Designing with Dissemination in Mind: Optimization of a mHealth Physical Activity Intervention for Breast Cancer Survivors

 描述(由申请人提供)：增加体力活动(PA)与减少与治疗相关的副作用、癌症复发和死亡率以及提高乳腺癌幸存者的生活质量和存活率有关。然而，幸存者表现出持续的、治疗后显著的PA下降，并且大多数不符合PA的建议。大多数现有的对幸存者PA的研究都是密集的、现场多成分干预，对哪些成分有效或哪些成分无效提供的洞察很少，而且规模化的潜力有限。这一职业发展奖的目标是帮助西沃恩·M·菲利普斯博士和公共卫生硕士西沃恩·M·菲利普斯实现她的长期目标，即成为一名独立调查者，在癌症幸存者中设计和实施优化的移动健康(MHealth)PA干预措施，以改善健康和疾病结果。菲利普斯博士的短期目标包括加强或获得PA和癌症存活率方面的专业知识、在PA干预中使用mHealth、多阶段优化策略(MOST)方法以及传播和实施(D&I)科学。与她的多学科导师和顾问团队合作，她制定了一项培训计划，通过课程作业、研讨会、专门培训、独立研究和有指导的研究项目来实现这些目标。这项拟议研究的目的是使用MOST方法论为乳腺癌幸存者开发和试行一套mHealth PA干预组件，目标是社会认知结构，并从一开始就考虑到D&I。MOST是一种创新的多阶段框架，改编自工程学，它使用高效的析因实验来评估干预组件的单独和组合效果，以确定哪些组件可以减少、消除或替换，以提高效率。将要测试的干预成分将与幸存者、社区合作伙伴和专家/临床医生合作选择，并在250名乳腺癌幸存者中进行为期12周的MOST试验的试点测试。这项拟议的实验检验了干预成分的可行性和可接受性，并量化了它们在12周和24周随访时对PA和患者报告的结果的初步影响。这些信息将被用来组合PA干预措施，以最大限度地提高PA并将成本和参与者负担降至最低，以便在未来的试验中进行测试。这项拟议的研究代表了利用MOST为乳腺癌幸存者设计优化的、可传播的mHealth PA干预的第一次系统性努力，并将导致对如何有效地改变幸存者PA的更好的理解。这些发现可能导致针对幸存者的更可扩展、更有效的PA干预，并最终改善健康和疾病结果。拟议的研究和培训计划的完成将为候选人提供必要的技能、经验和初步数据，以启动专注于PA和癌症生存的成功的独立研究计划。

 DESCRIPTION (provided by applicant): Increased physical activity (PA) is associated with reductions in treatment-related side effects, cancer recurrence and mortality and increased QOL and survival in breast cancer survivors. However, survivors demonstrate persist, significant post-treatment declines in PA, and the majority do not meet PA recommendations. Most existing studies of PA in survivors are intense, on-site multicomponent interventions that provide little insight into what components are, or are not, effective and have limited potential to be brought to scale. The goal of this Career Development Award is to assist Siobhan M. Phillips, PhD, MPH in her long- term goal of becoming an independent investigator in designing and implementing optimized mobile health (mHealth) PA interventions in cancer survivors to improve health and disease outcomes. Dr. Phillips's short- term goals include enhancing or gaining expertise in PA and cancer survivorship, use of mHealth in PA interventions, Multiphase Optimization Strategy (MOST) methodology and dissemination and implementation (D&I) sciences. In collaboration with her multidisciplinary team of mentors and advisors, she has developed a training plan to reach these goals via coursework, seminars, specialized trainings, independent studies, and a mentored research project. The purpose of the proposed research is to use MOST methodology to develop and pilot test a set of mHealth PA intervention components for breast cancer survivors targeted at social cognitive constructs and designed with D&I in mind from the outset. MOST is an innovative, multi-phase framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of interventio components to determine which ones can be reduced, eliminated or replaced to improve efficiency. The intervention components to be tested will be chosen in collaboration with survivors, community partners, and experts/clinicians and pilot tested in a 12-week MOST experiment in 250 breast cancer survivors. The proposed experiment examines the feasibility and acceptability of the intervention components and quantifies their preliminary effects on PA and patient reported outcomes at 12 weeks and 24 week follow-up. This information will be used to assemble a PA intervention optimized to maximize PA and minimize cost and participant burden to be tested in a future trial. The proposed study represents the first systematic effort to use MOST to design an optimized, disseminable, mHealth PA intervention for breast cancer survivors and will lead to an improved understanding of how to effectively change survivors' PA. These findings could result in more scalable, effective PA interventions for survivors, and, ultimately, improve health and disease outcomes. Completion of the proposed research and training plans will provide the candidate with the necessary skills, experience, and preliminary data to launch a successful independent research program focused on PA and cancer survivorship.