Roybal Center for Fearless Behavior Change - renewal Administrative Core

The goal of the Columbia Roybal Center for Fearless Behavior Change is to advance behavioral interventions that reduce psychological distress and improve health behaviors in midlife and older adults that experience serious health events. Each year, millions of adults experience events such as heart attacks, strokes, or life-threatening cancer diagnoses. For some, these events serve as a wake-up calls, or “teachable moments,” and those patients acquire health behaviors that prevent recurrent events and slow disease progression. Yet, many of these patients are highly distressed after these events, leading to substantial impact on quality of life, health behaviors, and prognosis. For example, 1 in 3 patients develop PTSD symptoms after cardiac arrest and critical illness, and 1 in 5 patients develop persistent depressive symptoms after heart attacks. Those patients who are highly distressed are less likely to follow recommended health behaviors such as taking medications, exercising, and having good sleep. We have shown that many patients avoid medications because they are reminders of disease risk, and exercise because physiological changes (e.g., heart rate) are frightening reminders of the possibility of a recurrent event. Accordingly, our Roybal Center is interested in advancing interventions that target these fear-based mechanisms for which interventions are underdeveloped. There are already evidence-based interventions for reducing other common forms of psychological distress after serious health events such as anxiety and depression. Our Center also aims to conduct implementation research that accelerates the adoption of these effective interventions into practice. Our Center's Administrative Core will support and facilitate the administrative management of the proposed Center, as well as the coordination of clinical trial selection via a national competition; financial and regulatory oversight of trials; maintenance of Common Evaluation Metrics including those relevant to DEIA in the make- up of scientific teams and recruitment/retention of participants; engagement with key stakeholders; communication within and between Roybal Centers and clinical trial scientists; and dissemination of scientific products. This Core will collaborate with the Stress Measurement Network and Science of Behavior Change program to ensure robust measurement of behavioral mechanisms in all trials. It will also convene an External Advisory Committee comprised of scientific experts in the conduct of behavioral trials and patient stakeholders that will review and prioritize applications for new trials to the Center as well as provide strategic advice on the overall conduct of the Center. This Core will remain in close communication with the Behavioral Intervention Development Core that provides implementation science, regulatory, and statistical support to trialists, and is responsible for conducting clinical trials in our Center. Together, these Cores will ensure the efficient and successful conduct and dissemination of rigorous behavioral trials with the potential to improve the well-being and prognosis of midlife and older adults who experience serious health events.