A web-based tailored health behavior intervention for African American colon canc

针对非裔美国人结肠癌的基于网络的定制健康行为干预

• 批准号: 7690837
• 负责人: MARLYN A Allicock
• 金额: $ 7.4万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-23 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7690837
• 关键词: Accounting; Address; Adoption; Affect; African American; Age; Aging; Baseline Surveys; Behavior; Behavior Therapy; Behavioral Research; Cancer Control; Cancer Etiology; Cancer Prognosis; Cancer Survivor; Cancer Survivorship; Cessation of life; Chronic Disease; Church; Cognitive; Colon; Colon Carcinoma; Comorbidity; Computers; Consumption; Data Collection; Development; Diagnosis; Diet; Disease; Effectiveness; Effectiveness of Interventions; Electronics; Ethnic Origin; Evaluation; Fatty acid glycerol esters; Feedback; Female; Genus Cola; Goals; Grant; Health Promotion; Health behavior; Hour; Incidence; Intake; Internet; Intervention; Life Style; Link; Mails; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Methods; Minority; Morbidity - disease rate; Names; Newsletter; North Carolina; Online Systems; Outcome; Participant; Physical activity; Pilot Projects; Population; Population Group; Primary Neoplasm; Printing; Process; Psychosocial Factor; Race; Randomized; Rectal Cancer; Recurrence; Research; Risk; Rural; Second Primary Cancers; Secondary Prevention; Self Efficacy; Social support; Staging; Subgroup; Surveys; Survival Rate; Technology; Testing; United States; Videotape; behavior change; cancer diagnosis; cancer prevention; demographics; design; eligible participant; experience; fruits and vegetables; good diet; health disparity; improved; interest; intervention effect; intervention program; lifestyle factors; male; member; mortality; new technology; post intervention; programs; psychosocial; randomized trial; secondary outcome; successful intervention; web site

DESCRIPTION (provided by applicant): Background African Americans experience disproportionate morbidity and mortality from colon and rectal cancers. Diets high in fruits and vegetables and moderate to vigorous physical activity all have the potential to significantly reduce colon cancer incidence and mortality, as well as risk for other co-morbidities. However, surprisingly, there have been relatively few empirically tested health behavior (diet and physical activity) interventions in African American colon cancer survivors. One reason may relate to the challenges of developing successful interventions, particularly for minority populations; thus, it may be particularly worthwhile to adapt programs which have demonstrated effectiveness in one population group to other segments of the population. The WATCH (Wellness for African Americans Through Churches) Project was a randomized trial in 12 rural North Carolina churches that demonstrated the effectiveness of a mailed tailored print and video (TPV) intervention consisting of four individually tailored newsletters and targeted videotapes to improve these behaviors. Results showed significant improvements (p<.05) for fruit and vegetable consumption (0.6 servings) and recreational physical activity (2.5 MET hours per week). Aims Here, we propose to conduct a pilot study (e-WATCH) to investigate whether the WATCH tailored print messages and videotapes can be effectively and efficiently disseminated to a different group of African Americans (colon cancer survivors) and using a different delivery channel or method (electronic technology via the internet). Secondary aims are to determine whether this intervention results in improvements in secondary outcomes, specifically self-efficacy and social support for improving health behaviors; and to use process evaluation measures to assess the feasibility, acceptability, and potential for wider dissemination of the e- WATCH program. Methods To accomplish these objectives, we will develop a password-protected website for e-WATCH that participants will access via the internet. Eligible participants will be African American males and females in North Carolina (n=200), 40-79 years, diagnosed with either Stage I or II colon cancer who have successfully completed treatment for their disease and who are at least 6 months post-diagnosis. Participants will be randomly assigned to receive the culturally and individually tailored intervention or the control condition (n=100 per group). They will complete a baseline survey online (querying on diet, physical activity, demographics, and psychosocial factors) and then will receive the WATCH tailored feedback and information (including the videotapes in digitized format) via the internet over a 5-6 month period after baseline data collection. Approximately six months after baseline, participants will complete a second survey assessing the same health behavior and psychosocial factors as at baseline. Control participants will receive a "delayed" intervention. Process and outcome evaluation measures collected pre- and post-intervention will assess exposure, cognitive processing, use of information, and acceptability. Evaluation will test whether this method of disseminating the WATCH program utilizing new technology produces comparable results to the previous randomized trial findings (i.e., the WATCH project). Significance This pilot study would inform on the potential to use the internet to deliver a culturally and individually tailored health behavior intervention in African American colon cancer survivors and whether such a program can be efficacious and feasible in this population, as well as on the extent to which psychosocial mediators such as social support and self-efficacy affect intervention effectiveness in this population. This project would also contribute to the understanding of how successful health promotion interventions can be modified for use in different segments of the population and for alternative forms (channels) of delivery.

描述（由申请人提供）：背景非裔美国人经历结肠癌和直肠癌的不成比例的发病率和死亡率。富含水果和蔬菜的饮食以及中等到剧烈的体力活动都有可能显着降低结肠癌的发病率和死亡率，以及其他合并症的风险。然而，令人惊讶的是，在非裔美国人结肠癌幸存者中，经过经验检验的健康行为（饮食和体育活动）干预相对较少。原因之一可能与制定成功的干预措施，特别是针对少数群体的干预措施的挑战有关;因此，特别值得将在一个人口群体中证明有效的方案适用于其他人口群体。WATCH（Wellness for African Americans Through Churches）项目是一项在北卡罗来纳州12个农村教堂进行的随机试验，该试验证明了邮寄定制印刷品和视频（TPV）干预的有效性，该干预包括四份单独定制的通讯和有针对性的录像带，以改善这些行为。结果显示，水果和蔬菜消费量（0.6份）和娱乐性体力活动（每周2.5 MET小时）有显著改善（p<0.05）。在这里，我们建议进行一项试点研究（电子手表），以调查手表定制的印刷信息和录像带是否可以有效和高效地传播到一个不同的群体的非洲裔美国人（结肠癌幸存者），并使用不同的传递渠道或方法（通过互联网的电子技术）。次要目的是确定这种干预是否会导致次要结局的改善，特别是改善健康行为的自我效能和社会支持;并使用过程评估措施来评估e-WATCH计划的可行性、可接受性和更广泛传播的潜力。方法为了实现这些目标，我们将开发一个密码保护的网站，参与者将通过互联网访问的电子手表。合格的参与者将是北卡罗来纳州的非裔美国男性和女性（n=200），年龄40-79岁，被诊断患有I期或II期结肠癌，已成功完成疾病治疗并且至少6个月诊断后。参与者将被随机分配接受文化和个人定制的干预或对照条件（每组n=100）。他们将在线完成基线调查（询问饮食、体力活动、人口统计学和心理社会因素），然后在基线数据收集后的5-6个月内通过互联网接收WATCH定制的反馈和信息（包括数字化格式的录像带）。基线后约6个月，参与者将完成第二次调查，评估与基线相同的健康行为和心理社会因素。对照组受试者将接受“延迟”干预。干预前后收集的过程和结果评价指标将评估暴露、认知处理、信息使用和可接受性。评价将测试这种利用新技术传播WATCH计划的方法是否产生与先前随机试验结果相当的结果（即，WATCH项目）。意义这个试点研究将告知潜在的使用互联网提供一个文化和个人定制的健康行为干预在非裔美国人结肠癌幸存者和这样一个程序是否可以有效和可行的在这个人群中，以及在何种程度上心理社会中介，如社会支持和自我效能影响干预效果在这个人群。该项目还将有助于了解如何修改成功的健康促进干预措施，以用于不同的人群和替代的提供形式（渠道）。