HMC Supplement Progress Report - MAINTENANCE

February 2006

Supplement Title:                 Maintenance Trajectories Across Behaviors & Associated Impact on Quality of Life

Supplement Chair/
Affiliation:                             Susan Hughes, DSW - University of Illinois, Chicago

Purpose:                               To pool maintenance data across eight funded HMC studies in order to address three main research                                              objectives: (1) to examine variability across behaviors in the way that maintenance is assessed,                                              (2) to assess the degree of variability in maintenance across behaviors, and (3) to determine the level                                              of maintenance necessary across behaviors to impact a common outcome.

Maintenance
Sharepoint Group:                Sharepoint Contact – Rachel Seymour
(In addition to HMC Members)

Progress to Date:  Prior to the August 2005 HMC meeting, 20 HMC investigators completed the original web-based adherence survey.  Findings from the survey were reviewed at the August 2005 HMC meeting.  At this meeting, we agreed to explore using the term “maintenance” in place of the term “adherence”.  Three cognitive interviews were conducted by one of the Supplement co-investigators with PI’s from three of the collaborating study sites. The cognitive interviews explored the conceptualizations of “maintenance” and “adherence”, operationalization of the terms in the context of each of the studies, and the appropriateness of replacing the term “adherence” with the term “maintenance” in the survey items.  The survey was revised based on the findings and collaborating Supplement sites were asked to complete the revised survey.  Preliminary analyses of the revised survey are being conducted and will be presented and discussed at the March 2006 HMC meeting. Analyses will include presentation of the findings, and a comparison between results from the original and revised versions of the survey.

An initial protocol application was submitted to the UIC Institutional Review Board.  We have received preliminary approval pending receipt of supporting documentation from each of the collaborating sites.  Documentation has been submitted to the IRB and we are awaiting notification of final approval.

Challenges to Date:  One challenge has been making sure that we are all talking about the same underlying construct when we use common terminology (e.g., maintenance, adherence).

Next Steps:  Following analyses of the revised maintenance survey, we will ask all HMC investigators to complete a condensed version of the survey.  We will use the findings from the survey to develop a manuscript that describes the conceptualization and operationalization of the construct of maintenance across HMC studies.  We plan to have a first draft of a manuscript by August 2006.  We will take the lead in identifying an expert who will make a presentation on data analysis at a subsequent HMC meeting, including longitudinal methods, trajectory analyses, and strategies to handle missing data.