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An Interactive E-Health Program to Promote Health Behaviors among Cancer Survivor

促进癌症幸存者健康行为的互动电子健康计划

基本信息

批准号：
8214517
负责人：
PAUL KREBS
金额：
$ 9.22万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-02-01 至 2014-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8214517
关键词：
Address Adherence Adopted Adult Aftercare Age Aging Appointment Behavior Behavior Therapy Behavioral Cancer Patient Cancer Survivor Cardiovascular Diseases Caring Clinic Clinic Visits Clinical Cognitive Collaborations Colorectal Cancer Communication Programs Communications Media Comorbidity Data Detection Diabetes Mellitus Diet Dietary Practices Disease Education Elderly Evidence based intervention Fatigue Goals Health Health Communication Health Personnel Health Promotion Health behavior Health behavior change Healthcare High Fiber Diet Low Fat Home environment Instruction Intervention Knowledge Life Life Style Malignant Neoplasms Malignant neoplasm of prostate Measures Memorial Sloan-Kettering Cancer Center Methodology Morbidity - disease rate Multimedia Neoplasm Metastasis Oncologist Osteoporosis Outcome Pain Participant Patients Persons Phase Physical activity Physicians Pilot Projects Population Preventive Primary Health Care Printing Provider Quality of life Recommendation Recording of previous events Recruitment Activity Recurrence Reporting Research Risk Risk Behaviors Risk Factors Sampling Self Efficacy Smoking Staging Surveys Survival Rate Survivors Technology Telephone Testing Time Tobacco Use Cessation Training United States active method base behavior change cancer care cancer diagnosis cancer therapy cohort design evidence base experience follow-up functional disability high risk improved interest intervention program malignant breast neoplasm meetings motivated behavior programs public health relevance smoking cessation social survivorship theories tool

项目摘要

DESCRIPTION (provided by applicant): Cancer survivors need assistance from their healthcare providers in quitting smoking, and improving their physical activity and dietary behaviors within the context of their post-treatment cancer care. Physician advice has been shown to motivate behavior change, yet clinicians report multiple barriers in assisting patients to implement such changes. This pilot project will examine the feasibility and potential impact of an intervention for promoting healthy lifestyle behaviors as cancer patient's transition to survivorship. We will use a systematic methodology to adapt existing print and telephone-based interventions to an interactive e-health format for self- directed home use. The program, based on DVD format, will be able to be readily integrated into the clinical encounter as an enhancement to clinician advice by providing education and behavior change strategies. In collaboration with four follow-up care clinics, we will recruit a sample of participants with a history of the most prevalent cancers. Using a within-clinic, pre-post design, all patients will be screened for smoking, dietary, and physical activity behaviors. We will recruit cancer survivors at the time of their follow-up clinic appointments and provide the health communication program with instruction to use it at home. Changes in health behaviors and theory-driven variables related to health behavior change will be accessed via phone three months following participants' appointments. This project represents an important effort to disseminate best-practices for a high-risk population of cancer survivors using an inexpensive, yet underutilized communication medium. PUBLIC HEALTH RELEVANCE: There are an estimated 10.8 million persons in the United States who have a history of cancer, a number that has been steadily increasing due to progress in detection and treatment and the overall aging of the population. The 5-year expected survival rate now averages 66% for all cancers and is as high as 98% for early stage breast and prostate cancers. The lives of cancer survivors, however, are often marked by health problems including comorbidities such as cardiovascular disease, diabetes and osteoporosis, as well as treatment sequelae and functional deficits. Cancer survivors are more likely to be older, to die from non-cancer causes, and to suffer functional impairments of daily living than those who have not had a cancer diagnosis. Despite their increased vulnerability, significant percentages of cancer survivors remain nonadherent to lifestyle behavior recommendations, suggesting the need for follow-up care that more fully addresses preventive healthcare and management of comorbid conditions. Although numerous surveys indicate that most survivors are interested in improving their health, several studies have found that a diagnosis of cancer does not necessarily result in increased adherence to healthy lifestyles. A range of interventions is clearly needed to meet the needs of cancer survivors in adopting healthy lifestyle changes. Since most cancer survivors prefer to receive health-related information from their oncologists and/or primary care providers, they need to have the capacity to deliver the assistance that survivors expect. Physician advice has been shown to motivate behavior change, yet clinicians report multiple barriers (e.g., time and training) in assisting patients to implement such changes. This proposed study will address this need by developing and pilot testing an interactive e-health behavior change tool that clinicians can give to patients recently completing cancer treatment that will provide a). Information about the benefits of healthy lifestyle behaviors in survivorship and b). Evidence-based strategies for making desired behavior changes. We will use a carefully planned qualitative and quantitative methodology for adapting evidence-based interventions to the e-health format, thereby supporting a much-needed effort to create a viable survivor-targeted intervention that meets both providers' and survivors' needs. Ultimately, if this theory-based, targeted enhancement is disseminated, it promises to achieve significant impact in reducing behavioral risk factors by reaching a large number of survivors.

