Micro-randomized trial of a physical activity intervention to manage pain symptoms among older cancer survivors

项目总结/摘要 老年癌症幸存者特别受到癌症及其治疗的影响， 以及心理社会的短期和长期副作用，例如增加经历慢性疼痛的风险 症状强有力的证据表明，体力活动与慢性疼痛的低评级症状相关。 尽管身体活动的好处众所周知，但只有7%的老年癌症幸存者符合当前的身体活动 建议.老年癌症患者的高疼痛评分与低体力活动水平相关 幸存者因此，了解如何以及何时最好地进行身体活动干预至关重要 健康信息传递，以减少经历慢性疼痛的老年癌症幸存者的慢性疼痛症状 疼痛症状。本申请书提出了惠特尼·韦尔奇博士的职业发展计划， 独立的研究项目，研究身体活动和维持 通过减少老年癌症幸存者的慢性症状来提高独立性。韦尔奇博士的职业生涯 发展将得到一个特殊的跨学科研究小组的支持，该小组具有悠久的历史 联邦资金和成功的指导记录。她的导师Rini博士Spring博士和Wolf博士 是国际公认的癌症生存，适应性干预设计领域的学者， 卫生知识普及和卫生宣传。该应用程序的总体目标是开发和 测试身体活动促进信息的时间，以增加身体活动并减少疼痛症状 在经历慢性疼痛症状的老年癌症幸存者中使用微随机试验设计。 在目标1中，我们建议使用以患者为中心的健康素养方法来开发和选择基于理论的 健康信息，增加幸存者参与针对其当前疼痛的体力活动的可能性 症状在目标2中，我们将进行微观随机试验，这是一种新的实验设计， 优化即时干预的构建，以确定最佳疼痛状态（疼痛/无痛）， 传递一个信息，以增加身体活动和概率，老年癌症幸存者将从事 体力活动。最后，我们提出了一个探索性的目标，以确定最佳的疼痛状态（疼痛/无疼痛）， 传递信息以增加身体活动，并且参与者将经历随后的 疼痛发作本研究的结果将为R 01提交提供坚实的基础，以便进行 时间适应性体力活动干预治疗老年癌症幸存者的疼痛症状这个奖项将 直接导致建立一个独立的研究计划，在身体活动和健康研究 在老年癌症幸存者中。

PROJECT SUMMARY/ABSTRACT The older cancer survivor is particularly affected by cancer and its treatments with numerous physical, mental, and psychosocial short- and long-term side effects, such as an increase in risk to experience chronic pain symptoms. Strong evidence indicates physical activity is correlated with lower rated symptoms of chronic pain. Despite the known benefits of physical activity, only 7% of older cancer survivors meet current physical activity recommendations. High ratings of pain are associated with low physical activity levels in older cancer survivors. Therefore, it is critical to understand how and when to best deliver physical activity intervention health messaging to reduce chronic pain symptoms among older cancer survivors who experience chronic pain symptoms. This application proposes the career development plan for Dr. Whitney Welch to establish an independent research program examining the relationship between physical activity and the maintenance of independence through the reduction of chronic symptoms among older cancer survivors. Dr. Welch's career development will be supported by an exceptional interdisciplinary group of investigators with a lengthy history of federal funding and a track record of successful mentorships. Her mentors, Dr. Rini, Dr. Spring, and Dr. Wolf are internationally recognized scholars in the areas of cancer survivorship, adaptive intervention design, and health literacy and health communications, respectively. The overall aim of this application is to develop and test the timing of physical activity promotion messages to increase physical activity and reduce pain symptoms among older cancer survivors who experience chronic pain symptoms using a micro-randomized trial design. In Aim 1, we propose to use a patient-centered, health literacy approach to develop and select theory-based health messaging that increase survivors' likelihood of engaging in physical activity tailored to their current pain symptoms. In Aim 2, we will conduct a micro-randomized trial, a new experimental design developed to optimize the construction of in-the-moment interventions, to determine the optimal pain state (pain/no pain) to deliver a message to increase physical activity and the probability that older cancer survivors will engage in physical activity. Finally, we propose an exploratory aim to determine the optimal pain state (pain/no pain) to deliver the message to increase physical activity and the probability participants will experience a subsequent pain episode. Results from this study will provide a robust foundation for a R01 submission to conduct a just-in- time adaptive physical activity intervention to manage pain symptoms in older cancer survivors. This award will directly lead to the establishment of an independent research program in physical activity and health research among older cancer survivors.