Exploring the concept of dyadic health in Thai couples coping with breast cancer: A preliminary study of a partnered approach to physical activity in breast cancer survivors and spouse care partners

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The proposed supplement application responds to the Notice of Special Interest (NOSI) identified in NOT-CA- 21-058 for projects to stimulate and strengthen global cancer survivorship research. The parent grant is an efficacy trial to determine the benefits of dyadic exercise (e.g., both patients and spouses together) to optimize physical, emotional and relationship health among cancer survivors and their spouse care partners. The parent trial (R01CA218093) focuses on dyadic health of both patients and their spouses, often informal caregivers, who are in turn at higher risk of poor outcomes than spouses who do not care for an ill loved one. Improving health behaviors, such as physical activity, can have a substantial impact on quality of life and survival in cancer survivors and their partners, but most cancer survivors have low rates of physical activity while the health of partners is virtually ignored. Patients living in low to middle income countries (LMIC) face many barriers to exercise, including a lack of supportive care programs specific to the unique needs of cancer patients and a lack of social support to promote behavior change and maintenance. We include the spouse to promote patient retention and adherence to exercise through social support, but also by participating in exercise as well the spouse themselves can also benefit from becoming more physically active. We are proposing build upon an existing relationship between the parent trial’s institution with Mahidol University and the Siriraj Hospital Cancer Center to explore the concept of dyadic health and pilot test an adaption of the parent trial’s dyadic health management strategy to promote physical activity among breast cancer survivors and their spouse care partners. We will conduct a two-phase project, starting with a mixed-methods investigation to assess dyadic adjustment and dyadic health among Thai couples coping with breast cancer and their interest and preferences for a dyadic physical activity program. Data gathered from the first phase will be used to develop and pilot a culturally specific dyadic physical activity program in a sample of Thai couples. The proposed project will stimulate a new collaboration between investigators from the parent trial and investigators and clinicians in Thailand who are interested in learning new approaches to improve outcomes in Thai breast cancer survivors and cancer care partners. The proposed project is directly responsive to the NOSI that calls for administrative supplements to support NCI-funded investigators to leverage existing relationships/partnerships with stakeholders in LMICs to conduct research that will enhance understanding of the gaps in post-treatment follow-up care, with the goal of addressing physical and psychosocial needs of cancer survivors and their caregivers at the individual, facility, and systems levels. Specifically, this project addresses three priority areas listed in the NOSI including: 1) studies to identify supportive care needs of cancer survivors and their caregivers, 2) research to identify strategies/opportunities for developing health promotion interventions, and 3) feasibility studies to understand adoption and adaption of evidence-based survivorship interventions.