Project Grant R01DK147813

STEPNET-ADAPT Project Grant Summary

The University of California, San Diego received a $796,998 Project Grant award from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under the Diabetes, Digestive, and Kidney Diseases Extramural Research program (CFDA 93.847), effective July 9, 2026, with a completion date of February 28, 2031. The award funds the STEPNET-ADAPT initiative, a sequential multiple assignment randomized trial (SMART) designed to develop and evaluate a personalized, adaptive mobile health intervention for increasing physical activity in hemodialysis patients. The intervention delivers wearable activity trackers, automated personalized text messaging incorporating behavioral strategies such as goal-setting and self-monitoring, and tiered behavioral support including online or in-person coaching for non-responsive participants. The 12-month study consists of a 6-month intervention phase followed by a 6-month observational period, with real-time adaptation mechanisms triggered when participants fail to meet step goals for four consecutive weeks.

The primary deliverable is evidence regarding intervention efficacy, measured by changes in average weekly step count from baseline to six months. Secondary outcomes include quantitative assessments of intervention engagement, hospitalizations, cardiovascular events, all-cause mortality, and cost-effectiveness data. This research addresses a significant clinical gap by transitioning from standardized approaches to a dynamic, personalized framework for physical activity promotion in hemodialysis care, with particular focus on identifying non-responders and delivering tailored adaptive augmentation to improve health outcomes in this vulnerable population.