Digital Self-Management and Peer Mentoring Intervention to Improve the Transition from Pediatric to Adult Health Care for Childhood Cancer Survivors

数字化自我管理和同伴指导干预，以改善儿童癌症幸存者从儿科向成人医疗保健的过渡

• 批准号: 10715644
• 负责人: Katie A Devine
• 金额: $ 69万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10715644
• 关键词: Accountability; Address; Adherence; Adolescent and Young Adult; Adult; Age; Appointment; Behavior; Cancer Center; Cardiovascular Diseases; Caring; Childhood; Chronic Disease; Disparity; Education; Emotions; Enrollment; Failure; Feedback; Financial Hardship; Future; Goals; Guidelines; Health; Health Services Accessibility; Health behavior; Healthcare; Hispanic; Informal Social Control; Insurance; Intervention; Knowledge; Late Effects; Latino; Learning Module; Link; Longterm Follow-up; Malignant Childhood Neoplasm; Malignant Neoplasms; Managed Care; Mediating; Mediator; Medical Records; Mental Health; Monitor; Neurocognitive; Online Systems; Outcome; Outcome Measure; Parents; Participant; Pediatric Oncology Group; Quality of life; Randomized; Recommendation; Recording of previous events; Reporting; Research; Risk; Sampling; Screening for cancer; Self Care; Self Efficacy; Self Management; Social support; Socioeconomic Status; Subgroup; Surveillance Program; Survivors; Testing; Translating; Translations; Treatment Efficacy; Vulnerable Populations; aged; arm; barrier to care; cancer therapy; childhood cancer survivor; clinical practice; critical developmental period; critical period; digital; digital platform; efficacious intervention; efficacy evaluation; efficacy trial; ethnic health disparity; experience; feasibility trial; follow-up; health management; health record; health related quality of life; improved; innovation; interest; low health literacy; medical appointment; mobile application; neoplasm registry; novel; peer coaching; poor health outcome; racial disparity; randomized trial; scale up; screening guidelines; skills; social; social health determinants; survivorship; theories; therapy design; treatment as usual; treatment center; treatment effect; usability; virtual; young adult

Project Summary/Abstract Childhood cancers require lifelong risk-based follow-up care tailored to their treatment exposures, including routine medical appointments, monitoring for late effects, and regular cancer screenings. Unfortunately, less than 1 in 5 adult survivors of childhood cancer obtain such risk-based follow-up care. The transition from pediatric to adult follow-up care for adolescent and young adult (AYA) survivors is a critical period when many survivors are lost to follow-up, particularly AYA survivors who identify as Hispanic or have low self-efficacy to manage their care. While the barriers to care are well-characterized, there are no efficacious interventions to help improve this transition for AYA survivors of childhood cancer. To address this gap, we developed Managing Your Health, a digital self-management and peer mentoring intervention to improve survivorship care self-management. It consists of six 1:1 virtual sessions with a peer mentor, another young adult survivor who independently manages their own care. Each session involves discussion of a complementary web-based self-management educational module. Peer mentors act as supportive accountability agents, providing specialized support based on shared experience and facilitating engagement with the modules. Our preliminary two-arm randomized feasibility trial showed that survivors found the intervention useful, were highly engaged, and reported significant improvements in self-management. Per participant feedback, we translated the web-based modules into a mobile app for easier accessibility. The goal of this project is to evaluate the efficacy of Managing Your Health (app + peer mentoring) compared with educational control in a two-arm randomized trial with 300 young adult survivors of childhood cancer currently aged 18-25 years. We will oversample for AYA survivors who identify as Hispanic given evidence of low self- efficacy and follow-up care in this group. Participants will complete outcome measures at baseline, 3 months, and 12 months post-randomization, with medical record abstraction for guideline-concordant care at 12 months. Specific aims will evaluate the efficacy of the intervention on self-management behaviors, quality of life, and adherence to guideline-concordant follow-up care, as well as mediators and moderators of treatment effects. The proposed research aligns with priorities detailed in the notice of special interest “Navigating Pediatric to Adult Health Care: Lost in Translation,” and seeks to address gaps in the long-term health care of childhood cancer survivors by evaluating an innovative theory-based intervention to facilitate the transition from pediatric to adult self-management of care.

项目总结/文摘