A mixed methods approach to evaluating the Role of individual differences: Impact on fruit and vegetable intake outcomes in NOURISH-T+ parents of pediatric cancer survivors

项目摘要 成功解决健康生活方式行为(例如，健康饮食、体力活动)的干预措施 儿科癌症幸存者(PCS)是迫切需要的，因为大约40%到50%的PCS 超重/肥胖。可改变的行为，如不健康的饮食摄取和久坐行为是 PCS患者治疗后体重增加。改善PCS的饮食行为和体力活动减少 后遗症和慢性病的风险。此应用程序的父授权R01CA240319是 首次大规模、多部位、随机对照的靶向干预(Nutiish-T+)临床试验 说英语和西班牙语的PCS及其父母的不同群体中的肥胖。 在父母资助中测试的干预计划Nutiish-T+是一项有效性试验，并不 调查干预结果的可变性，在科学文献中被描述为 重要的是增加对目标实现和行为改变的理解。干预的可能性 Nutiish-T+的结果可变性提高了检查个体差异的重要性，这种差异可能 解释干预效果，最大限度地提高干预效果，并告知未来对该方法的调整， 顺应了个性化用药的趋势。对于关键因素是什么，人们知之甚少 行为改变结果的个体差异性。我们对这一问题的理解存在很大差距 动机的机械性作用和其他个体差异。拟议的项目解决了这一知识 GAP通过混合方法设计，探索个体差异在水果和蔬菜上的作用 (F/V)摄入量，与行为变化有关的标准指标。 目标1：检查干预后3个月主要F/V摄入量结果的变异性。 O目标1a：确定F/V摄入量的极端观察结果(即对F/V的最高遵守 准则与最低依存度)，以指导面试参与者的选择。 O目标1b：检查潜在的个体差异变量和F/V之间的关系 采用半结构式访谈指南的构建。 目标2：描述父母对最重要的潜在个体差异变量的看法 通过半结构化访谈引导他们的行为改变。 在这个多样化的补充中，我将获得更多的经验，使我能够进行我的癌症研究 事业更上一层楼。我的长期职业目标是成为一名独立的癌症研究临床医生- 科学家专注于设计和实施适应文化的健康行为改变干预措施 旨在改善儿童、青少年和年轻人的生活方式、生活质量和生存能力，以及 他们的家人。我的短期职业目标包括完成我的博士学习，获得必要的技能 竞争癌症控制领域的顶级博士后奖学金，并成功获得F32奖学金。

Project Summary Interventions successfully addressing healthy lifestyle behavior (e.g., healthy eating, physical activity) in pediatric cancer survivors (PCS) are urgently needed as approximately 40% to 50% of PCS have overweight/obesity. Modifiable behaviors, such as unhealthy dietary intake and sedentary behavior are key to post-treatment weight gain among PCS. Improving eating behaviors and physical activity in PCS decreases the risk of negative late effects and chronic illness. The parent grant to this application, R01CA240319, is the first large scale multi-site, randomized controlled clinical trial of an intervention (NOURISH-T+) that targets obesity in a diverse group of English and Spanish speaking PCS and their parents. The intervention program, NOURISH-T+, tested in the parent grant is an efficacy trial and does not investigate the variability in intervention outcomes that has been described in the scientific literature as important in increasing understanding of goal attainment and behavior change. The potential for intervention outcome variability in NOURISH-T+ raises the importance of examining individual differences that might explain intervention efficacy, maximize intervention impact, and inform future tailoring of this approach, consistent with the trend to personalized medicine. Relatively little is known about what key factors explain individual variability in behavior change outcomes. There are major gaps in our understanding of the mechanistic role of motivation and other individual differences. The proposed project addresses this knowledge gap by exploring, through a mixed-methods design, the role of individual differences on fruit and vegetable (F/V) intake, a standard index related to behavioral change.  Aim 1: Examine the variability in primary F/V intake outcomes at 3-months post-intervention. o Aim 1a: Identify F/V intake extreme observations (i.e., highest adherence to F/V guidelines vs. lowest adherence) to guide the selection of participants to interview. o Aim 1b: Examine the relation between potential individual difference variables and F/V intake to inform the construction of the semi-structured interview guide.  Aim 2: Describe parents' perceptions of potential individual difference variables most important to them in eliciting behavior change via semi-structured interviews. During this diversity supplement, I will gain further experience that will enable me to take my cancer research career to the next level. My long-term career goal is to become an independent cancer research clinician- scientist focused on the design and implementation of culturally adapted health behavior change interventions designed to improve lifestyle, quality of life, and survivorship in children, adolescents and young adults, and their families. My short-term career goals include completing my Ph.D. studies, gaining the skills necessary to compete for a top post-doctoral fellowship in cancer control, and writing a successful F32 grant.