Micro-randomized trial of a physical activity intervention to manage pain symptoms among older cancer survivors

项目摘要/摘要 老年癌症幸存者尤其受到癌症及其治疗的影响， 以及心理社会的短期和长期副作用，如经历慢性疼痛的风险增加 症状。强有力的证据表明，体力活动与慢性疼痛的低级别症状相关。 尽管已知体育锻炼的好处，但只有7%的老年癌症幸存者能进行目前的体育锻炼 建议。老年癌症患者疼痛程度高与体力活动水平低有关 幸存者。因此，了解如何以及何时以最佳方式提供体力活动干预至关重要 健康信息，以减少经历慢性癌症的老年癌症幸存者的慢性疼痛症状 疼痛症状。此申请为惠特尼·韦尔奇博士提出职业发展计划，以建立 一项独立的研究计划，考察身体活动与维持健康的关系 通过减少老年癌症幸存者的慢性症状实现独立。韦尔奇博士的职业生涯 发展将得到一个具有悠久历史的特殊跨学科调查小组的支持 联邦资助和成功导师的记录。她的导师里尼博士、斯普林博士和沃尔夫博士 是国际公认的癌症存活率、适应性干预设计和 分别是健康素养和健康传播。此应用程序的总体目标是开发和 测试体育活动推广消息的时间，以增加体力活动并减少疼痛症状 在经历慢性疼痛症状的老年癌症幸存者中，使用微随机试验设计。 在目标1中，我们建议使用以患者为中心的健康素养方法来开发和选择基于理论的 健康信息，增加幸存者根据当前疼痛进行体力活动的可能性 症状。在目标2中，我们将进行微随机试验，这是一种新的实验设计，旨在 优化即时干预的构建，以确定最佳疼痛状态(疼痛/无疼痛)以 传递增加体力活动和老年癌症幸存者参与的概率的信息 体力活动。最后，我们提出了一个探索性目标，以确定最佳疼痛状态(疼痛/无疼痛)以 传递信息以增加体力活动，参与者可能会经历随后的 疼痛发作。这项研究的结果将为R01提交进行Just-in-in- 时间适应性体力活动干预以管理老年癌症幸存者的疼痛症状。这一奖项将 直接导致在体育活动和健康研究方面建立独立的研究方案 在老年癌症幸存者中。

PROJECT SUMMARY/ABSTRACT The older cancer survivor is particularly affected by cancer and its treatments with numerous physical, mental, and psychosocial short- and long-term side effects, such as an increase in risk to experience chronic pain symptoms. Strong evidence indicates physical activity is correlated with lower rated symptoms of chronic pain. Despite the known benefits of physical activity, only 7% of older cancer survivors meet current physical activity recommendations. High ratings of pain are associated with low physical activity levels in older cancer survivors. Therefore, it is critical to understand how and when to best deliver physical activity intervention health messaging to reduce chronic pain symptoms among older cancer survivors who experience chronic pain symptoms. This application proposes the career development plan for Dr. Whitney Welch to establish an independent research program examining the relationship between physical activity and the maintenance of independence through the reduction of chronic symptoms among older cancer survivors. Dr. Welch's career development will be supported by an exceptional interdisciplinary group of investigators with a lengthy history of federal funding and a track record of successful mentorships. Her mentors, Dr. Rini, Dr. Spring, and Dr. Wolf are internationally recognized scholars in the areas of cancer survivorship, adaptive intervention design, and health literacy and health communications, respectively. The overall aim of this application is to develop and test the timing of physical activity promotion messages to increase physical activity and reduce pain symptoms among older cancer survivors who experience chronic pain symptoms using a micro-randomized trial design. In Aim 1, we propose to use a patient-centered, health literacy approach to develop and select theory-based health messaging that increase survivors' likelihood of engaging in physical activity tailored to their current pain symptoms. In Aim 2, we will conduct a micro-randomized trial, a new experimental design developed to optimize the construction of in-the-moment interventions, to determine the optimal pain state (pain/no pain) to deliver a message to increase physical activity and the probability that older cancer survivors will engage in physical activity. Finally, we propose an exploratory aim to determine the optimal pain state (pain/no pain) to deliver the message to increase physical activity and the probability participants will experience a subsequent pain episode. Results from this study will provide a robust foundation for a R01 submission to conduct a just-in- time adaptive physical activity intervention to manage pain symptoms in older cancer survivors. This award will directly lead to the establishment of an independent research program in physical activity and health research among older cancer survivors.