Promoting post-treatment self-management among Latinos with cancer

描述(申请人提供)：说西班牙语的拉美裔癌症患者在信息需求、与临床医生的沟通、护理质量、癌症后遗症风险增加及其治疗方面存在差异。患者激活干预措施，例如那些促进生存护理计划(SCP)的干预措施，对于提高他们的自我效能至关重要 以及解决这些差距的资源。这项研究的总体目标是使讲西班牙语的癌症幸存者能够在急性癌症治疗阶段结束后积极参与他们的护理。该项目的目的是评估该项目的可行性、可接受性、 以及通过交互式移动电话应用程序(MSCP)为说西班牙语的乳腺癌或结直肠癌患者提供生存护理规划和教育的初步效果，因为他们在公立医院的积极治疗即将结束。手机在拉美裔中是一种很好的交付方式，因为他们广泛使用具有网络功能的手机来访问互联网。我们将开发一个低识字率的西班牙语手机应用程序(MSCP)，帮助癌症幸存者了解他们的诊断和治疗，实施和跟踪体力活动和压力管理实践，识别复发或治疗后期效应的症状，并将这些症状传达给他们的医疗保健提供者。通过对50名患有非转移性乳腺癌或结直肠癌的西班牙语拉丁裔患者进行为期3个月的试验性随机对照试验(RCT)，我们将比较为期3个月的交互式MSCP干预和常规护理对3个月后自我报告结果的影响，包括癌症应对自我效能、癌症特异性痛苦、疲劳和步行。我们还将评估所需的后续访问和监督检查的知识。为了评估干预和研究程序的可行性和可接受性，我们将收集关于以下方面的过程评估数据：治疗总结的成本；方案的遵从性；不良事件；MSCP的使用；以及主要信息者(10名干预组参与者和4名肿瘤学提供者)对干预、研究程序和结果(例如，感知到的益处、易用性、负担)的看法。MSCP将利用每日日记和累积条形图进行自我监控，对日记条目、日常压力管理和锻炼信息进行即时积极反馈，以及提供逐步指导使用癌症应对技能的低识字率模块。这项为期两年的研究结果将为我们进行大规模随机对照试验做准备。在用户友好的手机应用程序中使用SCP信息是促进高质量生存护理的一种有前途的方法。这些类型的干预措施可能是满足拉美裔癌症幸存者的信息和自我护理需求的可接受和经济的方式，并有助于减少保健和癌症护理方面的差距。如果在随后的研究中被证明是有效的，这种用户友好、安全的移动电话工具可以帮助讲西班牙语的癌症幸存者，以及潜在的其他弱势群体，满足急性癌症治疗后基于证据的医疗保健和自我管理建议。

DESCRIPTION (provided by applicant): Spanish-speaking Latinos with cancer experience disparities related to the need for information, communication with clinicians, quality of care, an increased risk of the sequelae of cancer and its treatment. Patient activation interventions, such as those that promote survivorship care planning (SCP) are critical to increase their self-efficacy and resources for addressing these disparities. The overall goal of this study is to enable Spanish-speaking cancer survivors to be active participants in their care once the acute cancer treatment phase has ended. The aims of this project are to evaluate the feasibility, acceptability, and preliminary efficacy of providing survivorship care planning and education through an interactive mobile phone application (mSCP) for Spanish-speaking men and women with breast or colorectal cancer as they approach the end of active treatment in public hospital settings. Mobile phones are an excellent delivery mode among Latinos due to their widespread use of web-enabled phones to access the internet. We will develop a low- literacy Spanish-language mobile phone application (mSCP) that helps cancer survivors understand their diagnosis and treatment, implement and track physical activity and stress management practices, recognize symptoms of recurrence or late effects of treatment, and communicate these symptoms to their health care providers. Through a pilot 3-month randomized controlled trial (RCT) among 50 Spanish-speaking Latinos with non-metastatic breast or colorectal cancer, we will compare the effects of the 3-month interactive mSCP intervention versus usual care on self-reported outcomes at 3 months including cancer coping self-efficacy, cancer-specific distress, fatigue, and walking. We also will assess knowledge of needed follow-up visits and surveillance exams. To assess the feasibility and acceptability of the intervention and study procedures, we will collect process evaluation data on: costs to produce a treatment summary; protocol adherence; adverse events; use of the mSCP; and key informants' (10 intervention group participants and 4 oncology providers) perceptions of the intervention, study procedures, and outcomes (e.g., perceived benefits, ease of use, burden). The mSCP will utilize daily diary and cumulative bar graphs for self-monitoring, immediate positive feedback on diary entries, daily stress management and exercise messages, and low-literacy modules with step-by-step guides to using the cancer coping skills. Results of this 2-year study will prepare us to conduct a large-scale RCT. Having SCP information in a user-friendly mobile phone application is a promising approach to promote high quality survivorship care. These types of interventions may be acceptable and economical ways of meeting the informational and self-care needs of Latino cancer survivors and help reduce disparities in health and cancer care. If proven effective in a subsequent study, this user-friendly, secure mobile phone tool could help Spanish-speaking cancer survivors, and potentially other vulnerable populations, meet evidence- based recommendations for health care and self-management after acute cancer treatment.