Targeting Caregivers to Enhance Health Behaviors in Pediatric Cancer Survivors

以护理人员为目标，增强儿童癌症幸存者的健康行为

• 批准号: 8442668
• 负责人: Marilyn Stern
• 金额: $ 20.89万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-24 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8442668
• 关键词: 11 year old; Academic Medical Centers; Acute Lymphocytic Leukemia; Address; Adherence; Adolescent; Age; Attitude; Behavior; Behavioral; Cancer Survivorship; Cardiovascular Diseases; Caregivers; Cephalic; Child; Childhood; Clinic; Data; Development; Diet; Dietary intake; Dose; Eating; Eating Behavior; Effectiveness; Enrollment; Epidemic; Evaluation; Exercise; Family; Feedback; Future; Gender; General Population; Growth; Health; Health Personnel; Health behavior; Health behavior change; Hypertension; Institute of Medicine (U.S.); Intake; Intervention; Knowledge; Link; Literature; Malignant Neoplasms; Measures; Medical Records; Metabolic syndrome; Modeling; Obesity; Overweight; PTPN6 gene; Parents; Participant; Patients; Pattern; Pediatric Hospitals; Perception; Physical activity; Population; Public Health; Quality of life; Race; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Risk; Risk Factors; Role; Surveys; Survivors; Testing; Time; Universities; Variant; Virginia; Weight; Weight Gain; Weight maintenance regimen; Work; acronyms; base; behavior change; cancer therapy; childhood cancer survivor; efficacy testing; follow-up; fruits and vegetables; group intervention; health knowledge; improved; obesity in children; obesity risk; obesity treatment; physical conditioning; post intervention; prevent; programs; public health relevance; response; role model; sarcoma; survivorship; treatment as usual

DESCRIPTION (provided by applicant): Rates of overweight and obesity for off-treatment pediatric cancer survivors (PCS) are high, ranging from about 40% in Acute Lymphoblastic Leukemia survivors to 50% among survivors of some sarcomas. However, in comparison to the general pediatric population where rates of overweight and obesity are also high (approx. 30%), the risk for concomitant negative health consequences is significantly greater in PCS. In line with recent calls in the literature and in accordance with the Institute of Medicine's (IOM) report on the importance of follow-up in promoting healthy behaviors in survivors, we propose a feasibility trial to deal with the increasing overweight and obesity rates among PCS by targeting their caregivers as key agents for PCS behavior change. We specifically focus on caregivers' behaviors, attitudes and roles in promoting healthier eating and physical activity (PA) in PCS and adapt an evidence-informed manualized parent intervention -- NOURISH -- found to be effective for caregivers of overweight and obese children and adolescents. We adapt NOURISH for caregivers of five - 11 year old PCS (6 months to 4 years off active cancer treatment). We propose a pilot feasibility RCT- NOURISH-T (Nourishing Our Understanding of Role modeling to Improve Support for Healthy Transitions) to evaluate 1) the preliminary effectiveness of NOURISH-T for pediatric cancer survivors, compared to an Enhanced Usual Care (EUC) control condition; and 2) factors to consider to improve future adaptations of the intervention, including determining the best time post-cancer treatment to offer the intervention to caregivers based on caregiver participation rates and response variability as a function of the PCS age, gender, race, and time since end of treatment. The proposed project will enroll caregivers of a total of 66 PCS at Virginia Commonwealth University (VCU) and the University of Pittsburgh and Children's Hospital of Pittsburgh (UP) to participate in the 6-session group intervention with assessments occurring pre and post the intervention and at a 6-month follow-up. Primary Specific Aims: 1. to document the feasibility of an optimal time post-cancer treatment to offer a health behavior change intervention (NOURISH-T) targeting eating and physical activity behaviors to caregivers of overweight and obese pediatric cancer survivors (PCS). 2. To test the preliminary efficacy of NOURISH-T on improving child dietary intake, PA, QOL and BMI. Secondary Aim: 3. To explore whether caregivers in NOURISH-T show improved dietary intake, PA, QOL, BMI, and lowered child vulnerability perceptions and child over-protectiveness than caregivers in EUC.

描述（由申请人提供）：停止治疗的儿童癌症幸存者（PCS）的超重和肥胖率很高，范围从急性淋巴细胞白血病幸存者的约40%到某些肉瘤幸存者的50%。然而，与超重和肥胖率也很高的普通儿科人群相比（约为100%），30%），PCS中伴随不良健康后果的风险显著更大。根据最近的呼吁，在文献中，并按照医学研究所（IOM）的报告，后续行动的重要性，促进健康的行为在幸存者，我们提出了一个可行性试验，以处理日益增加的超重和肥胖率之间的PCS针对他们的照顾者作为关键代理PCS行为改变。我们特别关注照顾者在PCS中促进健康饮食和体育活动（PA）的行为，态度和角色，并采用循证的手动父母干预- NOURISH -发现对超重和肥胖儿童和青少年的照顾者有效。我们为5 - 11岁PCS的护理人员（6个月至4年的积极癌症治疗）调整了NOURISH。我们提出了一项试点可行性RCT- NOURISH-T（滋养我们对角色模型的理解，以改善对健康过渡的支持），以评估1）NOURISH-T对儿童癌症幸存者的初步有效性，与增强型糖尿病护理（EUC）对照条件相比;以及2）考虑改善干预的未来适应性的因素，包括基于护理者参与率和响应可变性确定癌症治疗后向护理者提供干预的最佳时间，所述响应可变性是PCS年龄、性别、种族和自治疗结束以来的时间的函数。 拟议的项目将在弗吉尼亚联邦大学（VCU）和匹兹堡大学和匹兹堡儿童医院（UP）招募总共66名PCS的护理人员参加6次小组干预，并在干预前后和6个月随访时进行评估。具体目标：1。记录癌症治疗后最佳时间的可行性，以向超重和肥胖儿童癌症幸存者（PCS）的护理人员提供针对饮食和身体活动行为的健康行为改变干预（NOURISH-T）。2.检测NOURISH-T在改善儿童膳食摄入、PA、QOL和BMI方面的初步疗效。次要目标：3。探讨NOURISH-T中的照顾者是否比EUC中的照顾者显示出改善的饮食摄入、PA、QOL、BMI，以及降低的儿童脆弱性感知和儿童过度保护。