Nurse Scientist Awarded R01 Grant to Advance COPD Care in Rural Communities

Sarah Miller, Ph.D., RN, Assistant Dean, PhD Program, has received a highly competitive R01 grant for $1.78 million from the National Institutes of Health's National Institute of Nursing Research (NIH/NINR). Charlie Strange, M.D., College of Medicine, is a Co-Investigator on the award. They will lead a four-year study evaluating an innovative respiratory intervention for patients with chronic obstructive pulmonary disease (COPD).

The R01 represents the NIH's flagship research project grant and is widely regarded as a significant milestone in an independent research career. Dr. Miller's award positions her among a select group of early-career faculty to secure this level of federal funding.

COPD is the sixth leading cause of death in the United States and the third leading cause of death worldwide. The burden falls disproportionately on rural populations, where individuals are more likely to experience harmful environmental exposures, such as wood smoke, dust, and agricultural byproducts, that negatively affect respiratory health.

“For many patients with COPD, dyspnea or shortness of breath is often the most distressing part of COPD. It affects every single aspect of daily life,” said Dr. Miller.

The Respiratory Muscle Strength Training and Fitness Program (RESP-FIT) intervention combines respiratory muscle strength training (RMST) with mobile health (mHealth) technology to deliver an accessible, home-based program that reaches patients beyond traditional clinical settings. RESP-FIT integrates a portable training device, behavior-change theory, mHealth, remote spirometry, and ecological momentary assessment to monitor lung function and symptoms in real time. RESP-FIT targets physical deconditioning, dyspnea-related kinesiophobia, and accessibility barriers that have long limited respiratory care in rural communities.

"This award allows us to bring an evidence-based respiratory therapy directly into the homes of patients who have historically been left out of COPD research and care," said Dr. Miller. "We have a real opportunity to improve breathing, reduce symptoms, and advance the respiratory health of rural communities in South Carolina and beyond."

Dr. Miller and her team will conduct a randomized controlled trial with 288 adults with COPD. The study will evaluate effects on respiratory muscle strength, dyspnea, quality of life, and health behaviors. The team will also examine how real-world factors, such as social support, access to resources, and environmental exposures, shape engagement and outcomes. “We can’t separate COPD from the environments people live in. Their experiences and exposures are part of the disease story,” said Dr. Miller.

Dr. Miller is also the Site Principal Investigator on an R01 with collaborator Dr. Roberto Benzo (the Mayo Clinic), focused on the delivery of remote cardiopulmonary rehabilitation to rural patients with COPD.

“Rural communities have long carried the disproportionate burden of chronic lung disease,” said Dr. Miller. “We want to change that.”