Optimization of a mHealth Physical Activity Promotion Intervention with Mindful Awareness for Adolescent and Young Adult Cancer Survivors

优化青少年和年轻癌症幸存者的 mHealth 身体活动促进干预措施和正念意识

• 批准号: 10679048
• 负责人: Siobhan Marie Phillips
• 金额: $ 63.1万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679048
• 关键词: Accelerometer; Address; Adherence; Adolescent and Young Adult; Adolescent and young adult cancer patients; Adverse effects; Age; American Cancer Society; Anxiety; Awareness; Behavior; Cancer Burden; Cancer Prognosis; Cancer Survivor; Cancer Survivorship; Cellular Phone; Cessation of life; Child Care; Chronic Disease; Communities; Compassion; Development; Disease Outcome; Educational Intervention; Electronics; Emotional; Engineering; Exercise; Fatigue; Funding; Gender; Goals; Health; Health Benefit; Health Care Costs; Health Promotion; Health behavior and outcomes; Height; Individual; Intervention; Knowledge; Light; Malignant Neoplasms; Measures; Mediator; Mental Depression; Methodology; Methods; Mindfulness Training; Morbidity - disease rate; Outcome; Physical activity; Population; Population Intervention; Posttraumatic growth; Psychosocial Factor; Public Health; Quality of life; Randomized; Recommendation; Recurrent Malignant Neoplasm; Research; Research Design; Research Methodology; Research Priority; Resources; Risk; Role; Schools; Self Efficacy; Site Visit; Sleep; Social support; Survival Rate; Survivors; Symptoms; Technology; Testing; Time; Treatment Side Effects; Treatment-Related Cancer; Work; behavior change; burden of illness; cancer care; cancer recurrence; cancer type; comorbidity; cost; design; digital health; disorder risk; emotion regulation; evidence base; exercise intervention; experience; experimental study; fitbit; follow-up; improved; improved outcome; intervention effect; mHealth; mindfulness; mortality; multiphase optimization strategy; peer; premature; programs; psychosocial; reduce symptoms; remote delivery; response; sedentary; sleep quality; telephone coaching; vigorous intensity

PROJECT SUMMARY/ABSTRACT There are approximately 680,000 adolescent and young adult cancer survivors (AYACS) in the U.S., and the survival rate in this group is increasing. AYACS experience a myriad of deleterious treatment-related side effects, higher rates of physical and emotional problems and are at a heighted risk of early morbidity and mortality compared to non-cancer age-matched controls. Increased moderate to vigorous intensity physical activity (MVPA) is consistently associated with enhanced quality of life (QOL), reduced cancer treatment- related side effects and chronic disease risk, and improved cancer prognosis in cancer survivors. Yet, the majority of AYACS (~60%) do not meet cancer-specific MVPA recommendations (i.e., 150 mins/week), and very little research on MVPA in cancers survivors has focused specifically on AYACS. Existing studies of MVPA in survivors are largely resource-intensive, costly, and deliver multiple components (i.e., coaching calls, supervised exercise) simultaneously limiting scalability. Three evidence-based strategies have been identified that may be particularly useful for overcoming these barriers and increasing MVPA in AYACS: 1) electronic delivery of a MVPA program, 2) social support, and 3) mindfulness training. However, little is known on the unique roles of social support and mindfulness in MVPA promotion. More granular information about the discrete effects of these components is needed to optimize intervention configuration in order to maximize an effective and scalable MVPA program for AYACS. The purpose of this study is to apply the Multiphase Optimization Strategy (MOST), to determine which types of social support and mindfulness training intervention components optimally increase MVPA in a 12-week mHealth MVPA intervention with a 12 week follow-up. MOST is a framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of intervention components to determine which ones can be reduced, eliminated or replaced to improve efficiency. Inactive AYACS (n=304) will receive a core intervention consisting of the OPTIMAL AYAO app and Fitbit and be randomly assigned to 4 components under consideration for inclusion in the optimized intervention: 1) general mindfulness training; 2) MVPA specific mindfulness training; 3) e-coach and 4) engagement of a buddy. We will also examine the effects of increasing MVPA on symptom burden, intensities of other activities (i.e. light and sedentary), and sleep quality and duration and potential mediators and moderators of component effects. The proposed study represents the first systematic effort to use MOST to design an optimized, scalable mHealth MVPA intervention for AYACS. This study will lead to an improved understanding of how to effectively change AYACS' MVPA and ultimately, improve health and disease outcomes in this population.

项目摘要/摘要 美国大约有680,000名青少年和年轻的成年癌症幸存者（AYACS），以及 该组的生存率正在增加。 AYACS经历了无数有害治疗相关的一面 影响，身体和情绪问题的较高率，并且有早期发病率的风险高 与非癌症年龄匹配的对照相比，死亡率。中度到剧烈的身体增加 活动（MVPA）始终与增强的生活质量（QOL），癌症治疗降低相关 - 相关的副作用和慢性疾病风险，并改善了癌症幸存者的癌症预后。但是， 大多数AYAC（约60％）不符合特定于癌症的MVPA建议（即150分钟/周），而 对癌症幸存者中MVPA的研究很少，专门针对AYACS。现有的研究 幸存者的MVPA在很大程度上是资源密集的，昂贵的，并提供多个组件（即教练电话， 监督练习）同时限制可扩展性。已经确定了三种基于证据的策略 这对于克服这些障碍和增加AYAC中的MVPA可能特别有用：1）电子 提供MVPA计划，2）社会支持和3）正念培训。但是，在 社会支持和正念在MVPA促销中的独特作用。关于 需要这些组件的离散效果来优化干预配置，以最大化 AYACS的有效且可扩展的MVPA程序。这项研究的目的是应用多相 优化策略（大多数），确定哪些类型的社会支持和正念培训 干预组件在12周的MHealth MVPA干预措施中最佳地增加MVPA，12周 后续。大多数是根据工程改编的框架，该工程使用高效的阶乘实验 评估干预组件的个人和结合的影响，以确定哪些可以是 减少，消除或更换以提高效率。非活动的AYAC（n = 304）将接受核心干预 由最佳AYAO应用程序和Fitbit组成，并随机分配给4个组件 考虑纳入优化干预措施：1）一般正念训练； 2）特定于MVPA 正念训练； 3）电子指导和4）伙伴的参与。我们还将研究增加的影响 MVPA症状负担，其他活动的强度（即光和久坐）以及睡眠质量和 持续时间和潜在的介体和组件效应的主持人。拟议的研究代表了第一个 系统的努力用于设计针对AYACS的优化，可扩展的MHealth MVPA干预。这 研究将使人们对如何有效改变AYACS的MVPA以及最终，最终对如何有效地了解 改善该人群的健康和疾病结果。