTB)—specifically designed to increase bystander behaviors in response to sexual risk. Participants in this RCT will be 80 young adult community members who will attend two study sessions at the University of Nebraska-Lincoln’s Virtual Reality Lab. Those randomized to the intervention condition will complete pre-test self-report measures of intervention outcomes and potential moderators (gender, alcohol use, rape myth acceptance), then participate in a brief, MTB session designed to increase bystander behaviors in response to sexual risk. Results of this RCT should provide initial data supporting the efficacy of MTB as well as identify key moderators in promoting bystander behaviors to prevent sexual assault. We expect MTB to increase self-reported and actual bystander behaviors and to be particularly effective for women, light drinkers, and those who are low on endorsement of rape myths. These data will be useful in justifying a larger-scale evaluation of MTB and, ultimately, should lead to broader implementation of the intervention.
Department of Health Services Research & Administration, UNMC
Project: Developing Strategies to Implement Evidence-Based Colorectal Cancer Screening Intervention Using Participatory Approach
A long-term goal of this project is to improve colorectal cancer (CRC) screening rates in rural areas and reduce geographic disparities in cancer prevention. We propose a guided “participatory approach” that helps rural healthcare providers identify, locate, and select evidence-based interventions (EBIs) of CRC screening that are most promising to rural practice organizations’ goals, needs, and capacities. We will adapt Evidence to Action Workshop and use it to guide a research-practice partnership with the Great Plains Health Innovation Network (GPHIN), an Accountable Care Organization (ACO) in rural Nebraska, consisting of a hospital and six primary practices. Since this approach includes a large amount of face-to-face training that may not be possible in rural practice settings, our short-term goal in this pilot study is to design the most appropriate delivery methods of this participatory approach for rural practitioners using various synchronous (real-time) and asynchronous (time-lagged) distance learning and decision-support technologies. Our specific aims include: (1) developing strategies to conduct the participatory workshop (Evidence to Action Workshop) in the 2 rural ACO clinics, and (2) assessing feasibility of obtaining reliable CRC screening data through a retrospective 14 examination of patient claims data from 5 ACO clinics.
Director, Center for Reducing Health Disparities, UNMC
Project: Sustaining the Reach of a Scalable Weight Loss Intervention Through Financial Incentives: an Exploratory Randomized Controlled Trial at Nebraska Medicine Fontenelle Clinic
To increase the population health impact of community-based weight loss programs, there is a need to reduce the common high attrition rates after initial registration. Providing modest financial incentives, as an implementation strategy, has been effective in improving initial program reach and may be instrumental in closing the attrition gap and reducing racial disparities in weight management. Our evaluation of ‘Weigh and Win’ (WAW), a technology- and community-based weight loss program implemented in Colorado, suggests that African American participants, who are typically less likely to engage in weight loss programs and lose less weight than Caucasian participants, may be more receptive when an incentive-based, behavioral economics approach is used. African American participants were not only overrepresented in WAW, they were also more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants. Furthermore, our R21 study identified unique incentive strategies that might be more attractive to African Americans than to Caucasians based on hypothetical incentive scenarios. However, there is a lack of research on the effect of different incentive options on actual participation and the ability of these incentives in closing the initial attrition gap. The objective of this proposal is to assess how the use of different incentive strategies—based on our previous work—may reduce the initial attrition gap when implementing WAW in a primary care clinic predominantly serving African American patients through an innovative research-practice partnership involving primary care, research expertise, and a small business.
College of Education & Human Sciences, UNL
Project: Neural Predictors of Speech Perception Outcomes in Adults with Cochlear Implants
Cochlear implants (CIs) have benefited more than 324,200 individuals worldwide who are deaf or severely hard of hearing since 1984. Although CIs can significantly improve auditory speech perception, leading to better quality of life for severe-to-profoundly deaf individuals, the success rate is highly variable and speech perception outcomes (SPOs) differ widely across CI users. Many factors can contribute to this wide variability, such as age of implantation, duration of deafness, level of preoperative usable residual hearing, pre-CI hearing aid use, and the design of CI electrodes. However, these factors explain only about 10-20% of the variance. Therefore, a large portion of the variance in post-surgical SPOs remains unclear and unpredictable, leading to great difficulty in determining who will benefit from a CI. The goal of this project is to identify the brain-based factors that determine the variability in SPOs in order to characterize the factors leading to successful SPOs. Functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS) will be used to measure brain activity, and diffusion weighted imaging (DWI) will be used to measure white matter integrity prior to implantation; these measures will be contrasted with a group of normal hearing controls. After implantation, only fNIRS (which is fully compatible with a CI) will be used to measure changes in activity together with changes in speech perception at three- and six-month follow-up visits after the activation of the CI. The central hypothesis, formulated on the promising predictive powers of brain-based measures, is that pre-surgical neural markers predict SPOs following implantation. If this hypothesis is correct, pre-surgical brain imaging scans might be introduced in the evaluation process of CI candidacy. The long-term goal is to implement an imaging-guided process to determine pre-surgical CI candidacy and assist in post-surgical aural rehabilitation.