Peer Coaching for Physical Activity Promotion among Breast Cancer Survivors: Adapting an Efficacious Intervention to Prepare for Implementation

促进癌症幸存者体力活动的干预措施改善了他们的功能，减少了疲劳和 为癌症的康复和未来癌症的风险降低提供其他益处。有必要进行干预 这可以在广泛的范围内实施。我们提供了为期12周的基于理论的运动干预 通过电话进行同伴辅导在显著增加中等到剧烈的体力活动方面是有效的 (MVPA)在乳腺癌幸存者中的随机对照试验。来自美国的同行教练 癌症协会的Reach to Recovery计划经过培训和监督，以提供名为 共同前进(MFT)(Pinto，Stein&Dunsiger，2015)。我们的目标是为更广泛的 通过改编现有网络平台(Mentor1to1™)进行干预和收集，从而实施MFT 为大规模实施做准备的关键指标。父赠款有两个阶段：在第一阶段 (已完成)，我们与InquistHealth团队合作将Mentor1to1™修改为MFT干预创建 在第二阶段，我们将进行一项随机对照试验，在试验中，10-12名同行教练将 将WebMFT分发给56名乳腺癌幸存者，他们将被随机接受WebMFT或MVPA 追踪。所有研究参与者都将收到Fitbit活动跟踪器，他们将被要求每周佩戴 已经12周了。此外，WebMFT参与者还将收到每周通过网络发送的咨询电话 站台。我们将检查幸存者的预后(客观测量的MVPA和自我报告的疲劳，质量 生活、身体功能和情绪)在基线和12周时，并在12周时进行比较。 在本补充资料中，我们将：1)为行为改变技术(BCT)编写WebMFT干预代码 我们打算使用公开可用的分类法，从教练那里交付培训材料(Michie等人，2013)。 我们将进一步推进，并通过编码BCT来编码在干预交付期间实施的BCT 从咨询电话的录音中。我们将确定已实施的边界技术与预期的边界技术的比例 预测干预依从性(提供咨询电话的次数)和幸存者每周的MVPA分钟数 根据Fitbit活动跟踪器的记录，持续12周。2)增加评估幸存者个人情况的措施(3 自我效能感、行为自我调节策略的使用和对体育活动的情感反应) 以及基线、4周、8周和12周的个人变量(锻炼的社会支持)。这些理论基础 在干预阶段收集的代表社会-生态模型水平的变量将是 用于预测干预依从性和幸存者每周MVPA分钟数。关于BCT的数据和在 本课程将分析内部和人际层面的理论结构，以阐明行为的过程 变更启动(根据NOT-OD-22-140)。这一结果将促进人们对设计干预措施的了解 有效地激励癌症幸存者变得活跃从而改善他们的功能的BCT 和康复。

Interventions promoting physical activity among cancer survivors improve their functioning, reduce fatigue and offer other benefits for cancer recovery and risk reduction for future cancer. There is a need for interventions that can be implemented on a wide scale. Our 12-week theory-based exercise intervention that was delivered by peer coaches by telephone was efficacious in significantly increasing moderate-to-vigorous physical activity (MVPA) among breast cancer survivors, in randomized controlled trial. The peer coaches from the American Cancer Society’s Reach to Recovery program were trained and supervised to deliver the intervention called Moving Forward Together (MFT) (Pinto, Stein & Dunsiger, 2015). Our goal is to prepare for wider implementation of MFT by adapting an existing web platform (Mentor1to1™) for the intervention and collect key indices to prepare for large scale implementation. The parent grant has two phases: in Phase 1 (completed), we worked with the InquistHealth team to modify Mentor1to1™for the MFT intervention creating webMFT, and in Phase 2, we will conduct a randomized controlled trial in which 10-12 peer coaches will deliver webMFT to 56 breast cancer survivors who will be randomized to receive either webMFT or MVPA Tracking. All study participants will receive a Fitbit activity tracker which they will be asked to wear each week for 12 weeks. webMFT participants, in addition, will receive weekly counseling calls delivered via the web platform. We will examine survivor outcomes (objectively measured MVPA and self-reported fatigue, quality of life, physical functioning and mood) at baseline and 12 weeks and compare groups at 12 weeks. In this supplement, we will: 1) code the webMFT intervention for Behavior Change Techniques (BCTs) that we intend to deliver from coach training materials, using a publicly available taxonomy (Michie et al., 2013). We will advance further and code BCTs that are implemented during intervention delivery by coding BCTs from audio-recordings of counseling calls. We will determine the ratio of implemented BCTs to intended BCTs to predict intervention adherence (number of counseling calls delivered) and survivors’ MVPA minutes/week for 12 weeks, as recorded by Fitbit activity trackers. 2) add measures to assess survivors’ intrapersonal (3 domains of self-efficacy, use of behavior self-regulation strategies, and affective response to physical activity) and intrapersonal variables (social support for exercise) at baseline, 4, 8 and 12 weeks. These theory-based variables, representing levels of the Social-Ecological Model, collected during the intervention phase will be used to predict intervention adherence and survivors’ MVPA minutes/week. Data on BCTs and changes in theoretical constructs at the intra-and interpersonal levels will be analyzed to elucidate the process of behavior change initiation (per NOT-OD-22-140). The results will advance knowledge of designing interventions with BCTs that are effective in motivating cancer survivors to become active and thereby improve their functioning and recovery.