Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent Therapy

经验丰富的肺癌幸存者在意向治疗后进行远程康复

• 批准号: 10420876
• 负责人: Duc M. Ha
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10420876
• 关键词: Activities of Daily Living; Address; Adherence; Adverse effects; Adverse event; Authorship; Behavioral; Cancer Biology; Cancer Survivor; Cancer Survivorship; Caring; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Colorado; Conduct Clinical Trials; Data; Data Analyses; Diagnosis; Doctor of Philosophy; Education; Elderly; Enrollment; Environment; Equilibrium; Excision; Exercise; Exercise Physiology; Feeling; Funding; Goals; Health; Health Sciences; Impaired health; Impairment; Improve Access; Institutes; Intervention; Interview; K-Series Research Career Programs; Knowledge; Leisures; Longevity; Lung; Malignant neoplasm of lung; Master' s Degree; Medical; Medical Oncology; Medical center; Medicine; Mentors; Modeling; Non-Small-Cell Lung Carcinoma; Operative Surgical Procedures; Outcome; Participant; Patient Outcomes Assessments; Patient Participation; Patient Self-Report; Patients; Physical Function; Physical activity; Physical therapy; Physicians; Program Accessibility; Publishing; Qualitative Research; Quality of life; Radiation; Randomized; Recommendation; Recording of previous events; Rehabilitation therapy; Reporting; Research; Research Personnel; Safety; Self Efficacy; Services; Stage at Diagnosis; Structure; Supportive care; Survival Rate; Survivors; Symptoms; System; Teacher Professional Development; Techniques; Technology; Testing; Time; Training; Translational Research; Transportation; Travel; United States Department of Veterans Affairs; Universities; Veterans; Work; arm; base; behavior change; behavioral health; cancer diagnosis; cancer rehabilitation; cancer therapy; career; career development; chemoradiation; clinical center; cost effective; curative treatments; design; exercise capacity; exercise program; exercise rehabilitation; exercise training; expectation; experience; experimental arm; health goals; improved; improved functioning; innovation; loss of function; mid-career faculty; oncology program; precision oncology; professor; programs; psychosocial; pulmonary rehabilitation; randomized trial; rehabilitation research; rehabilitation science; rehabilitation service; research and development; screening; social cognitive theory; systematic review; telehealth; telerehabilitation; uptake; usability

This project entitled “Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent Therapy”, is a Career Development Award (CDA) – 2 resubmission to the Veterans Affairs (VA) Rehabilitation Research and Development (RR&D) Service (RFA RX-20-006). The candidate, Dr. Duc M. Ha, MD, MAS, is a Staff Pulmonologist at the Rocky Mountain Regional VA Medical Center (RMR VAMC) and Assistant Professor at the University of Colorado Anschutz Medical Campus (CU AMC). Dr. Ha has completed a master’s degree in clinical research, postdoctoral research in pulmonary exercise physiology and patient-reported outcomes, and published first-authorship, original research articles on the health impairments of Veteran lung cancer survivors following curative intent therapy. Dr. Ha’s career development goals are to acquire in-depth training in 1) qualitative research, 2) behavioral health science, and 3) the design and conduct of clinical trials focused on rehabilitation and exercise. His longer-term goals are to evaluate rehabilitation services to improve the lives of Veteran lung cancer survivors as a VA physician investigator. Dr. Ha’s primary mentor, Dr. Robert L. Keith, MD, is Professor of Medicine and Cancer Biology at CU AMC and Associate Chief of Staff for Research at RMR VAMC. Dr. Keith is a national leader in lung cancer with a proven track record of research funding and mentoring. Dr. Ha’s co-mentors (and their relevant expertise) are Drs. David B. Bekelman, MD, MPH, Associate Professor of Medicine (qualitative research, supportive care), Jamie L. Studts, PhD, Professor of Medical Oncology (behavioral health science, lung cancer survivorship), and Jennifer E. Stevens-Lapsley, PT, PhD, Professor of Physical Therapy (rehabilitation science). The environment is collaborative with a long history of faculty development. This includes the RMR Geriatric Research, Education and Clinical Center; Center of Innovation for Veteran-Centered and Value-Driven Care; Lung Precision Oncology Program; and the University of Colorado Clinical and Translational Sciences Institute. Lung cancer is the second-most commonly diagnosed cancer among U.S. Veterans – over 8,200 incident cases are diagnosed each year. Approximately 50% of lung cancers are diagnosed at stage I-III and therefore eligible for curative intent therapy. Survival rates among Veterans with early stage lung cancer have increased along with advances in surgical and radiation techniques. Following curative intent therapy, many Veterans experience physical function loss and increased symptom burden. Consequently, approaches are needed to improve their function and quality of life (QoL). We hypothesize that telerehabilitation could mitigate these adverse effects. Therefore, we seek to: (Aim 1) Conduct a qualitative study to assess (a) Veteran lung cancer survivors’ health goals following curative intent therapy, (b) knowledge of outcome expectations for exercise and rehabilitation, and (c) perceived self-efficacy and impediments towards technology. Participants (N=30) will undergo semi-structured interviews guided by the Social Cognitive Theory. Qualitative data analysis will be guided by thematic analysis. Results will be used to guide telerehabilitation programming. (Aim 2) Conduct a pilot randomized study to examine the (a) feasibility, (b) acceptability, and (c) explore the effects of a telerehabilitation intervention with these patients. Participants (N=40) will be randomized (1:1) to receive 12 weeks of telerehabilitation (experimental arm) or assessment only (control arm). Feasibility will be assessed by enrollment, adherence, and retention; acceptability by System Usability Scales; and exploratory effects by linear mixed effects models comparing changes in function, symptom control, and QoL between groups. This CDA-2 project will inform strategies to tailor telerehabilitation and provide pilot data and training for an early career physician investigator to establish independence, with a goal of a large-scale randomized trial (VA Merit) of an optimized telerehabilitation program to improve the physical and psychosocial function, independence, and QoL of Veteran lung cancer survivors following curative intent therapy.

