Previvors Recharge: A Resilience Program for Cancer Previvors

据估计，大约5%-10%的确诊癌症是由遗传性癌症引起的 与生殖系突变(遗传基因突变直接传递)相关的综合征(HC) 从父母到孩子，这会导致某些类型的癌症的遗传易感性)。最新流行病学 模型表明，每279人中就有1人可能是最常见的一种HCS的携带者，而且基因方面的进展 检测继续发现新的遗传突变。拥有HCS(前任)的个人拥有高达80%的 终生罹患癌症的风险，并在以下期间罹患多原发癌的风险增加 他们的一生，通常在很小的时候起病。前人面临着多种形式的逆境，包括 每年的癌症筛查和不确定不仅是他们自己的健康，而且是受影响家庭的健康 会员。先证者在预期、经历和等待的过程中也经常经历“恐惧”。 筛查结果。虽然促进前任韧性的干预措施将解决一个重要的 未得到满足的公共卫生需求，现有的解决方案存在一些缺口，限制了有效性， 传播，以及对先驱的适用性。 拟议的研究将采用参与式设计方法来创建和审查 预充电的可接受性和初步效果，这是一种专门为以下对象设计的增强弹性的解决方案 并主要通过双向文本消息传递。预充电将使用经过验证的方法来 行为改变，通过促进积极的心态、强大的社会关系和 对意义和目的有深刻的认识，同时也积极应对焦虑。系统的设计与开发 来自10位前顾问和6位顾问的广泛和持续的最终用户意见将告知预收费 这方面的专家。将招募129名Prevor进行为期30天的试点测试。第一阶段 里程碑将包括：1)节目的可接受性，总体平均评分至少为4分 5在广泛使用的可接受性衡量标准上，并获得75%的认可，用户将推荐 计划给前同事；(2)继续收到短信和一条或一条或 至少70%的参与者与在线工具进行了更多的互动；以及(3)从该计划中受益， 康纳·戴维森复原力量表治疗前后的显著改善证明了这一点。引航员 未能维持参与度的参与者将被要求提供有关预充电方式的反馈 改进了。此次试点测试的数据将为定制文本的进一步开发奠定基础-- 消息传送解决方案，以提高不断扩大的Previvor人口的复原力。这种类型的 易于传播、可能具有成本效益且高度定制的解决方案将克服 现有干预措施，并提供关于其他关键行为(例如，保健)的消息传送框架 提供商通信)。

It is estimated that approximately 5-10% of all diagnosed cancers are caused by Hereditary Cancer Syndromes (HCS) that are associated with germline mutations (inherited genetic mutations passed directly from a parent to a child that create a genetic predisposition to certain types of cancer). Recent epidemiologic models indicate that 1 in 279 people may be carriers of one of the most common HCS, and advances in genetic testing continue to identify new inherited mutations. Individuals with an HCS (Previvors) have up to an 80% lifetime risk of developing cancer and are at an increased risk of developing multiple primary cancers during their lifetime, often with onset at an early age. Previvors face multiple forms of adversity, including a multitude of annual cancer screenings and the uncertainty of not only their own health but the health of affected family members. Previvors also regularly experience “scanxiety” while anticipating, undergoing, and awaiting the results of screenings. While interventions to promote resilience among Previvors would address an important unmet public health need, existing solutions have a number of gaps that limit effectiveness, widespread dissemination, and applicability to Previvors. The proposed research will employ a participatory design approach to create and examine the acceptability and preliminary effects of PREcharge, a resilience-boosting solution specifically designed for Previvors and delivered primarily via bi-directional text messaging. PREcharge will use proven approaches to behavior change tailoring to increase resilience by promoting a positive mindset, strong social connections, and a deep sense of meaning and purpose while also proactively addressing scanxiety. The design and development of PREcharge will be informed by extensive and ongoing end-user input from 10 Previvor advisors as well as 6 experts in this area. One hundred and twenty-nine Previvors will be recruited for a 30-day pilot test. Phase I milestones will include: 1) acceptability of the program, as evidenced by overall mean ratings of at least 4 out of 5 on a widely used acceptability measure and obtaining 75% endorsement that users would recommend the program to a fellow Previvor; (2) engagement as evidenced by continued receipt of text messages and one or more interactions with the online tools by at least 70% of participants; and (3) benefit from the program, evidenced by statistically significant pre-post improvement on the Connor Davidson Resilience Scale. Pilot participants who fail to sustain engagement will be asked to provide feedback on how PREcharge could be improved. The data from this pilot test will lay the foundation for the further development of tailored text- messaging solutions to improve resilience outcomes among the expanding population of Previvors. This type of easily disseminable, potentially cost-effective, and highly tailored solution would overcome the limitations of existing interventions and provide a framework for messaging on other key behaviors (e.g., health care provider communication) in the future.