The COACH Study: A Framework for individualized COaching in young Adult Cancer survivors to encourage Healthy behaviors

COACH 研究：对年轻成人癌症幸存者进行个性化辅导以鼓励健康行为的框架

• 批准号: 10435905
• 负责人: Sylvia Crowder
• 金额: $ 8.69万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-04 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10435905
• 关键词: Address; Adherence; Adult; African American; African American population; Age; Age-Years; American Cancer Society; Area; Awareness; Behavior; Behavior Therapy; Behavioral; Belief; Body Weight; Body Weight decreased; Breast Cancer survivor; Cancer Survivor; Cancer Survivorship; Cardiovascular Diseases; Clinical; Constipation; Cultural Characteristics; Data; Development; Diabetes Mellitus; Diagnosis; Diet; Enrollment; Ensure; Environmental Risk Factor; Ethnic Origin; Fatigue; Food Preferences; Future; Gender; Goals; Growth and Development function; Guidelines; Habits; Health behavior; Hispanic; Hispanic Americans; Individual; Intervention; Interview; Knowledge; Late Effects; Life; Life Style; Malignant Neoplasms; Metabolic syndrome; Methods; Modality; Movement; National Cancer Institute; Not Hispanic or Latino; Nutritional; Obesity; Overweight; Patients; Physical activity; Population; Publishing; Quality of life; Race; Randomized; Randomized Clinical Trials; Recommendation; Reporting; Research; Risk; Risk Factors; Sampling; Structure; Survivors; Time; Vulnerable Populations; age related; approach behavior; base; behavior influence; cancer diagnosis; cancer risk; comorbidity; cultural health; dietary guidelines; ethnic minority; exercise intervention; experience; fitbit; frailty; gender difference; health care delivery; health disparity; healthy lifestyle; healthy weight; high body mass index; human old age (65+); improved; lifestyle intervention; obesity prevention; preference; programs; psychosocial; public health priorities; racial and ethnic; recruit; reduced muscle mass; sedentary; sedentary lifestyle; social cognitive theory; social culture; symptomatology; walking speed; wearable sensor technology; weight gain prevention; young adult

PROJECT SUMMARY When a young adult (YA) is diagnosed with cancer, normal growth and development is disrupted, heightening nutritional needs in a vulnerable population. YA Hispanic and African Americans survivors are particularly vulnerable as they are more likely to have a higher body mass index (BMI) pre-treatment, further increasing the risk of late effects of cancer and comorbidities. Following treatment, YA survivors report worse quality of life (QOL) and greater symptomatology, including fatigue, constipation, frailty, low muscle mass, slow walking speed, and weakness similar to adults aged 65 and older. As a result of treatment, changes in body weight and limitations in physical movement are a major concern in 30-60% of survivors. While a number of lifestyle interventions have been published, only two published YA cancer survivor studies have incorporated a diet and PA bundled health behavior approach. Each study followed different dietary guidelines and both studies were conducted in YA breast cancer survivors who may have different needs as a result of treatment and gender differences. There is a lack of understanding of YA from racial/ethnic minority backgrounds as the aforementioned studies did not include Hispanic survivors and recruited only a small handful of African American survivors, an important gap we plan to address in this application. Thus, healthy lifestyle interventions encompassing diet and physical activity (PA) to prevent obesity-related late effects are warranted. The goal of the current study is to take a sequential mixed methods approach addressing this knowledge gap to gain essential quantitative and qualitative information that will serve as the framework for our next steps; a healthy lifestyle intervention for YA cancer survivors that are diverse in terms of race, ethnicity, gender, cancer diagnosis, time since diagnosis, and treatment. In Aim 1, we will recruit a diverse sample of YA cancer survivors currently between 20-30 years of age to obtain objective and subjective lifestyle behavior data on current diet quality, PA, and quality of life. For Aim 2, we will recruit a subset of Aim 1 survivors to participate in phenomenological based semi-structured interviews guided by the Social Cognitive Theory to (a) explore sociocultural, environmental, and individual factors associated with lifestyle behaviors; (b) explore awareness of ACS guidelines, current practices, and essential intervention modules (e.g., integrating cultural foods and preferences) to inform intervention content and modality. There is an urgent need to develop health behavior interventions for YA cancer survivors that are effective and easily disseminated. Successful completion of this study will provide the information needed to create and enhance the framework for our proposed intervention “COACH: Individualized COaching in young Adult Cancer survivors to encourage Healthy behaviors” in terms of format and module content, with desirable patient-level preferences for sociocultural and environmental factors. The intervention framework created at the end of the study will be easily modified to best suit an individual’s background, taking into consideration their worldview, increasing the potential to be widely disseminated and effective.

项目摘要 当一个年轻人（YA）被诊断出患有癌症时，正常生长和发育被禁用，增加 脆弱人群中的营养需求。 YA西班牙裔和非裔美国人的生存特别是 易受伤害，因为它们更有可能具有更高的体重指数（BMI）预处理，进一步增加了 癌症和合并症后期影响的风险。治疗后，YA冲浪者报告生活质量较差 （QOL）和更大的症状学，包括疲劳，便秘，脆弱，肌肉低，步行速度缓慢， 和与65岁及65岁的成年人相似的弱点。由于治疗，体重的变化和 身体运动的局限性是30-60％的生存问题的主要问题。而多种生活方式 已经发布了干预措施，只有两项已发表的YA癌症生存研究纳入了饮食和 PA捆绑的健康行为方法。每项研究都遵循不同的饮食指南，两项研究均为 在YA乳腺癌存活中进行的，由于治疗和性别可能有不同的需求 差异。从种族/族裔少数民族背景中，缺乏对YA的了解 关于典型的研究不包括西班牙裔冲浪者，只招募了少数非裔美国人 幸存者，我们计划在此应用程序中解决的重要差距。那是健康的生活方式干预措施 保证了饮食和体育锻炼（PA）以防止肥胖有关的晚期作用。目标 当前的研究是采用解决此知识差距的顺序混合方法方法 基本的定量和定性信息将作为我们下一步的框架；健康 在种族，种族，性别，癌症诊断方面对YA癌症生存的生活方式干预， 自诊断和治疗以来的时间。在AIM 1中，我们将招募目前YA癌症存活的潜水员样本 在20-30岁之间，获得有关当前饮食质量的客观和主观生活方式行为数据，PA， 和生活质量。对于AIM 2，我们将招募AIM 1生存的子集以参与现象学 由社会认知理论指导的半结构化访谈（a）探索社会文化，环境， 以及与生活方式行为相关的个人因素； （b）探索对ACS准则的认识，当前 实践和基本干预模块（例如，整合文化食品和偏好）来告知 干预内容和方式。迫切需要开发YA癌的健康行为干预措施 有效且容易传播的幸存者。这项研究的成功完成将提供 为我们提议的干预措施创建和增强框架所需的信息“教练：个性化 在年轻成人癌症幸存者的指导下，以形式和模块来鼓励健康的行为” 内容，对社会文化和环境因素具有理想的患者级别偏好。干预 在研究结束时创建的框架将很容易修改，以最适合个人的背景 考虑到他们的世界观，增加了广泛传播和有效的潜力。