该项目名为“治愈性意向治疗后退伍军人肺癌幸存者的远程康复”， 是职业发展奖（CDA）- 2重新提交给退伍军人事务部（VA）康复研究 （D）资源和发展服务（RFA RX-20-006）。候选人Duc M.哈，医学博士，硕士，是一个工作人员 洛矶山地区退伍军人医疗中心（RMR VAMC）的肺病学家， 科罗拉多大学安舒茨医学院（CU AMC）。哈博士已完成硕士学位， 临床研究，肺运动生理学和患者报告结果的博士后研究，以及 发表了关于退伍军人肺癌幸存者健康损害的第一作者，原创研究文章 治疗意图治疗之后。哈博士的职业发展目标是获得以下方面的深入培训： 定性研究，2）行为健康科学，3）临床试验的设计和实施，重点是 康复和锻炼。他的长期目标是评估康复服务，以改善他们的生活。 退伍军人肺癌幸存者作为退伍军人管理局医生调查员。 博士他的主要导师，罗伯特·L。医学博士基思是加州大学AMC分校的医学和癌症生物学教授 RMR VAMC研究副主任。基思博士是全国肺癌领域的领导者， 在研究资助和指导方面有良好的记录。哈博士的共同导师（及其相关专业知识）是 Drs.大卫B。Bekelman，MD，MPH，医学副教授（定性研究，支持性护理）， Jamie L. Studts博士，肿瘤内科教授（行为健康科学，肺癌生存率）， 和詹妮弗·E. Stevens-Lapsley，PT，PhD，物理治疗教授（康复科学）。的 环境是协作与教师发展的悠久历史。这包括RMR老年人 研究，教育和临床中心;退伍军人为中心和价值驱动的护理创新中心; 肺精确肿瘤学计划;和科罗拉多大学临床和转化科学研究所。 肺癌是美国退伍军人中第二大最常见的癌症-超过8，200例 每年都有确诊病例。大约50%的肺癌是在I-III期被诊断出来的， 符合治愈性治疗的条件早期肺癌的退伍军人的生存率增加了 沿着手术和放射技术的进步。经过治疗意图治疗，许多退伍军人 经历身体功能丧失和症状负担增加。因此，需要采取各种办法， 改善其功能和生活质量（QoL）。我们假设远程康复可以减轻这些 不良影响因此，我们寻求：（目的1）进行定性研究，以评估（a）退伍军人肺癌 治疗意图治疗后幸存者的健康目标，（B）对锻炼预期结果的了解 和康复，以及（c）自我效能感和技术障碍。参与者（N=30） 在社会认知理论的指导下进行半结构化面试。定性数据分析将 以专题分析为指导。结果将用于指导远程康复规划。(Aim（2）进行a 一项初步随机研究，以检查（a）可行性，（B）可接受性，（c）探索 对这些患者进行远程康复干预。参与者（N=40）将被随机（1：1）接受12 远程康复（实验组）或仅评估（对照组）周。可行性将由 入组、依从性和保留率;系统可用性量表的可接受性;以及 线性混合效应模型比较两组之间功能、症状控制和生活质量的变化。 该CDA-2项目将为定制远程康复战略提供信息，并提供试点数据和培训， 一个早期职业医生研究者，以建立独立性，目标是进行大规模随机试验（VA 优点）的优化远程康复计划，以改善身体和心理社会功能， 治疗性治疗后退伍军人肺癌幸存者的独立性和生活质量。