Text-messaging Communication Micro-Intervention for Couples Coping with Advanced GI Cancer

癌症诊断需要患者和他们的亲密伴侣进行有效的沟通，以应对疾病- 相关挑战。研究表明，使用有效沟通策略的夫妻拥有更好的 个体心理调适和较高的关系满意度。然而，许多夫妇都有困难 沟通与癌症相关的问题，这些问题可能会导致个人、人际关系和患者健康状况变差 结果。虽然改善夫妻交流的二元干预已被证明是有效的，但它们 通常是时间密集型的，覆盖范围有限。招募夫妇参加二元干预的挑战是 有很好的记录，招聘率低，特别是在服务不足的夫妇中。微观干预， 由简短的教育材料和通过短信或手机发送的简短活动组成 应用，有很大的潜力通过以下方式增加对不同夫妇群体的接触和参与 提高灵活性，减少准入门槛。此前的研究发现，微干预措施是 有效地在广泛的个人中促进健康行为的改变，并增强二元性 在社区夫妻中发挥作用。到目前为止，还没有开发出现有的微观干预措施 并在患有癌症的夫妇中进行了测试。因此，拟议的项目旨在开发和中试一种 短信微干预的重点是提高夫妻应对 晚期胃肠道(GI)癌。二元微干预的内容将改编自 为癌症和非癌症夫妇开发的现有的、经经验验证的夫妇干预措施。目标1 重点是通过焦点小组和对应对夫妇的采访来发展微观干预 代表少数群体的高级GI癌症和社区顾问，以及用户体验 与目标人群进行测试。收集的数据将用于提高内容的相关性、可接受性、 微观干预的可行性和文化敏感性。目标2将是对二元组的随机试验 评估可行性和可接受性的微观干预。目标3将检查干预前后的结果 以关系满意度和建设性沟通的改善来衡量。该项目正在进行中 与国家癌症研究所癌症存活率的优先研究领域保持一致，并有可能 通过增加未得到充分服务的夫妇的参与来增加癌症方面的健康公平。拟议的项目将 为申请者提供5个关键领域的培训：(1)心理肿瘤学和癌症控制；(2)理论和 与行为干预措施的发展、实施和传播有关的教学学 癌症的背景，(3)特定于发展心理社会干预的混合研究方法，(4) 卫生公平、多样性和包容性培训，以及(5)专业发展。独特而博大精深的 杜克大学医学中心可用的资源，包括杜克癌症研究所，将帮助和 加强培训，提高科学生产力，圆满完成拟议项目。

A cancer diagnosis requires patients and their intimate partners to communicate effectively to navigate illness- related challenges. Research indicates that couples who use effective communication strategies have better individual psychological adjustment and higher relationship satisfaction. However, many couples have difficulty communicating about cancer-related issues which can lead to poorer individual, relationship, and patient health outcomes. While dyadic interventions to improve couple communication have proven efficacious, they are often time intensive and have limited reach. The challenges of recruiting couples into dyadic interventions are well-documented, with low recruitment rates especially among underserved couples. Micro-interventions, which consist of brief educational materials and short activities delivered via text message or a mobile application, have significant potential to increase reach and participation in diverse groups of couples by increasing flexibility and reducing barriers to access. Previous studies have found micro-interventions to be effective in promoting health behavior change in a wide range of individuals and in enhancing dyadic functioning in community couples. To date, there are no existing micro-interventions that have been developed and tested in couples coping with cancer. Therefore, the proposed project aims to develop, and pilot test a text-messaging micro-intervention focused on improving communication skills for couples coping with advanced gastrointestinal (GI) cancer. The content of the dyadic micro-intervention will be adapted from existing, empirically validated couple-based interventions developed for cancer and non-cancer couples. Aim 1 focuses on developing the micro-intervention through focus groups and interviews with couples coping with advanced GI cancer and community advisors representative of minority groups, along with user experience testing with the target population. The data collected will be used to increase content relevance, acceptability, feasibility, and cultural sensitivity of the micro-intervention. Aim 2 will be a randomized pilot test of the dyadic micro-intervention to assess feasibility and acceptability. Aim 3 will examine pre-to-post intervention outcomes as measured by improvements in relationship satisfaction and constructive communication. This project is in line with the National Cancer Institute’s priority research area of cancer survivorship and has the potential to increase health equity in cancer by increasing participation of underserved couples. The proposed project will provide training in 5 key areas for the applicant: (1) psycho-oncology and cancer control, (2) theories and didactics related to the development, implementation, and dissemination of behavioral interventions in the context of cancer, (3) mixed research methods specific to development of psychosocial interventions, (4) health equity, diversity, and inclusion training, and (5) professional development. The unique and extensive resources available at Duke University Medical Center, including the Duke Cancer Institute, will aid and enhance training, scientific productivity, and successful completion of the proposed project.