Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health

适应多种行为有效改善 (AMPLIFI) 癌症幸存者健康的干预措施

• 批准号: 10247730
• 负责人: Wendy Demark-Wahnefried
• 金额: $ 141.41万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10247730
• 关键词: Address; Aftercare; Aging; Alabama; Appalachian Region; Area; Behavior; Behavior Therapy; Behavioral; Breast Cancer survivor; Cancer Burden; Cancer Center; Cancer Prognosis; Cancer Survivor; Cancer Survivorship; Cardiovascular Diseases; Caring; Centers for Disease Control and Prevention (U.S.); Collaborations; Cost Analysis; Country; Data; Diabetes Mellitus; Diagnosis; Diet; Dietary Intervention; Dissemination and Implementation; Early Diagnosis; Early treatment; Eating; Economics; Future; General Population; Goals; Guidelines; Health; Health Sciences; Health behavior; Health behavior change; Home; Individual; Intervention; Learning; Life; Life Style; Life Style Modification; Malignant Neoplasms; Mediating; Mississippi; Modeling; Obesity; Osteoporosis; Outcome; Physical activity; Population; Prevalence; Price; Process; Public Health; Randomized Controlled Trials; Regional Cancer; Research; Research Project Grants; Resource Sharing; Risk; Rural Minority; Sampling; Science; Scientist; Screening for cancer; Second Primary Cancers; Second Primary Neoplasms; Survival Rate; Survivors; Technology; Tennessee; Testing; Time; Transportation; Travel; Unhealthy Diet; Universities; Visiting Nurse; Waiting Lists; Weight; Work; arm; behavior change; cancer care; cancer diagnosis; cancer risk; cancer therapy; cancer type; comorbidity; comparative efficacy; cost; dissemination research; effective intervention; efficacious intervention; efficacy testing; exercise adherence; exercise intervention; functional decline; good diet; health disparity; high risk; implementation research; improved; neoplasm registry; physical inactivity; population based; programs; recruit; treatment arm; trend; unhealthy lifestyle

Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health By 2020, the number of cancer survivors in the US will exceed 20 million due to trends toward aging, and improved cancer screening and treatment. Cancer survivorship is a victory, but it comes at a price. Once an individual is diagnosed with cancer, they are at much higher risk for second malignancies, cardiovascular disease, diabetes, osteoporosis, and functional decline (resulting in a loss of independence). Currently, the costs for these downstream effects are estimated to be at least $135 billion annually. Unhealthy lifestyle behaviors (e.g., a poor diet resulting in obesity and physical inactivity) associate with poorer outcomes after a cancer diagnosis. These behaviors also tend to cluster, i.e., people who practice one unhealthy behavior tend to practice another. It is hypothesized that cancer survivors may be able to improve their overall health and reduce comorbidity through lifestyle modification, particularly since estimates indicate that only 15-47% of cancer survivors adhere to national guidelines for weight status, diet and physical activity. While effective interventions in each of these domains exists, there has been little effort to disseminate these interventions broad scale and to survivors most in need (older, rural, minorities). Moreover, there is a relative dearth of research in determining optimal means of combining interventions, which is critical since many survivors practice more than one, or multiple suboptimal behaviors. The overarching aims AMPLIFI are to learn how to: 1) improve health behaviors in cancer survivors who practice multiple suboptimal health behaviors; and 2) adapt efficacious interventions to optimize their reach by the use of technology among cancer survivors, while also collecting data to inform the future dissemination and implementation (D&I) potential of these interventions. AMPLIFI involves 3 highly interrelated research projects supported by 4 highly integrated cores. It will enlist the efforts of 852 survivors of a broad array of cancers that have favorable 5-year cancer-free survival rates (oversampling those who are older, rural and minority) and gather the input of 48 key stakeholders to accomplish the following Specific Aims: 1) Understand how to adapt efficacious interventions for widespread dissemination through the use of technology, while maintaining the integrity of key components which drive behavior change; 2) Optimize acceptability and use of interventions (largely developed and tested in homogeneous samples of breast cancer survivors) to older, rural, minority survivors of many cancer types; 3) Test the efficacy of the adapted interventions delivered alone, in sequence, or combined; 4) Contribute to the science of D&I research by developing a new adaptation model; and 5) Determine factors that improve the D&I potential of distance-delivered health behavior change interventions by determining how they mediate behavior change and in whom they work best. Our ultimate goal is to improve the health of the highly vulnerable and ever increasing population of cancer survivors.

适应多重行为干预，有效地改善（AMPLIFI）癌症幸存者的健康 到2020年，由于老龄化趋势，美国癌症幸存者的数量将超过2000万， 改善癌症筛查和治疗。癌症生存是一种胜利，但它是有代价的。一旦 一个人被诊断患有癌症，他们患第二种恶性肿瘤的风险要高得多， 疾病、糖尿病、骨质疏松症和功能衰退（导致丧失独立性）。目前 这些下游影响的成本估计每年至少为1 350亿美元。 不健康的生活方式行为（例如，不良饮食导致肥胖和缺乏运动）与 癌症诊断后的预后较差。这些行为也倾向于集群，即，实践的人 不健康的行为倾向于实践另一种。据推测，癌症幸存者可能能够改善 通过改变生活方式，改善他们的整体健康状况，减少并发症，特别是因为估计表明， 只有15-47%的癌症幸存者遵守国家体重状况，饮食和体育活动指南。 虽然在上述每个领域都有有效的干预措施，但很少努力传播这些措施， 干预措施的范围广泛，并针对最需要的幸存者（老年人、农村、少数民族）。此外，还有一个亲戚 缺乏研究，以确定最佳手段相结合的干预措施，这是至关重要的，因为许多 幸存者实践不止一种或多种次优行为。 AMPLIFI的首要目标是学习如何：1）改善癌症幸存者的健康行为， 实践多种次优健康行为; 2）采用有效的干预措施， 在癌症幸存者中使用技术，同时也收集数据，为未来的传播提供信息， 这些措施的执行（D&I）潜力。AMPLIFI涉及3个高度相关的研究项目 由4个高度集成的内核支持。它将招募852名癌症幸存者的努力， 具有良好的5年无癌生存率（对老年人、农村和少数民族进行过抽样）， 收集48个关键利益相关者的意见，以实现以下具体目标：1）了解如何适应 有效的干预措施，通过使用技术进行广泛传播，同时保持 推动行为改变的关键要素的完整性; 2）优化干预措施的可接受性和使用 （主要是在乳腺癌幸存者的同质样本中开发和测试） 许多癌症类型的幸存者; 3）测试单独、依次 4）通过开发新的适应模式，为D&I研究科学做出贡献;以及5） 通过以下方式确定提高远程提供的健康行为改变干预措施的D&I潜力的因素： 决定它们如何调节行为变化，以及它们在谁身上效果最好。我们的最终目标是提高 高度脆弱和不断增加的癌症幸存者的健康。