Fit2ThriveMIND: Optimizing a mHealth Physical Activity Intervention with Mindful Awareness Lessons in Breast Cancer Survivors

Fit2ThriveMIND：通过乳腺癌幸存者的正念意识课程优化移动健康身体活动干预

• 批准号: 10539045
• 负责人: Siobhan Marie Phillips
• 金额: $ 65.58万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10539045
• 关键词: Accelerometer; Address; Adherence; Adoption; Aftercare; Age; American Cancer Society; Anxiety; Awareness; Behavior; Breast Cancer survivor; Cancer Prognosis; Cancer Survivorship; Cellular Phone; Cessation of life; Chronic Disease; Communities; Compassion; Development; Diagnosis; Disease Outcome; Educational Intervention; Engineering; Exercise; Fatigue; Funding; Goals; Health; Health Benefit; Health Care Costs; Health Promotion; Health behavior outcomes; Individual; Intervention; Knowledge; Light; Maintenance; Measures; Mediator of activation protein; Mental Depression; Methodology; Methods; Mindfulness Training; Outcome; Physical activity; Physical activity scale; Population; Population Intervention; Posttraumatic growth; Psychosocial Factor; Public Health; Quality of life; Randomized; Recommendation; Research; Research Design; Research Methodology; Research Priority; Resources; Role; Self Efficacy; Site Visit; Sleep; Social support; Supervision; Survivors; Symptoms; Technology; Testing; Text; Time; Treatment Side Effects; Treatment-Related Cancer; Work; adverse outcome; base; behavior change; burden of illness; cancer care; cancer recurrence; cancer risk; comorbidity; cost; design; disorder risk; emotion regulation; evidence base; exercise intervention; experimental study; fitbit; follow-up; improved; improved outcome; innovation; intervention effect; mHealth; mindfulness; mortality; multiphase optimization strategy; premature; programs; reduce symptoms; remote delivery; response; sedentary; sleep quality; symptom management; symptomatic improvement; telephone coaching; vigorous intensity

PROJECT SUMMARY/ABSTRACT There are approximately 4 million breast cancer survivors (BCS) in the U.S., and this population is expected to increase by 1 million in the next ten years. Increased moderate-to-vigorous intensity physical activity (MVPA) is consistently associated with reductions in treatment-related side effects, cancer recurrence and mortality, and increased QOL in BCS. Yet, the majority of BCS (~70%) do not meet MVPA recommendations (i.e., 150 mins/week). Existing studies of MVPA in BCS are largely resource-intensive, costly, and deliver multiple components (i.e., coaching calls, supervised exercise) simultaneously limiting scalability. Three evidence- based strategies have been identified that may be particularly useful for overcoming these barriers and increasing MVPA in BCS: 1) electronic delivery of a MVPA program, 2) social support, and 3) mindfulness training. However, little is known about the unique roles of social support and mindfulness in MVPA promotion. More granular information about the discrete effects of these components is needed to optimize intervention configuration in order to maximize an effective and scalable MVPA program for BCS. The purpose of this study is to apply the Multiphase Optimization Strategy (MOST), to determine which types of social support and mindfulness training intervention components optimally increase and maintain MVPA in a 6-month mHealth MVPA intervention with a 6-month follow-up. MOST is a framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of intervention components to determine which ones can be reduced, eliminated, or replaced to improve efficiency. Inactive BCS (n=304) will receive a core intervention consisting of the FIt2ThriveMIND app and Fitbit and be randomly assigned to four components under consideration for inclusion in the optimized intervention: 1) general mindfulness training; 2) MVPA-specific mindfulness training; 3) text-coaching; and 4) engagement of a buddy. We will also examine the effects of increasing MVPA on symptom burden, other intensity activities (i.e. light and sedentary), and sleep quality and duration and potential mediators and moderators of component effects. All components with have a 6-month duration except text coaching which will include “boosters” personalized to an individual's MVPA goal- attainment during the 6-month follow-up period. The proposed study represents the first systematic effort to use MOST to design an optimized, scalable mHealth MVPA intervention in BCS that incorporates mindfulness and specifically tests a maintenance strategy. Knowledge gained from this study will inform the development of more effective and scalable interventions to improve health and disease outcomes among BCS. This study will lead to an improved understanding of how to effectively change and maintain BCS' MVPA and inform the development of more effective and scalable interventions to improve health and disease outcomes among BCS.

项目概要/摘要 美国大约有 400 万乳腺癌幸存者 (BCS)，预计这一人群将 未来十年增加100万。增加中等到剧烈强度的体力活动（MVPA） 始终与治疗相关副作用、癌症复发和死亡率的减少相关，并且 BCS 的生活质量提高。然而，大多数 BCS (~70%) 不符合 MVPA 建议（即 150 分钟/周）。 BCS 中 MVPA 的现有研究主要是资源密集型、成本高昂，并且提供多种 组件（即辅导电话、监督锻炼）同时限制了可扩展性。三个证据—— 已经确定了可能对克服这些障碍特别有用的战略 增加 BCS 中的 MVPA：1) 以电子方式交付 MVPA 计划，2) 社会支持，以及 3) 正念 训练。然而，人们对社会支持和正念在 MVPA 推广中的独特作用知之甚少。 需要有关这些组件的离散效应的更详细信息来优化干预 配置，以便最大限度地提高 BCS 的有效且可扩展的 MVPA 程序。本研究的目的 是应用多阶段优化策略（MOST）来确定哪些类型的社会支持和 正念训练干预组件在 6 个月的 mHealth 中最佳地增加和维持 MVPA MVPA 干预并进行 6 个月的随访。 MOST 是一个改编自工程的框架，高度使用 有效的析因实验来评估干预措施的单独和组合效果 确定可以减少、消除或替换哪些内容以提高效率。不活动的 BCS (n=304) 将 接受由 FIt2ThriveMIND 应用程序和 Fitbit 组成的核心干预，并被随机分配给四名 正在考虑纳入优化干预措施的组成部分：1）一般正念训练； 2） MVPA 特定的正念训练； 3）文本辅导； 4) 好友的参与。我们还将检查 增加 MVPA 对症状负担、其他强度活动（即轻度活动和久坐活动）和睡眠的影响 质量和持续时间以及成分效应的潜在中介和调节因素。所有组件都有一个 为期 6 个月，文字辅导除外，其中包括针对个人 MVPA 目标进行个性化的“助推器”- 6个月随访期间的成绩。拟议的研究代表了第一个系统性的努力 使用 MOST 在 BCS 中设计一种优化的、可扩展的 mHealth MVPA 干预措施，其中包含正念 并专门测试维护策略。从这项研究中获得的知识将为开发提供信息 更有效和可扩展的干预措施，以改善 BCS 的健康和疾病结果。这项研究将 提高对如何有效更改和维护 BCS MVPA 的理解，并告知 制定更有效和可扩展的干预措施，以改善健康和疾病结果 BCS。