Improving Evidence-Based Care Use for Adults with Peripheral Vestibular Disorders
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Abstract Peripheral vestibular disorders (PVDs), such as benign paroxysmal positional vertigo and peripheral vestibular hypofunction, result in debilitating symptoms including dizziness and loss of postural control. PVDs are common and increase in prevalence with age affecting up to 85% of those 80 years and older in the US. PVDs are associated with increased fall risk, a significant contributor to injuries and mortality in older adults. Physical therapy (PT) interventions to address the symptoms and impairments caused by PVDs are supported by clinical practice guidelines but are currently underutilized in clinical practice. Use of PT interventions for individuals diagnosed with PVDs are associated with an 86% decreased fall risk. Conversely, non-evidence- based treatment or no treatment negatively impacts quality of life for individuals with PVDs. There is a need to better understand why PT is currently underutilized and if there are healthcare disparities that exist, contributing to health outcomes among persons with PVDs. This project aims to address these gaps in knowledge with a qualitative assessment of factors associated with PT use for PVDs by engaging relevant groups to understand their perspectives and experiences. Specifically, this project aims to: 1) Identify the barriers to PT access for adults with PVDs from the perspective of relevant groups; 2) Develop an implementation plan to improve the uptake of PT use among adults with PVDs; and 3) Pilot the implementation plan to improve the uptake of PT use by adults with PVDs. This research directly aligns with Theme 4 of the 2023-2027 NIDCD Strategic Plan to translate and implement scientific advances into standard clinical care. The training objectives for this career development award include training in 1) qualitative research methods; 2) implementation science; 3) pragmatic research methods; and 4) professional development and grant writing. To achieve these training objectives, the applicant will complete coursework, attend workshops and conferences, complete the research aims, and receive excellent mentoring from a multidisciplinary mentoring team with expertise in qualitative research methods, human-centered design, stakeholder engagement, implementation science, pragmatic research, and real-world evidence. The research aims and training objectives build upon Dr. Dunlap’s clinical and research experience with adults experiencing balance and vestibular disorders and training in clinical research and epidemiological methods. Completion of the training objectives and research aims will allow Dr. Dunlap to meet her long-term goal of becoming a leading independent investigator with a focus on pragmatic rehabilitation research, to improve the quality of care and maximize mobility for adults with balance disorders.
