Building a physical activity intervention into clinical care for breast and colorectal cancer survivors in Wisconsin: a randomized controlled pilot trial
Building a physical activity intervention into clinical care for breast and colorectal cancer survivors in Wisconsin: a randomized controlled pilot trial
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DOI：
10.1007/s11764-019-00778-6
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发表时间：
2019-08-01
影响因子：
3.7
通讯作者：
Date, Preshita
中科院分区：
文献类型：
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作者：
Cadmus-Bertram, Lisa;Tevaarwerk, Amye J.;Date, Preshita
癌症生存护理计划（“护理计划”）通常建议积极的生活方式，但很少伴随着帮助患者制定规定的行为改变的计划。作为弥合这一差距的一步，本试验测试了通过多水平体力活动干预来增强护理计划的可行性。方法乳腺癌和结直肠癌幸存者与自我选择的支持伙伴（例如，配偶，朋友）。幸存者单独接受护理计划（对照组），而不是一个12周的体力活动模块（干预组）。对于干预组二人组，两名成员都接受了包括Fitbit跟踪器在内的多组件计划，幸存者的Fitbit与他/她的电子健康记录（EHR）相关联。治疗临床医生定期收到关于幸存者身体活动的更新。主要结局是使用混合模型分析的ActiGraph测量的身体活动。在12周时向参与者和临床医生发放反馈问卷。结果存活者（n = 50）年龄为54.4 ± 11.2岁，诊断后2.0 ± 1.5年。干预组的幸存者增加了69 +/- 84分钟/周的中等强度至高强度体力活动（MVPA），而对照组减少了20 +/- 71分钟/周（p = .001）。同样，每日步数增加了1470 +/- 1881，而减少了398 +/- 1751（P = .002）。在回应的临床医生中，100%的人至少查看了一次EHR中幸存者的活动数据，80%的人表示它提供了对患者生活方式的洞察。结论：通过多层次的、基于技术的干预来增强标准护理计划，可以增加癌症幸存者的体力活动。
Background Cancer survivorship care plans ("care plans") often recommend an active lifestyle yet are rarely accompanied by programs to help patients enact the prescribed behavior change. As a step towards bridging this gap, this trial tested the feasibility of augmenting care planning with a multi-level physical activity intervention. Methods Breast and colorectal cancer survivors were enrolled alongside a self-selected support partner (e.g., spouse, friend). Survivors received a care plan alone (comparison group) versus one augmented with a 12-week physical activity module (intervention group). For the intervention group dyads, both members received a multi-component program including Fitbit trackers, with the survivor's Fitbit linked to his/her electronic health record (EHR). Treating clinicians received periodic updates regarding the survivors' physical activity. The primary outcome was ActiGraph-measured physical activity, analyzed using mixed models. Feedback questionnaires were administered to participants and clinicians at 12 weeks. Results Survivors (n = 50) were 54.4 +/- 11.2 years of age and 2.0 +/- 1.5 years post-diagnosis. Survivors in the intervention group increased moderate-to-vigorous-intensity physical activity (MVPA) by 69 +/- 84 min/week vs. a 20 +/- 71 min/week decrease in the comparison group (p = .001). Likewise, daily steps increased by 1470 +/- 1881 vs. a 398 +/- 1751 decrease (P = .002). Among responding clinicians, 100% looked at survivors' activity data within the EHR at least once and 80% said it provided insight into their patients' lifestyles. Conclusions Augmenting a standard care plan with a multi-level, technology-based intervention increased physical activity among cancer survivors.