The development of a technology-based information support intervention (iSupport) among patients with differentiated thyroid cancer post radioactive iodine therapy

摘要 放射性碘（RAI）治疗通常用于诊断为分化型甲状腺癌的患者 (DTC)，约76%的患者接受RAI。RAI治疗后DTC患者报告 广泛的短期和晚期治疗效应、症状负担和未满足的信息需求 治疗相关的副作用。然而，甲状腺癌经常被称为“好癌症”，是一种恶性肿瘤。 研究不足的癌症人群进行生存研究和基于网络的干预措施。一种方法来解决 这些差距是通过数字技术，如基于网络的干预，这可以使患者 直接获得教育和支持工具，以减轻症状负担。我建议开发和评估一个 基于网络的干预，称为iSupport（RAI治疗后患者之间的信息支持），以减少 RAI后诊断为DTC患者的症状负担。我提出以下目标：目标1（K99）。 为RAI治疗后的DTC患者开发iSupport，一种基于网络的干预。目标2（K99）。测试 新开发的iSupport干预在RAI后DTC患者中的可用性。目标3（R 00）。 评估iSupport干预的可行性和可接受性。目标4（R 00）。检验初步疗效 iSupport干预与常规治疗（TAU）在DTC患者中的症状负担。的 K99阶段将包括：1）进行患者焦点小组（N=32）和个体利益相关者访谈（N=12） 开发iSupport和2）在RAI后DTC患者中测试iSupport干预的可用性 治疗（N=8）。R 00阶段将涉及进行一项初步随机对照试验（RCT; N=72），以：1） 评估iSupport的可行性和可接受性; 2）测试iSupport的初步有效性， a（TAU）对照组DTC患者的RAI相关症状负担、患者生物健康指标（口服 口腔健康问题）、DTC和RAI知识、应对副作用的自我效能、癌症- 与健康相关的生活质量。K99/R 00的总体目标是为卡尔博士提供 通过培训和指导，成为一名独立的癌症控制调查员， 在癌症患者中进行基于证据的技术干预。K99培训目标包括：1）增加 了解RAI后DTC患者的临床问题和症状，2）获得高级培训 在基于技术干预设计和开发中，3）发展行为干预方面的专业知识 临床试验设计和测试，以及4）完善拨款写作和领导技能，以确保未来的独立性。博士 卡尔的导师团队包括博士克里斯蒂格雷夫斯（主要），杰奎琳Jonklaas（共同导师），和克里斯汀 米勒（共同导师）谁是致力于她的职业发展。拟议的培训计划将有助于博士。 卡尔的过渡到独立作为一个癌症控制研究人员与数字健康干预的专业知识， 减轻症状负担，改善癌症患者治疗后的健康相关生活质量。

Abstract Radioactive iodine (RAI) therapy is routinely used among patients diagnosed with differentiated thyroid cancer (DTC), with approximately 76% of patients receiving RAI. Patients with DTC post RAI treatment report extensive short-term and late effects of treatment, symptom burden, and unmet informational needs about treatment related side effects. However, thyroid cancer is frequently referred to as the “good cancer” and is an understudied cancer population for survivorship research and web-based interventions. One way to address these gaps is through digital technologies such as a web-based intervention, which can empower patients with direct access to educational and support tools to reduce symptom burden. I propose to develop and evaluate a web-based intervention, called iSupport (informational support among patients post RAI treatment), to reduce symptom burden among patients diagnosed with DTC post RAI. I propose the following aims: Aim 1 (K99). Develop iSupport, a web-based intervention, for patients with DTC post RAI therapy. Aim 2 (K99). Test the usability of the newly developed iSupport intervention among patients with DTC post RAI. Aim 3 (R00). Assess the feasibility and acceptability of the iSupport intervention. Aim 4 (R00). Test the preliminary efficacy of the iSupport intervention vs. treatment as usual (TAU) among patients with DTC on symptom burden. The K99 phase will involve: 1) conducting patient focus groups (N=32) and individual stakeholder interviews (N=12) to develop iSupport and 2) testing the usability of the iSupport intervention among patients with DTC post RAI therapy (N=8). The R00 phase will involve conducting a pilot randomized controlled trial (RCT; N=72) to: 1) assess the feasibility and acceptability of iSupport and 2) test the preliminary efficacy of iSupport compared to a (TAU) control group with DTC patients on RAI-related symptom burden, patient bioheath indicators (oral mucositis; oral health problems), knowledge of DTC and RAI, self-efficacy for coping with side effects, cancer- related distress, and health-related quality of life. The overall objective of the K99/R00 is to provide Dr. Carr with training and mentorship to become an independent cancer control investigator with expertise in digital technology evidenced-based interventions among cancer patients. The K99 training goals include: 1) increase knowledge of clinical concerns and symptoms among patients with DTC post RAI, 2) obtain advanced training in technology-based intervention design and development, 3) develop expertise in behavioral intervention clinical trials design and testing, and 4) refine grant writing and leadership skills for future independence. Dr. Carr’s mentorship team includes Drs. Kristi Graves (primary), Jacqueline Jonklaas (co-mentor), and Kristen Miller (co-mentor) who are committed to her career development. The proposed training plan will facilitate Dr. Carr’s transition to independence as a cancer control researcher with expertise in digital health interventions to reduce symptom burden and improve health-related quality of life in cancer patient outcomes after treatment.