Advancing Understanding and Implementation of Digital Mindfulness Applications in Colombian Cancer Care

促进哥伦比亚癌症护理中数字正念应用的理解和实施

• 批准号: 10622777
• 负责人: Siobhan Marie Phillips
• 金额: $ 20.27万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 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 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10622777
• 关键词: Adolescent and Young Adult; Age; Behavior; Cancer Prognosis; Cancer Survivor; Cessation of life; Chronic Disease; Colombian; Disease Outcome; Educational Intervention; Emotional; Engineering; Exercise; Health; Health Care Costs; Height; Individual; Intervention; Light; Malignant Neoplasms; Mediator of activation protein; Mindfulness Training; Morbidity - disease rate; Outcome; Physical activity; Physical activity scale; Population; Population Intervention; Public Health; Quality of life; Randomized; Recommendation; Research; Resources; Risk; Role; Social support; Supervision; Survival Rate; Survivors; Symptoms; Treatment Side Effects; Treatment-Related Cancer; cancer care; cancer recurrence; comorbidity; cost; design; digital; disorder risk; evidence base; exercise intervention; experience; experimental study; fitbit; follow-up; improved; intervention effect; mHealth; mindfulness; mortality; multiphase optimization strategy; premature; programs; sedentary; sleep quality; telephone coaching; vigorous intensity

PROJECT SUMMARY/ABSTRACT There are approximately 680,000 adolescent and young adult cancer survivors (AYACS) in the U.S., and the survival rate in this group is increasing. AYACS experience a myriad of deleterious treatment-related side effects, higher rates of physical and emotional problems and are at a heighted risk of early morbidity and mortality compared to non-cancer age-matched controls. Increased moderate to vigorous intensity physical activity (MVPA) is consistently associated with enhanced quality of life (QOL), reduced cancer treatment- related side effects and chronic disease risk, and improved cancer prognosis in cancer survivors. Yet, the majority of AYACS (~60%) do not meet cancer-specific MVPA recommendations (i.e., 150 mins/week), and very little research on MVPA in cancers survivors has focused specifically on AYACS. Existing studies of MVPA in survivors are largely resource-intensive, costly, and deliver multiple components (i.e., coaching calls, supervised exercise) simultaneously limiting scalability. Three evidence-based strategies have been identified that may be particularly useful for overcoming these barriers and increasing MVPA in AYACS: 1) electronic delivery of a MVPA program, 2) social support, and 3) mindfulness training. However, little is known on the unique roles of social support and mindfulness in MVPA promotion. More granular information about the discrete effects of these components is needed to optimize intervention configuration in order to maximize an effective and scalable MVPA program for AYACS. The purpose of this study is to apply the Multiphase Optimization Strategy (MOST), to determine which types of social support and mindfulness training intervention components optimally increase MVPA in a 12-week mHealth MVPA intervention with a 12 week follow-up. MOST is a framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of intervention components to determine which ones can be reduced, eliminated or replaced to improve efficiency. Inactive AYACS (n=304) will receive a core intervention consisting of the OPTIMAL AYAO app and Fitbit and be randomly assigned to 4 components under consideration for inclusion in the optimized intervention: 1) general mindfulness training; 2) MVPA specific mindfulness training; 3) e-coach and 4) engagement of a buddy. We will also examine the effects of increasing MVPA on symptom burden, intensities of other activities (i.e. light and sedentary), and sleep quality and duration and potential mediators and moderators of component effects. The proposed study represents the first systematic effort to use MOST to design an optimized, scalable mHealth MVPA intervention for AYACS. This study will lead to an improved understanding of how to effectively change AYACS' MVPA and ultimately, improve health and disease outcomes in this population.

项目概要/摘要 美国大约有 680,000 名青少年和年轻成人癌症幸存者 (AYACS)， 该组的存活率正在增加。 AYACS 经历了无数与治疗相关的有害方面 影响，身体和情绪问题的发生率更高，并且早期发病的风险很高， 与非癌症年龄匹配对照相比的死亡率。增加中等到剧烈强度的体力活动 活动（MVPA）始终与生活质量（QOL）的提高、癌症治疗的减少有关 相关副作用和慢性病风险，并改善癌症幸存者的癌症预后。然而， 大多数 AYACS (~60%) 不符合癌症特异性 MVPA 建议（即每周 150 分钟），并且 很少有关于癌症幸存者 MVPA 的研究专门关注 AYACS。现有研究 幸存者的 MVPA 在很大程度上是资源密集型的、成本高昂的，并且提供多个组成部分（即辅导电话、 监督练习）同时限制了可扩展性。已经确定了三种基于证据的策略 这对于克服这些障碍并增加 AYACS 中的 MVPA 可能特别有用：1) 电子化 提供 MVPA 计划，2) 社会支持，以及 3) 正念训练。然而，人们对此知之甚少 社会支持和正念在 MVPA 推广中的独特作用。有关的更详细信息 需要这些组件的离散效应来优化干预配置，以便最大限度地发挥 针对 AYACS 的有效且可扩展的 MVPA 计划。本研究的目的是应用多相 优化策略 (MOST)，以确定哪些类型的社会支持和正念训练 干预措施可在 12 周 mHealth 中最佳地增加 MVPA 12 周 MVPA 干预 后续行动。 MOST 是一个改编自工程学的框架，它使用高效的因子实验来 评估干预措施的单独和综合效果，以确定哪些干预措施可以 减少、消除或替换以提高效率。不活跃的 AYACS (n=304) 将接受核心干预 由 OPTIMAL AYAO 应用程序和 Fitbit 组成，并随机分配给下面的 4 个组件 考虑纳入优化干预措施：1）一般正念训练； 2) MVPA 特定 正念训练； 3) 电子教练和 4) 好友的参与。我们还将研究增加的影响 MVPA 涉及症状负担、其他活动强度（即轻度活动和久坐活动）以及睡眠质量和 成分效应的持续时间以及潜在的中介因素和调节因素。拟议的研究代表了第一个 系统性地努力使用 MOST 为 AYACS 设计优化的、可扩展的 mHealth MVPA 干预措施。这 研究将加深对如何有效改变 AYACS MVPA 的理解，并最终， 改善该人群的健康和疾病结果。