Intervention to Increase Exercise among Breast Cancer Survivors

 描述（由申请人提供）： 这项研究将测试一种基于理论的干预措施，以增加乳腺癌幸存者的运动水平，以帮助他们自我管理长期治疗的副作用。这项研究的重点是结果预期（OEs），这是一个重要但研究不足的结构，是大多数行为改变理论的核心。OEs指的是人们期望通过参与一种行为来获得或避免什么;因此，人们锻炼是因为他们相信它会产生预期的结果。这项随机对照试验将测试一种多组分干预措施，以增加运动OE，并评估OE变化对运动意图和运动水平的影响。将从杜克癌症研究所招募88名早期（IA至IIB）非活动性乳腺癌幸存者进行家庭运动干预。参与者将被随机分配到运动OE干预组或注意力控制组。这两组人都将接受美国癌症协会的饮食和运动指南以及加速度计。干预组还将收到一份运行经验工作手册，其中包含自我指导活动，通过关注运行经验重要性（对结果的价值）、确定性（预期结果发生的概率）和可及性（考虑结果的频率）来增加运行经验。注意力控制组将收到一本包含相同活动的练习册，重点是饮食，而不是运动。将通过基线、干预后4周、8周和12周的在线调查评估OE重要性、OE确定性、OE可及性、锻炼意愿、锻炼和自我效能（潜在协变量）。在每个时间点，将收集加速度计数据作为客观运动测量。本研究的具体目的是：（1）在四个时间点（基线、干预后4周、8周和12周），检查OE干预组参与者与注意力控制组参与者之间OE重要性、确定性和可及性的轨迹;以及（2）检查锻炼意图的轨迹和每周总锻炼时间，OE干预组的参与者与注意力控制组的参与者之间，在四个时间点：基线，干预后4周，8周和12周。如果干预措施增加乳腺癌幸存者的运动，可能会改善生存时间和生活质量。这种干预措施可以在诊所环境中很容易地实施，以支持幸存者更多地锻炼，从而获得更好的长期结果。这项研究也提供了一个基础，发展一个护士科学家的研究计划，重点是设计基于理论的运动干预慢性病人群。

 DESCRIPTION (provided by applicant): This study will test a theory-based intervention to increase levels of exercise among breast cancer survivors, in order to help them self-manage their long-term treatment side effects. The study focuses on outcome expectations (OEs), a significant yet understudied construct that is central to most behavior change theories. OEs refer to what people expect to obtain or avoid by engaging in a behavior; thus, people exercise because they believe it will produce desired outcomes. This randomized controlled trial will test a multicomponent intervention to increase exercise OEs and assess effects of OE changes on exercise intentions and levels of exercise. Eighty-eight early stage (IA to IIB) inactive breast cancer survivors will be recruited from the Duke Cancer Institute for a home-based exercise intervention. Participants will be randomized to the exercise OE intervention or an attention control group. Both groups will receive the American Cancer Society diet and exercise guidelines and an accelerometer. The intervention group will also receive an OE workbook containing self-directed activities to increase OEs by focusing on OE importance (value placed on the outcome(s)), certainty (perceived probability outcome(s) will occur); and accessibility (frequency with which the outcome(s) are thought of). The attention control group will receive a workbook containing the same activities focused on diet, rather than exercise. OE importance, OE certainty, OE accessibility, exercise intentions, exercise, and self-efficacy (a potential co-variate) will be assessed through online surveys at baseline, 4-, 8-, and 12-weeks post-intervention. At each time point, accelerometer data will be collected as an objective exercise measure. Specific aims of the study are to: (1) examine trajectories of OE importance, certainty and accessibility between participants in the OE intervention arm compared to participants in the attention control arm, across four time points: baseline, 4-, 8- and 12-weeks post-intervention; and (2) examine trajectories of exercise intentions and total weekly minutes of exercise, between participants in the OE intervention arm compared to participants in the attention control arm, across four time points: baseline, 4, 8 and 12 weeks post-intervention. If the intervention increases exercise among breast cancer survivors it may lead to improved survivorship duration and quality of life. The intervention can be implemented readily in clinic settings to support survivors to exercise more and thus experience better long-term outcomes. This study also provides a foundation for a developing a nurse scientist's program of research focused on designing theory-based exercise interventions for chronically ill populations.