Mates in Motion: Feasibility and Acceptability of a Couple-Based Physical Activity Intervention

项目摘要 癌症幸存者的身体活动水平（PA）很低，但PA可能会改善癌症的困难影响。 治疗我们在这里重点关注PA，继最密集的癌症治疗形式，造血细胞， 移植（HCT）。虽然有治愈的潜力，但手术要求很高，有多种后遗症 包括化疗和放疗引起的血细胞减少以及心血管和肺部并发症。 PA在移植后减少，这种减少与身体功能较差有关。中度 运动对HCT患者是安全的，PA干预是可行的。关于疗效的发现， 然而，由于干预措施的组成部分和结果不一，这些措施的效果参差不齐。最大的审判， 日期报告无效结果，但运动干预是自我指导的（可以说是轻的），并评估了PA 通过自我报告。其他研究的结果表明，PA可以改善心肺功能、身体状况 HCT患者的表现和疲劳。HCT背景下的所有PA干预措施都完全集中在 忽视了家庭护理者参与和受益的机会，一个24/7的角色需要 提供医疗和后勤支助。HCT护理人员及其自身健康状况普遍存在痛苦 晋升被忽视。我们的目标是利用病人和照顾者的关系，以改善PA两者之间的 患者及其配偶/伴侣。为此，我们将测试一对夫妇的可行性和可接受性- 为一般癌症幸存者和护理人员开发的基于PA的干预，但可转化为HCT。指导 通过社会认知理论和相互依存/社区应对观点，这种干预提供了 培训沟通技巧和联合解决问题的服务，帮助合作伙伴支持一个 另一个在PA。我们已针对HCT后早期设置调整了该方案，并将使用Activograph器械， 监测PA并告知每周个性化步骤处方。具体目标是：（1）确定 招募[同意参加的合格夫妇的百分比]，坚持[参加干预会议的百分比，# 活动记录仪的有效佩戴天数、治疗师涵盖的治疗元素%]和保持率[随访% 完成的评估]。(2)确定干预措施的可接受性， 患者和护理人员（治疗满意度的多个维度）。(3)描述PA的变化模式 和社区应对（干预目标）的那些在干预相对于通常的照顾。发现将 为全面RCT的设计提供信息，以测试干预措施改善身体健康的有效性，测试 作用机制，并确定治疗反应的潜在调节剂。调查结果还将为努力提供信息 优化干预措施，使其融入标准移植护理，扩大提供者的 支持性护理选项。更广泛地说，干预措施可以适用于不同类型的病人照顾者 dyads二对and illness疾病context上下文.

PROJECT SUMMARY Levels of physical activity (PA) among cancer survivors are low, yet PA may ameliorate difficult effects of treatment. We focus here on PA following the most intensive form of cancer treatment, hematopoietic cell transplantation (HCT). While potentially curative, the procedure is highly demanding, with multiple sequelae including chemotherapy- and radiation-induced cytopenia, and cardiovascular and pulmonary complications. PA is diminished post-transplant, and this decrease is associated with poorer physical functioning. Moderate exercise has been deemed safe for HCT patients, and PA interventions feasible. Findings regarding efficacy, however, are mixed, in part due to heterogeneity of intervention components and outcomes. The largest trial to date reported null findings but the exercise intervention was self-directed (arguably light) and PA was assessed via self-report. Findings from other studies suggest that PA may improve cardiorespiratory fitness, physical performance, and fatigue among HCT patients. All PA interventions in the HCT setting have focused entirely on patients, ignoring an opportunity to engage and benefit the family caregiver, a 24/7 role requiring the provision of medical and logistical support. Distress is common among HCT caregivers and their own health promotion is neglected. We aim to leverage the patient-caregiver relationship to improve PA among both patients and their caregiving spouses/partners. To do so, we will test feasibility and acceptability of a couple- based PA intervention developed for general cancer survivors and caregivers but translatable to HCT. Guided by social cognitive theory and interdependence/ communal coping perspectives, this intervention provides training in communication skills and joint problem-solving in the service of helping partners support one another in PA. We have adapted this protocol for the early post-HCT setting and will use Actigraph devices to monitor PA and inform weekly individualized step prescription. Specific aims are to: (1) Determine feasibility of recruitment [% of eligible couples agreeing to participate], adherence [% of intervention sessions attended, # valid Actigraph wear days, % therapeutic elements covered by therapist], and retention [% follow-up assessments completed] in a single-site pilot RCT. (2) Determine acceptability of the intervention among patients and caregivers (multiple dimensions of treatment satisfaction). (3) Describe patterns of change in PA and communal coping (intervention targets) for those in the intervention relative to usual care. Findings will inform the design of a full-scale RCT to test efficacy of the intervention to improve physical well-being, test mechanisms of action, and identify potential moderators of treatment response. Findings will also inform efforts to optimize the intervention for integration into standard transplant care, expanding providers' repertoire of supportive care options. More broadly, the intervention could be adapted for different types of patient-caregiver dyads and illness contexts.