Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health

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PROJECT SUMMARY The supplement will add measures to the AMPLIFI P01 (abbreviated summary below) & enhance its contribution to the ADOPT Consortium. By 2020, the number of US cancer survivors will exceed 20 million. Cancer survivorship is a victory, but it comes at a price. Once a person is diagnosed with cancer, they are at much higher risk for 2nd cancers, cardiovascular disease, diabetes, osteoporosis, and functional decline (downstream effects estimated at$135 billion/year). A poor diet resulting in obesity and physical inactivity associates with poorer outcomes after a cancer diagnosis. It is hypothesized that cancer survivors may be able to improve their overall health and reduce comorbidity through lifestyle change; particularly since only 15-47% of cancer survivors adhere to national guidelines for weight status, diet and physical activity. While effective intervention sexist, there has been little effort to disseminate these broad scale and to survivors most in need (older, rural, minorities). There also is a dearth of research determining optimal means of combining interventions, which is critical since many survivors practice multiple suboptimal behaviors. The overarching aims AMPLIFI are: 1) improve health behaviors in cancer survivors who practice multiple suboptimal health behaviors; and 2) adapt efficacious interventions to optimize reach via technology while also collecting data to inform the future dissemination and implementation (D&I) potential of these interventions. AMPLIFI involves 3 highly interrelated research projects supported by 4 integrated cores. It will enlist the efforts of652 survivors of a broad array of cancers that have favorable 5-year survival rates (oversampling older, rural, minorities) and gather the input of 48 key stakeholders. Specific Aims: 1) Understand how to adapt efficacious interventions for widespread dissemination via technology, while maintaining the integrity of key components that drive behavior change; 2) Optimize acceptability and use of interventions among older, rural, minority survivors of many cancer types; 3) Test the efficacy of the adapted interventions delivered alone, in sequence, or combined; 4) Contribute to D&I research by developing a new adaptation model; and 5) Determine factors that improve the D&I potential of distance- delivered health behavior change interventions by determining how they mediate behavior change and in whom they work best. Our ultimate goal is to improve the health of the ever-increasing population of cancer survivors.