Efficacy of a self-advocacy serious game intervention for women with advanced cancer

自我倡导严肃游戏干预对晚期癌症女性的疗效

• 批准号: 10273535
• 负责人: Teresa Hagan Thomas
• 金额: $ 64.69万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10273535
• 关键词: 3-Dimensional; Address; Adult; Advanced Malignant Neoplasm; Advocacy; Advocate; Age; Behavioral; Behavioral Mechanisms; Belief; Breast; Caring; Communication; Complex; Decision Making; Educational process of instructing; Elements; Emergency Situation; Ensure; Exposure to; Face; Feedback; Future; Goals; Health; Health Personnel; Healthcare; Healthcare Systems; Hospitalization; Immersion; Individual; Intervention; Interview; Knowledge; Lead; Learning; Life; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Modeling; Motivation; Newly Diagnosed; Outcome; Paper; Participant; Patient Education; Patient Preferences; Patient Self-Report; Patient-Centered Care; Patient-Focused Outcomes; Patients; Personal Satisfaction; Provider; Public Health; Quality of Care; Quality of life; Randomized; Randomized Clinical Trials; Reporting; Research; Rewards; Risk; Sampling; Social support; Surveys; Symptoms; Technology; Testing; Theory of Change; Training; Transference; Video Games; Visit; Woman; Work; advanced breast cancer; base; behavior change; cancer care; cancer diagnosis; cancer therapy; care coordination; efficacy evaluation; efficacy testing; experience; experimental group; health care service utilization; improved; improved outcome; individualized feedback; innovation; intervention effect; learning outcome; novel; pilot trial; preference; primary outcome; programs; provider-level barriers; secondary outcome; skill acquisition; skills; skills training; success; symptom management; theories; treatment adherence

Project Summary Individuals with cancer must overcome multiple, ongoing challenges (“self-advocate”) related to their cancer experience to receive patient-centered care. Women with metastatic breast or advanced gynecologic cancer often face significant challenges managing their quality of life concerns and cancer- and treatment-related symptoms. If they do not self-advocate to manage these concerns, they risk having poor quality of life, high symptom burden, and care that is not patient-centered. Serious games (video games that teach) are effective health interventions that allow users to vicariously engage in situations reflecting their personal experiences, receive meaningful information, and learn personally relevant skills that they can apply in real life. The long- term objective of this work is to prepare patients with cancer to engage in patient-centered care by teaching them self-advocacy skills using immersive, accessible technologies. The goal of the current study is to test the efficacy of a novel intervention using a serious game platform to teach self-advocacy skills to women with metastatic breast or advanced gynecologic cancer. The Strong Together intervention consists of a multi- session, interactive serious game application with tailored self-advocacy goal-setting and training. The serious game is based on a self-advocacy conceptual framework and applies behavior change theories and serious game mechanisms to promote skill development and implementation. The game works by immersing users in the experiences of characters who are women with advanced cancer; requiring users to make decisions about how the characters self-advocate; demonstrating the positive and negative consequences of self-advocating or not, respectively; and providing multiple, individualized feedback mechanisms and game features to enforce self-advocacy skill acquisition and transference to real life. This study evaluates the efficacy of the Strong Together intervention by conducting a randomized clinical trial in 336 adult (ages >18 years) women within three months of a metastatic breast or Stage III or IV gynecologic cancer diagnosis. Participants will be randomly assigned to receive the 3-month Strong Together intervention or a paper self-advocacy guide. The primary outcome is patient self-advocacy. Secondary outcomes include quality of life, symptom burden, and patient-centered care. The central hypothesis is that the experimental group will have higher self-advocacy, quality of life, and patient-centered care and lower symptom burden compared to the paper self-advocacy guide group. As an exploratory outcome, we will determine if the intervention reduces suboptimal healthcare utilization. The study will also evaluate the behavioral and game mechanisms that influence the efficacy of the Strong Together intervention. This study provides the first theoretically based self-advocacy intervention for adult women with cancer and clarifies the mechanisms by which serious games teach skills and assist in transferring those skills to real life. Self-advocacy interventions have the potential to advance patient-centered care by providing patients with tangible skills that prepare them to meaningful engage in their cancer care.

项目摘要 癌症患者必须克服与癌症相关的多重持续挑战（“自我倡导”） 体验以病人为中心的护理。患有转移性乳腺癌或晚期妇科癌症的女性 在管理他们的生活质量问题以及与癌症和治疗相关的问题方面， 症状如果他们不自我倡导管理这些问题，他们的生活质量就会很差， 症状负担，以及不以患者为中心的护理。严肃的游戏（教学的视频游戏）是有效的 健康干预措施，使用户能够间接地参与反映其个人经历的情况， 接收有意义的信息，并学习他们可以在真实的生活中应用的个人相关技能。很长的- 这项工作的长期目标是准备与癌症患者从事以病人为中心的护理教学 他们使用沉浸式的，可访问的技术的自我宣传技能。本研究的目的是测试 一种新的干预措施的有效性，使用一个严肃的游戏平台，向患有糖尿病的妇女教授自我辩护技能。 转移性乳腺癌或晚期妇科癌症。“强强联手”的干预措施包括多方面的， 会议，互动的严重游戏应用程序与定制的自我宣传目标设定和培训。的严重 游戏是基于一个自我宣传的概念框架，并应用行为改变理论和严重的 游戏机制，以促进技能的发展和实施。游戏的工作原理是让用户沉浸在 女性晚期癌症患者的角色经历;要求用户做出决定， 人物如何自我主张;展示自我主张的积极和消极后果， 不，分别;并提供多个，个性化的反馈机制和游戏功能，以执行 自我倡导技能的获得和转移到真实的生活中。这项研究评估了强效 通过在336名成年（年龄> 18岁）妇女中进行随机临床试验， 三个月的转移性乳腺癌或III期或IV期妇科癌症诊断。参与者将被 随机分配接受为期3个月的Strong Together干预或纸质自我宣传指南。的 主要结果是患者自我辩护。次要结局包括生活质量、症状负担和 以病人为中心的护理核心假设是实验组会有更高的自我辩护， 生活质量、以病人为中心的护理和较低的症状负担相比，论文自我倡导 引导组。作为探索性结果，我们将确定干预是否减少了次优医疗保健 利用率这项研究还将评估影响疗效的行为和游戏机制， 一起强力干预。这项研究提供了第一个基于理论的自我辩护干预， 成年妇女与癌症，并阐明了机制，其中严重的游戏教技能，并协助 将这些技能运用到真实的生活中。自我倡导干预有可能推进以患者为中心的 通过为患者提供切实的技能，使他们做好准备，有意义地参与癌症护理。