Adaptation and implementation of a community-based intervention to reduce psychosocial distress and promote physical activity in rural breast cancer survivors

适应和实施基于社区的干预措施，以减少农村乳腺癌幸存者的社会心理困扰并促进身体活动

• 批准号: 10204942
• 负责人: Scherezade Kelly Mama
• 金额: $ 16.57万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10204942
• 关键词: Adoption; Adult; Aerobic; Aerobic Exercise; Area; Breast Cancer survivor; Cancer Control; Cancer Intervention; Cancer Survivor; Cancer Survivorship; Clinical; Collaborations; Communities; Data; Data Collection; Dissemination and Implementation; Distress; Educational workshop; Effectiveness; Evidence based intervention; Feedback; Focus Groups; Future; Goals; Health; Health Resources; Home; Intervention; Interview; K-Series Research Career Programs; Leisures; Life Style; Literature; Location; Medical Oncologist; Mental Health; Mentors; Methods; Morbidity - disease rate; Oncology Nurse; Outcome; Participant; Pennsylvania; Personal Satisfaction; Phase; Physical Function; Physical activity; Population; Positioning Attribute; Psychosocial Stress; Public Health; Quality of life; Randomized Controlled Trials; Reading; Recommendation; Recurrence; Reporting; Research; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Rural; Rural Community; Rural Population; Safety; Survivors; Telephone; Testing; Text; Time; Training; Translations; Underserved Population; Work; base; body-mind; cancer diagnosis; cancer health disparity; cancer prevention; career; community partnership; community setting; comorbidity; design; diaries; dissemination research; effectiveness implementation study; evidence base; exercise intervention; experience; health care availability; health disparity; implementation efforts; implementation outcomes; implementation research; improved; innovation; intervention participants; meetings; mortality; multidisciplinary; physical conditioning; physical inactivity; post intervention; preference; programs; psychological distress; psychosocial; public health relevance; recruit; skills; survivorship; treatment as usual; vigorous intensity

PROJECT SUMMARY / ABSTRACT Rural cancer survivors are less likely to meet physical activity recommendations than urban cancer survivors, contributing to physical inactivity-related cancer health disparities. Evidence-based interventions to reduce psychosocial distress and increase physical activity in cancer survivors were developed in urban or clinical settings and often fail when implemented in rural community settings. The goal of this career development award is to assist Scherezade K. Mama, DrPH in her long-term goal of becoming an independent investigator in designing and implementing physical activity interventions in underserved populations, including rural cancer survivors, to improve health outcomes and reduce health disparities. Dr. Mama’s short-term goals include gaining expertise in the use of psychosocial intervention methods, cancer survivorship and interventions to improve survivorship outcomes, intensive longitudinal methods, and dissemination and implementation research. In collaboration with her multidisciplinary team of mentors and advisors, she has developed a training plan to reach these goals via coursework, workshops, scientific meetings, directed readings, and a mentored research project. The primary objective of the proposed research project is to use a community- engaged approach to develop and evaluate an intervention to reduce psychosocial stress and increase physical activity in rural breast cancer survivors in central Pennsylvania. Focus groups (n=6) with community stakeholders and rural breast cancer survivors will be conducted to (a) determine how to best modify an evidence-based intervention for rural cancer survivors and for implementation in a community setting and (b) feedback the modified intervention. Rural breast cancer survivors (n=50) will be recruited through an existing community partnership to participate in the 3-month adapted community-based intervention or to receive usual care. The intervention consists of face-to-face and home-based sessions incorporating aerobic exercise and mind-body strategies to reduce psychosocial distress and increase physical activity. Participants complete assessments at four time points (baseline, 6-weeks, post-intervention, 6-months) and complete daily diaries assessing daily distress and physical activity throughout the 3-month intervention period. In-depth interviews will be conducted with intervention participants (n=25) and community stakeholders (n=10) after the 6-month study period to explore implementation outcomes. Findings from this study will fill a critical gap in the literature on the translation of evidence-based interventions into sustained practice in community settings and will inform the next phase of this research, an effectiveness-implementation hybrid study of a large-scale community- based randomized controlled trial to reduce psychosocial distress and increase physical activity in rural breast cancer survivors. Completion of the proposed research and training aims will provide Dr. Mama with the skills, experience, and preliminary data needed to launch a successful independent research career in physical activity promotion, cancer prevention and control, and health disparities.

项目概要/摘要 农村癌症幸存者比城市癌症幸存者更不可能达到体育活动建议， 导致与身体缺乏活动相关的癌症健康差异。循证干预措施可减少 癌症幸存者的心理社会困扰和增加身体活动是在城市或临床中发展的 但在农村社区实施时往往会失败。本职业发展目标 该奖项旨在协助 Scherezade K. Mama, DrPH 实现成为独立调查员的长期目标 为服务不足的人群（包括农村癌症）设计和实施体育活动干预措施 幸存者，以改善健康结果并减少健康差距。妈妈博士的短期目标包括 获得使用心理社会干预方法、癌症生存和干预措施的专业知识 改善生存结果、强化纵向方法以及传播和实施 研究。她与她的多学科导师和顾问团队合作，开发了 通过课程作业、研讨会、科学会议、定向阅读和指导来实现这些目标的培训计划 指导的研究项目。拟议研究项目的主要目标是利用社区- 参与式方法来制定和评估干预措施，以减少社会心理压力并增加 宾夕法尼亚州中部农村乳腺癌幸存者的体力活动。社区焦点小组 (n=6) 将与利益攸关方和农村乳腺癌幸存者进行（a）确定如何最好地修改 对农村癌症幸存者进行循证干预并在社区环境中实施；(b) 反馈修改后的干预措施。农村乳腺癌幸存者（n = 50）将通过现有的招募 社区伙伴关系参与为期 3 个月的适应性社区干预或接受常规干预 关心。干预措施包括面对面和家庭会议，其中包括有氧运动和 减少心理困扰和增加身体活动的身心策略。参与者完成 四个时间点（基线、6周、干预后、6个月）的评估和完整的每日日记 评估整个 3 个月干预期间的日常痛苦和体力活动。深度访谈 将在 6 个月后与干预参与者 (n=25) 和社区利益相关者 (n=10) 一起进行 研究期探索实施成果。这项研究的结果将填补文献中的一个关键空白 将循证干预措施转化为社区环境中的持续实践，并将提供信息 这项研究的下一阶段是对大型社区进行有效性实施混合研究 基于随机对照试验，以减少农村乳房的社会心理困扰并增加体力活动 癌症幸存者。完成拟议的研究和培训目标将为妈妈博士提供以下技能： 成功开展物理领域独立研究生涯所需的经验和初步数据 活动促进、癌症预防和控制以及健康差异。