Exploring the concept of dyadic health in Thai couples coping with breast cancer: A preliminary study of a partnered approach to physical activity in breast cancer survivors and spouse care partners

拟议的补充申请回应了NOT-CA-CA中确定的特殊利益通知(NOSI) 21-058用于刺激和加强全球癌症生存研究的项目。父级赠款是一项 疗效试验，以确定二元运动的益处(例如，患者和配偶一起)以优化 癌症幸存者及其配偶护理伙伴的身体、情感和关系健康。父辈 试验(R01CA218093)关注患者及其配偶的二元健康，通常是非正式的照顾者，他们 反过来，与不照顾病痛的爱人的配偶相比，他们面临着更高的不良结局风险。改善健康状况 行为，如体育活动，会对癌症患者的生活质量和存活率产生重大影响 幸存者和他们的伴侣，但大多数癌症幸存者的体力活动率较低，而 合作伙伴几乎被忽视了。生活在中低收入国家(LMIC)的患者面临着许多障碍 运动，包括缺乏针对癌症患者独特需求的支持性护理计划，以及缺乏 社会支持，以促进行为改变和维持。我们包括配偶以促进患者 通过社会支持保持和坚持锻炼，也通过参加锻炼以及 配偶本身也可以从更多的身体活动中受益。我们建议建立在一个 父母试验机构与Mahidol大学和Siriraj医院癌症的现有关系 中心探索二元健康的概念并进行试点试验，以适应父母试验的二元健康 促进乳腺癌幸存者及其配偶护理伙伴体力活动的管理策略。 我们将进行一个分两个阶段的项目，首先进行一项混合方法调查，以评估二元调节 泰国乳腺癌夫妇的二元健康状况及其对二元健康的兴趣和偏好 体力活动计划。从第一阶段收集的数据将用于开发和试点具有文化针对性的 泰国夫妇样本中的二元体力活动计划。拟议中的项目将刺激一种新的 来自父母试验的调查人员与泰国的调查人员和临床医生之间的合作 有兴趣学习改善泰国乳腺癌幸存者和癌症护理结果的新方法 合伙人。拟议的项目是对国家安全倡议的直接回应，该倡议呼吁对 支持NCI资助的调查人员利用与LMICs利益相关者的现有关系/伙伴关系来 开展研究，加强对治疗后后续护理差距的了解，目标是 满足癌症幸存者及其照顾者在个人、设施、 和系统级别。具体地说，这个项目涉及国家安全倡议中列出的三个优先领域，包括：1)研究 为了确定癌症幸存者及其照顾者的支持性护理需求，2)研究以确定 制定健康促进干预措施的战略/机会，以及3)了解可行性研究 循证生存干预措施的采纳和适应。

The proposed supplement application responds to the Notice of Special Interest (NOSI) identified in NOT-CA- 21-058 for projects to stimulate and strengthen global cancer survivorship research. The parent grant is an efficacy trial to determine the benefits of dyadic exercise (e.g., both patients and spouses together) to optimize physical, emotional and relationship health among cancer survivors and their spouse care partners. The parent trial (R01CA218093) focuses on dyadic health of both patients and their spouses, often informal caregivers, who are in turn at higher risk of poor outcomes than spouses who do not care for an ill loved one. Improving health behaviors, such as physical activity, can have a substantial impact on quality of life and survival in cancer survivors and their partners, but most cancer survivors have low rates of physical activity while the health of partners is virtually ignored. Patients living in low to middle income countries (LMIC) face many barriers to exercise, including a lack of supportive care programs specific to the unique needs of cancer patients and a lack of social support to promote behavior change and maintenance. We include the spouse to promote patient retention and adherence to exercise through social support, but also by participating in exercise as well the spouse themselves can also benefit from becoming more physically active. We are proposing build upon an existing relationship between the parent trial’s institution with Mahidol University and the Siriraj Hospital Cancer Center to explore the concept of dyadic health and pilot test an adaption of the parent trial’s dyadic health management strategy to promote physical activity among breast cancer survivors and their spouse care partners. We will conduct a two-phase project, starting with a mixed-methods investigation to assess dyadic adjustment and dyadic health among Thai couples coping with breast cancer and their interest and preferences for a dyadic physical activity program. Data gathered from the first phase will be used to develop and pilot a culturally specific dyadic physical activity program in a sample of Thai couples. The proposed project will stimulate a new collaboration between investigators from the parent trial and investigators and clinicians in Thailand who are interested in learning new approaches to improve outcomes in Thai breast cancer survivors and cancer care partners. The proposed project is directly responsive to the NOSI that calls for administrative supplements to support NCI-funded investigators to leverage existing relationships/partnerships with stakeholders in LMICs to conduct research that will enhance understanding of the gaps in post-treatment follow-up care, with the goal of addressing physical and psychosocial needs of cancer survivors and their caregivers at the individual, facility, and systems levels. Specifically, this project addresses three priority areas listed in the NOSI including: 1) studies to identify supportive care needs of cancer survivors and their caregivers, 2) research to identify strategies/opportunities for developing health promotion interventions, and 3) feasibility studies to understand adoption and adaption of evidence-based survivorship interventions.