描述（由申请人提供）：癌症幸存者需要他们的医疗保健提供者帮助戒烟，并在治疗后癌症护理的背景下改善他们的身体活动和饮食行为。医生的建议已被证明可以激励行为改变，但临床医生报告说，在帮助患者实施这种改变方面存在多种障碍。这个试验项目将研究在癌症患者向生存过渡时，促进健康生活方式行为的干预措施的可行性和潜在影响。我们将使用一种系统的方法来调整现有的印刷和电话为基础的干预措施，以互动的电子健康格式的自我导向的家庭使用。该计划，DVD格式的基础上，将能够很容易地集成到临床遇到作为一个增强临床医生的建议，提供教育和行为改变策略。我们将与四家后续护理诊所合作，招募一批有最常见癌症病史的参与者。采用诊所内、前后设计，对所有患者进行吸烟、饮食和体力活动行为筛查。我们将在癌症幸存者的后续诊所预约时招募他们，并提供健康沟通计划，指导他们在家中使用。健康行为的变化和与健康行为变化相关的理论驱动变量将在参与者预约后三个月通过电话访问。该项目是一项重要的努力，利用一种廉价但未得到充分利用的传播媒介，向癌症幸存者高危人群传播最佳做法。公共卫生关系：据估计，美国有1080万人有癌症史，由于检测和治疗的进步以及人口的整体老龄化，这个数字一直在稳步增长。所有癌症的5年预期存活率平均为66%，早期乳腺癌和前列腺癌的5年预期存活率高达98%。然而，癌症幸存者的生活往往伴随着健康问题，包括心血管疾病、糖尿病和骨质疏松症等合并症，以及治疗后遗症和功能缺陷。癌症幸存者更有可能年龄更大，死于非癌症原因，并且比那些没有癌症诊断的人遭受日常生活功能障碍。尽管他们的脆弱性增加，显着比例的癌症幸存者仍然不遵守生活方式的行为建议，这表明需要后续护理，更全面地解决预防性医疗保健和共病的管理条件。虽然许多调查表明，大多数幸存者有兴趣改善他们的健康状况，但一些研究发现，癌症的诊断并不一定会导致对健康生活方式的坚持。显然需要一系列干预措施来满足癌症幸存者改变健康生活方式的需求。由于大多数癌症幸存者更愿意从肿瘤学家和/或初级保健提供者那里获得与健康相关的信息，他们需要有能力提供幸存者所期望的援助。医生的建议已被证明可以激励行为改变，但临床医生报告了多种障碍（例如，时间和培训），以帮助患者实施这些变化。这项拟议的研究将通过开发和试点测试一种交互式电子健康行为改变工具来满足这一需求，临床医生可以将该工具提供给最近完成癌症治疗的患者。关于健康生活方式行为对生存率和B）的益处的信息。基于证据的策略，使所需的行为改变。我们将使用一种精心规划的定性和定量方法，使循证干预措施适应电子保健形式，从而支持急需的努力，以创造一种可行的、以幸存者为目标的干预措施，满足提供者和幸存者的需求。最终，如果这种基于理论的有针对性的增强被传播，它有望通过接触大量幸存者来减少行为风险因素。