Web-based Physical Activity Intervention for Young Adult Cancer Survivors

描述（由申请人提供）：被诊断患有癌症的年轻人是一个特别脆弱的群体，他们的医疗和心理社会需求往往被忽视。那些年龄在18岁到39岁之间被诊断患有癌症的人面临着许多增加的风险，包括心血管疾病、第二次癌症和情绪困扰的风险增加。尽管如此，只有很小比例的癌症研究关注年轻人的生存问题。拟议研究的目标是通过开发和试点测试针对这一人群的体育活动干预来解决年轻成年癌症幸存者中一些未满足的需求。选择体育活动作为目标行为如下：1。年轻的成年癌症幸存者中有很高比例的人有久坐不动的生活方式。研究表明，增加体育锻炼的癌症幸存者心肺功能得到改善，疲劳减少，情绪改善，癌症治疗效果更好。干预将基于先前开发的、有理论基础的、针对久坐不动的成年人量身定制的互联网干预。这种先前开发的干预措施使用跨理论模型和社会认知理论的组成部分来促进身体活动；例如，参与者每月在网上完成问卷调查，并收到针对他们的自我效能、决策平衡和变革过程的量身定制的反馈报告。干预网站还包括一些功能，比如在照顾幼儿的同时锻炼的技巧和当地的体育活动资源。干预网站将增加两个关键的增强功能，以针对年轻的成年癌症幸存者人群。与癌症幸存者开始锻炼计划有关的信息；点对点支持组件。一旦增加了这些改进，10名年轻的成年癌症幸存者将评估干预措施并提供定性反馈。根据这一反馈，将根据需要对干预措施进行进一步修订。该干预措施将在40名年轻成年癌症幸存者中进行试点测试。参与者将被随机分配到干预组（接受12周的干预网站访问）或对照组（接受三个癌症特定网站的信息）。将收集干预的可行性和可接受性数据，以及干预效果的初步数据（即体力活动水平、情绪和疲劳）。后者将用于设计未来疗效试验时的效应量估计。每年有超过70,000名20多岁和30多岁的人被诊断患有癌症，有证据表明，这些年轻人（相对于年龄较大的癌症幸存者和一般人群）患心血管疾病、其他恶性肿瘤和痛苦的风险更高。不幸的是，针对癌症幸存者的行为干预可能会减少这些风险，但目前还没有针对年轻人。拟议的研究将通过开发和试点测试一种基于互联网的体育活动干预，为年轻的成年癌症幸存者解决这一问题。

DESCRIPTION (provided by applicant): Young adults diagnosed with cancer constitute a particularly vulnerable population whose medical and psychosocial needs are often overlooked. Those diagnosed with cancer between the ages of 18 and 39 face a number of increased risks including an increased risk of cardiovascular disease, second cancers, and emotional distress. Despite this, only a very small percentage of cancer research has focused on the survivorship issues of young adults. The goal of the proposed research is to address some of the unmet needs among young adult cancer survivors by developing and pilot testing a physical activity intervention for this population. Physical activity was selected as the target behavior as: 1. a high percentage of young adult cancer survivors have a sedentary lifestyle and 2. research has shown that cancer survivors who increase their physical activity experience improved cardiopulmonary function, reduced fatigue, enhanced mood and superior cancer outcomes. The intervention will be based on a previously developed, theoretically-grounded, tailored Internet intervention for sedentary adults. This previously developed intervention uses components of the Transtheoretical Model and Social Cognitive Theory to promote physical activity; for example, participants complete monthly questionnaires online and received tailored feedback reports addressing their self-efficacy, decisional balance and processes of change. The intervention website also includes features such as tips for exercising while caring for young children and local physical activity resources. Two key enhancements will be added to the intervention website in order to target the young adult cancer survivor population- 1. information pertinent to cancer survivors initiating an exercise program and 2. a peer-to-peer support component. Once these enhancements have been added, 10 young adult cancer survivors will evaluate the intervention and provide qualitative feedback. Additional revisions will be made to the intervention, as needed, based on this feedback. The intervention will then be pilot tested with a sample of 40 young adult cancer survivors. Participants will be randomly assigned to an intervention group (receiving 12 weeks of access to the intervention website) or a comparison group (receiving information on three cancer-specific Internet sites). Data on intervention feasibility and acceptability will be collected along with preliminary data on intervention effects (i.e., on physical activity level, mood, and fatigue). The latter will be used for effect size estimates when designing a future efficacy trial. Over 70,000 individuals in their twenties and thirties are diagnosed with cancer each year and there is evidence that these young adults are at increased risk (relative to older cancer survivors and the general population) for cardiovascular disease, additional malignancies, and distress. Unfortunately, the behavioral interventions for cancer survivors that might diminish some of these risks have not yet targeted young adults. The proposed research would address this oversight by developing and pilot testing an Internet-based physical activity intervention for young adult cancer survivors.