Text-messaging Communication Micro-Intervention for Couples Coping with Advanced GI Cancer

癌症诊断需要患者和他们的亲密伴侣进行有效的沟通，以驾驭疾病- 相关挑战。研究表明，使用有效沟通策略的夫妇 个体心理调适和较高的关系满意度。然而，许多夫妇很难 沟通可能导致个人、关系和患者健康状况恶化的癌症相关问题 结果。虽然改善夫妻沟通的二元干预措施已被证明是有效的，但它们 通常是时间密集型的，并且覆盖范围有限。招募夫妇进行二元干预的挑战是 登记良好，招募率低，特别是在得不到充分服务的夫妇中。微观干预， 其中包括通过短信或移动的提供的简短教育材料和简短活动 应用，有很大的潜力，以增加接触和参与不同群体的夫妇， 增加灵活性和减少准入障碍。以前的研究发现，微干预是 有效地促进健康行为的改变，在广泛的个人和提高双 在社区夫妻中发挥作用。到目前为止，还没有制定任何现有的微观干预措施， 并在应对癌症的夫妇中进行了测试。因此，拟议项目旨在开发和试点测试一种 短信微干预，重点是提高沟通技巧的夫妇应对 晚期胃肠道（GI）癌。二元微观干预的内容将改编自 现有的，经验验证的夫妇为癌症和非癌症夫妇开发的干预措施。要求1 重点是通过焦点小组和与夫妇的访谈来发展微观干预， 高级GI癌症和少数群体代表的社区顾问，沿着用户体验 测试目标人群。收集的数据将用于提高内容的相关性，可接受性， 微观干预的可行性和文化敏感性。目标2将是一个随机试点测试的二元 微观干预，以评估可行性和可接受性。目标3将检查干预前后的结果 通过关系满意度和建设性沟通的改善来衡量。这个项目正在 符合国家癌症研究所的癌症生存的优先研究领域，并有可能 通过增加得不到充分服务的夫妇的参与，提高癌症的健康公平性。拟议项目将 为申请人提供5个关键领域的培训：（1）心理肿瘤学和癌症控制，（2）理论和 教学法有关的发展，实施，和传播的行为干预措施， 癌症背景下，（3）特定于心理社会干预发展的混合研究方法，（4） 健康公平、多样性和包容性培训;（5）专业发展。独特而广泛的 包括杜克癌症研究所在内的杜克大学医学中心的可用资源将帮助和 加强培训，提高科学生产力，圆满完成拟议项目。

A cancer diagnosis requires patients and their intimate partners to communicate effectively to navigate illness- related challenges. Research indicates that couples who use effective communication strategies have better individual psychological adjustment and higher relationship satisfaction. However, many couples have difficulty communicating about cancer-related issues which can lead to poorer individual, relationship, and patient health outcomes. While dyadic interventions to improve couple communication have proven efficacious, they are often time intensive and have limited reach. The challenges of recruiting couples into dyadic interventions are well-documented, with low recruitment rates especially among underserved couples. Micro-interventions, which consist of brief educational materials and short activities delivered via text message or a mobile application, have significant potential to increase reach and participation in diverse groups of couples by increasing flexibility and reducing barriers to access. Previous studies have found micro-interventions to be effective in promoting health behavior change in a wide range of individuals and in enhancing dyadic functioning in community couples. To date, there are no existing micro-interventions that have been developed and tested in couples coping with cancer. Therefore, the proposed project aims to develop, and pilot test a text-messaging micro-intervention focused on improving communication skills for couples coping with advanced gastrointestinal (GI) cancer. The content of the dyadic micro-intervention will be adapted from existing, empirically validated couple-based interventions developed for cancer and non-cancer couples. Aim 1 focuses on developing the micro-intervention through focus groups and interviews with couples coping with advanced GI cancer and community advisors representative of minority groups, along with user experience testing with the target population. The data collected will be used to increase content relevance, acceptability, feasibility, and cultural sensitivity of the micro-intervention. Aim 2 will be a randomized pilot test of the dyadic micro-intervention to assess feasibility and acceptability. Aim 3 will examine pre-to-post intervention outcomes as measured by improvements in relationship satisfaction and constructive communication. This project is in line with the National Cancer Institute’s priority research area of cancer survivorship and has the potential to increase health equity in cancer by increasing participation of underserved couples. The proposed project will provide training in 5 key areas for the applicant: (1) psycho-oncology and cancer control, (2) theories and didactics related to the development, implementation, and dissemination of behavioral interventions in the context of cancer, (3) mixed research methods specific to development of psychosocial interventions, (4) health equity, diversity, and inclusion training, and (5) professional development. The unique and extensive resources available at Duke University Medical Center, including the Duke Cancer Institute, will aid and enhance training, scientific productivity, and successful completion of the proposed project.