FitFab 4 Survivors

描述（由申请人提供）：儿童急性淋巴细胞白血病（ALL）治疗的进展导致幸存者队列不断增长。许多儿童ALL的幸存者不符合体力活动或健康饮食的建议，并且在进入成年后有肥胖和超重的风险。这些生活方式行为有可能使这些幸存者已经面临的健康问题复杂化。迄今为止，几乎没有有效的干预措施可以帮助这群希望采取更健康生活方式的癌症幸存者。由于急性淋巴细胞白血病的幸存者在地理上分散，人数相对较少，因此需要制定远距离提供的干预措施。该提案的主要目的是开发和可行性测试一种创新的干预措施，旨在促进健康的饮食摄入，增加身体活动，并防止体重增加，可以使用智能手机技术提供。该干预措施将针对13-19岁儿童ALL的青少年幸存者开发，这些幸存者至少停止治疗2年。干预措施将包括使用专门的研究设计的智能手机应用程序（app），每周支持性咨询，以及父母在参与干预时帮助他们支持孩子的材料。该应用程序将包括几乎毫不费力地自我监测饮食，身体活动和体重的工具;激励信息和使用虚拟代币经济来鼓励参与;以及允许参与者相互支持的社交网络组件。社会认知理论的元素将被用于开发应用程序和干预。形成阶段的重点是干预和软件开发，随后将在40名青少年中进行干预的试点测试，这些青少年被随机分配到等待列表对照（WLC）组或干预组。结果将包括饮食摄入质量、身体活动、体重指数和健康行为变化的社会认知介质。调查小组在儿科心理学，儿科血液肿瘤学，肥胖流行病学/预防和计算机科学领域拥有专业知识，因此，已经准备好进行拟议的研究。这项提案的成功完成将为一项更大规模的多中心随机对照试验奠定基础，我们将在该试验中评估我们干预措施的有效性和成本效益。 公共卫生相关性：虽然儿童急性淋巴细胞白血病（ALL）治疗的成功进展导致幸存者人数不断增加，但这些幸存者面临许多长期健康问题的风险。这些健康问题因饮食摄入不足、缺乏运动和体重增加而变得复杂。提高这一癌症幸存者群体的生存质量已被强调为国家卫生机构和癌症幸存者倡导团体的高度优先事项。然而，到目前为止，很少有干预措施，以帮助这些幸存者的所有作出改变的生活方式行为，可能会提高他们的整体生存质量。该提案的主要目的是开发和可行性测试一种创新干预措施，旨在促进儿童癌症幸存者的健康，可以使用研究设计的智能手机应用程序和基于电话的咨询来提供。这项提案的成功完成将为一项更大规模的多中心随机对照试验奠定基础，我们将在该试验中评估我们干预措施的有效性和成本效益。

DESCRIPTION (provided by applicant): Advancements in treatment for childhood Acute Lymphoblastic Leukemia (ALL) have resulted in a growing cohort of survivors. Many survivors of childhood ALL do not meet recommendations for physical activity or healthy diet, and are at risk for obesity and overweight as they move into adulthood. These lifestyle behaviors have the potential to complicate health problems for which these survivors are already at risk. To date, there are few efficacious interventions available to assist this group of cancer survivors wishing to adopt healthier lifestyles. Because survivors of ALL are geographically dispersed and relatively small in numbers, interventions will need to be developed to be delivered at a distance. The primary aim of this proposal is the development and feasibility testing of an innovative intervention designed to promote healthy dietary intake, increase physical activity, and prevent weight gain that can be delivered using smarthphone technology. The intervention will be developed for adolescent survivors of childhood ALL ages 13-19 years who are at least 2 years off treatment. The intervention will include the use of a specialized, study-designed smartphone application (app), weekly supportive counseling, and materials for parents to help them support their child as they take part in the intervention. The app will include tools for near effortless self-monitoring of diet, physical activity, and weight; motivational messages and the use of a virtual token-economy to encourage participation; and a social-networking component that will allow participants to support one another. Elements of social- cognitive theory will be used to develop the app and intervention. A formative phase focused on intervention and software development will be followed by a pilot test of the intervention among 40 adolescents randomized to either a wait-list control (WLC) arm or the intervention arm. Outcomes will include quality of dietary intake, physical activity, body-mass index and social cognitive mediators of health behavior change. The investigative team has expertise in areas of pediatric psychology, pediatric hematology-oncology, obesity epidemiology/prevention, and computer science and thus, is well poised to undertake the proposed research. The successful completion of this proposal will set the stage for a larger multi-center randomized controlled trial in which we will evaluate the efficacy and cost-effectiveness of our intervention. PUBLIC HEALTH RELEVANCE: While successful advancements in treatment for childhood Acute Lymphoblastic Leukemia (ALL) have resulted in a growing cohort of survivors, these survivors are at risk for a number of long-term health problems. These health problems are complicated by poor dietary intake, physical inactivity, and weight gain. Improving the quality of survivorship among this group of cancer survivors has been highlighted as a high priority among national health agencies and cancer survivor advocacy groups. However, to date there are few interventions to assist these survivors of ALL to make changes to lifestyles behaviors that may improve their overall quality of survivorship. The primary aim of this proposal is the development and feasibility testing of an innovative intervention designed to promote health among survivors of childhood cancer that can be delivered using a study designed smartphone application and phone-based counseling. The successful completion of this proposal will set the stage for a larger multi-center randomized controlled trial in which we will evaluate the efficacy and cost-effectiveness of our intervention.