Adaptation and implementation of a community-based intervention to reduce psychosocial distress and promote physical activity in rural breast cancer survivors

适应和实施基于社区的干预措施，以减少农村乳腺癌幸存者的社会心理困扰并促进身体活动

• 批准号: 10285046
• 负责人: Scherezade Kelly Mama
• 金额: $ 16.57万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10285046
• 关键词: Adoption; Adult; Aerobic; Aerobic Exercise; Area; Breast Cancer survivor; Cancer Control; Cancer Intervention; Cancer Survivor; Cancer Survivorship; Clinical; Collaborations; Communities; Data; Data Collection; Distress; Educational workshop; Effectiveness; Evidence based intervention; Feedback; Focus Groups; Future; Goals; Health; Health Resources; Home environment; Intervention; Interview; K-Series Research Career Programs; Leisures; Life Style; Literature; Location; Medical Oncologist; Mental Health; Mentors; Methods; Morbidity - disease rate; Oncology Nurse; Outcome; Participant; Pennsylvania; Personal Satisfaction; Phase; Physical Function; Physical activity; Population; Positioning Attribute; Psychosocial Stress; Public Health; Quality of life; Randomized Controlled Trials; Reading; Recommendation; Recurrence; Reporting; Research; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Rural; Rural Community; Rural Population; Safety; Survivors; Telephone; Testing; Text; Time; Training; Translations; Underserved Population; Work; base; body-mind; cancer diagnosis; cancer health disparity; cancer prevention; career; community partnership; community setting; comorbidity; design; diaries; dissemination research; effectiveness implementation study; evidence base; exercise intervention; experience; health care availability; health disparity; implementation research; improved; innovation; intervention participants; meetings; mortality; multidisciplinary; physical conditioning; physical inactivity; post intervention; preference; programs; psychological distress; psychosocial; public health relevance; recruit; skills; survivorship; treatment as usual; vigorous intensity

PROJECT SUMMARY / ABSTRACT Rural cancer survivors are less likely to meet physical activity recommendations than urban cancer survivors, contributing to physical inactivity-related cancer health disparities. Evidence-based interventions to reduce psychosocial distress and increase physical activity in cancer survivors were developed in urban or clinical settings and often fail when implemented in rural community settings. The goal of this career development award is to assist Scherezade K. Mama, DrPH in her long-term goal of becoming an independent investigator in designing and implementing physical activity interventions in underserved populations, including rural cancer survivors, to improve health outcomes and reduce health disparities. Dr. Mama’s short-term goals include gaining expertise in the use of psychosocial intervention methods, cancer survivorship and interventions to improve survivorship outcomes, intensive longitudinal methods, and dissemination and implementation research. In collaboration with her multidisciplinary team of mentors and advisors, she has developed a training plan to reach these goals via coursework, workshops, scientific meetings, directed readings, and a mentored research project. The primary objective of the proposed research project is to use a community- engaged approach to develop and evaluate an intervention to reduce psychosocial stress and increase physical activity in rural breast cancer survivors in central Pennsylvania. Focus groups (n=6) with community stakeholders and rural breast cancer survivors will be conducted to (a) determine how to best modify an evidence-based intervention for rural cancer survivors and for implementation in a community setting and (b) feedback the modified intervention. Rural breast cancer survivors (n=50) will be recruited through an existing community partnership to participate in the 3-month adapted community-based intervention or to receive usual care. The intervention consists of face-to-face and home-based sessions incorporating aerobic exercise and mind-body strategies to reduce psychosocial distress and increase physical activity. Participants complete assessments at four time points (baseline, 6-weeks, post-intervention, 6-months) and complete daily diaries assessing daily distress and physical activity throughout the 3-month intervention period. In-depth interviews will be conducted with intervention participants (n=25) and community stakeholders (n=10) after the 6-month study period to explore implementation outcomes. Findings from this study will fill a critical gap in the literature on the translation of evidence-based interventions into sustained practice in community settings and will inform the next phase of this research, an effectiveness-implementation hybrid study of a large-scale community- based randomized controlled trial to reduce psychosocial distress and increase physical activity in rural breast cancer survivors. Completion of the proposed research and training aims will provide Dr. Mama with the skills, experience, and preliminary data needed to launch a successful independent research career in physical activity promotion, cancer prevention and control, and health disparities.

项目摘要 /摘要 与城市癌的生存相比 有助于与身体无关的癌症健康分布。基于证据的干预措施以减少 在城市或临床上开发了社会心理困扰和增加癌症存活的体育活动 设置，在农村社区环境中实施时通常会失败。这个职业发展的目标 奖项是协助Scherezade K. Mama，DRPH的长期目标，即成为独立调查员 在设计和实施服务不足的人群（包括农村癌症）的体育锻炼干预措施时 幸存者，以改善健康状况并减少健康差异。妈妈博士的短期目标包括 在使用社会心理干预方法，癌症生存和干预措施方面获得专业知识 改善生存结果，密集的纵向方法以及传播和实施 研究。与她的多学科导师和顾问团队合作，她开发了一个 培训计划通过课程，研讨会，科学会议，有导阅读和A 指导的研究项目。拟议的研究项目的主要目的是使用一个社区 - 开发和评估干预措施以减轻社会心理压力并增加的方法 宾夕法尼亚州中部农村乳腺癌的体育活动。与社区的焦点小组（n = 6） 利益相关者和粗糙的乳腺癌存活率将进行（a）确定如何最好地修改 基于证据的粗糙癌症生存和在社区环境中实施的干预措施和（b） 反馈修改后的干预措施。农村乳腺癌存活（n = 50）将通过现有 社区合作伙伴关系，参加3个月改编的基于社区的干预措施或接受常规 关心。干预措施包括编码有氧运动的面对面和家庭课程 减少心理困扰并增加体育锻炼的思维体策略。参与者完成 四个时间点的评估（基线，6周，干预后，6个月）和每日日记 在整个3个月的干预期内评估每日苦难和体育锻炼。深入的访谈 将在6个月后与干预参与者（n = 25）和社区利益相关者（n = 10）一起进行 探索实施成果的学习期。这项研究的发现将填补文献中的关键空白 关于将基于证据的干预措施转化为社区环境中持续实践的，并将告知 这项研究的下一阶段是大规模社区的有效实施混合研究 基于随机对照试验，以减少社会心理困扰并增加农村乳房的体育锻炼 癌症存活。拟议的研究和培训目标的完成将为妈妈博士提供技能， 经验和初步数据才能启动成功的独立研究职业 活动促进，预防癌症和控制以及健康分布。