Designing with Dissemination in Mind: Optimization of a mHealth Physical Activity Intervention for Breast Cancer Survivors

 描述（由申请人提供）：增加体力活动（PA）与治疗相关副作用、癌症复发和死亡率的降低以及乳腺癌幸存者的QOL和生存率增加相关。然而，幸存者表现出持续的，显着的治疗后PA下降，大多数不符合PA的建议。大多数现有的PA在幸存者中的研究是密集的，现场多组分干预，提供什么成分是，或不是，有效的，并有有限的潜力，被带到规模。这个职业发展奖的目标是帮助Siobhan M。菲利普斯，博士，公共卫生硕士在她的长期目标，成为一个独立的调查员，在设计和实施优化的移动的健康（mHealth）PA干预癌症幸存者，以改善健康和疾病的结果。菲利普斯博士的短期目标包括增强或获得PA和癌症存活率方面的专业知识，在PA干预中使用mHealth，多阶段优化策略（MOST）方法以及传播和实施（D&I）科学。与她的导师和顾问的多学科团队合作，她制定了一个培训计划，通过课程，研讨会，专业培训，独立研究和指导研究项目来实现这些目标。拟议研究的目的是使用MOST方法开发和试点测试一套针对社会认知结构的乳腺癌幸存者的移动健康PA干预组件，并从一开始就考虑到D&I。MOST是一个创新的、多阶段的框架，它采用高效的析因实验来评估干预组件的单个和组合效应，以确定哪些组件可以减少、消除或替换，以提高效率。将与幸存者，社区合作伙伴和专家/临床医生合作选择要测试的干预成分，并在250名乳腺癌幸存者中进行为期12周的MOST试验。拟议的实验检查干预组件的可行性和可接受性，并量化其对PA和患者报告的结果在12周和24周随访的初步影响。这些信息将用于组合PA干预措施，以最大限度地提高PA并最大限度地降低成本和参与者负担，以便在未来试验中进行测试。拟议的研究代表了第一次系统性的努力，使用MOST为乳腺癌幸存者设计一个优化的，可传播的，移动健康PA干预，并将导致更好地了解如何有效地改变幸存者的PA。这些发现可以为幸存者提供更可扩展，更有效的PA干预措施，并最终改善健康和疾病结果。完成拟议的研究和培训计划将为候选人提供必要的技能，经验和初步数据，以启动一个成功的独立研究计划，重点是PA和癌症生存。

 DESCRIPTION (provided by applicant): Increased physical activity (PA) is associated with reductions in treatment-related side effects, cancer recurrence and mortality and increased QOL and survival in breast cancer survivors. However, survivors demonstrate persist, significant post-treatment declines in PA, and the majority do not meet PA recommendations. Most existing studies of PA in survivors are intense, on-site multicomponent interventions that provide little insight into what components are, or are not, effective and have limited potential to be brought to scale. The goal of this Career Development Award is to assist Siobhan M. Phillips, PhD, MPH in her long- term goal of becoming an independent investigator in designing and implementing optimized mobile health (mHealth) PA interventions in cancer survivors to improve health and disease outcomes. Dr. Phillips's short- term goals include enhancing or gaining expertise in PA and cancer survivorship, use of mHealth in PA interventions, Multiphase Optimization Strategy (MOST) methodology and dissemination and implementation (D&I) sciences. In collaboration with her multidisciplinary team of mentors and advisors, she has developed a training plan to reach these goals via coursework, seminars, specialized trainings, independent studies, and a mentored research project. The purpose of the proposed research is to use MOST methodology to develop and pilot test a set of mHealth PA intervention components for breast cancer survivors targeted at social cognitive constructs and designed with D&I in mind from the outset. MOST is an innovative, multi-phase framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of interventio components to determine which ones can be reduced, eliminated or replaced to improve efficiency. The intervention components to be tested will be chosen in collaboration with survivors, community partners, and experts/clinicians and pilot tested in a 12-week MOST experiment in 250 breast cancer survivors. The proposed experiment examines the feasibility and acceptability of the intervention components and quantifies their preliminary effects on PA and patient reported outcomes at 12 weeks and 24 week follow-up. This information will be used to assemble a PA intervention optimized to maximize PA and minimize cost and participant burden to be tested in a future trial. The proposed study represents the first systematic effort to use MOST to design an optimized, disseminable, mHealth PA intervention for breast cancer survivors and will lead to an improved understanding of how to effectively change survivors' PA. These findings could result in more scalable, effective PA interventions for survivors, and, ultimately, improve health and disease outcomes. Completion of the proposed research and training plans will provide the candidate with the necessary skills, experience, and preliminary data to launch a successful independent research program focused on PA and cancer survivorship.