Fit2ThriveMIND: Optimizing a mHealth Physical Activity Intervention with Mindful Awareness Lessons in Breast Cancer Survivors

Fit2ThriveMIND：通过乳腺癌幸存者的正念意识课程优化移动健康身体活动干预

• 批准号: 10539045
• 负责人: Siobhan Marie Phillips
• 金额: $ 65.58万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10539045
• 关键词: Accelerometer; Address; Adherence; Adoption; Aftercare; Age; American Cancer Society; Anxiety; Awareness; Behavior; Breast Cancer survivor; Cancer Prognosis; Cancer Survivorship; Cellular Phone; Cessation of life; Chronic Disease; Communities; Compassion; Development; Diagnosis; Disease Outcome; Educational Intervention; Engineering; Exercise; Fatigue; Funding; Goals; Health; Health Benefit; Health Care Costs; Health Promotion; Health behavior outcomes; Individual; Intervention; Knowledge; Light; Maintenance; Measures; Mediator of activation protein; Mental Depression; Methodology; Methods; Mindfulness Training; Outcome; Physical activity; Physical activity scale; Population; Population Intervention; Posttraumatic growth; Psychosocial Factor; Public Health; Quality of life; Randomized; Recommendation; Research; Research Design; Research Methodology; Research Priority; Resources; Role; Self Efficacy; Site Visit; Sleep; Social support; Supervision; Survivors; Symptoms; Technology; Testing; Text; Time; Treatment Side Effects; Treatment-Related Cancer; Work; adverse outcome; base; behavior change; burden of illness; cancer care; cancer recurrence; cancer risk; comorbidity; cost; design; disorder risk; emotion regulation; evidence base; exercise intervention; experimental study; fitbit; follow-up; improved; improved outcome; innovation; intervention effect; mHealth; mindfulness; mortality; multiphase optimization strategy; premature; programs; reduce symptoms; remote delivery; response; sedentary; sleep quality; symptom management; symptomatic improvement; telephone coaching; vigorous intensity

PROJECT SUMMARY/ABSTRACT There are approximately 4 million breast cancer survivors (BCS) in the U.S., and this population is expected to increase by 1 million in the next ten years. Increased moderate-to-vigorous intensity physical activity (MVPA) is consistently associated with reductions in treatment-related side effects, cancer recurrence and mortality, and increased QOL in BCS. Yet, the majority of BCS (~70%) do not meet MVPA recommendations (i.e., 150 mins/week). Existing studies of MVPA in BCS are largely resource-intensive, costly, and deliver multiple components (i.e., coaching calls, supervised exercise) simultaneously limiting scalability. Three evidence- based strategies have been identified that may be particularly useful for overcoming these barriers and increasing MVPA in BCS: 1) electronic delivery of a MVPA program, 2) social support, and 3) mindfulness training. However, little is known about the unique roles of social support and mindfulness in MVPA promotion. More granular information about the discrete effects of these components is needed to optimize intervention configuration in order to maximize an effective and scalable MVPA program for BCS. The purpose of this study is to apply the Multiphase Optimization Strategy (MOST), to determine which types of social support and mindfulness training intervention components optimally increase and maintain MVPA in a 6-month mHealth MVPA intervention with a 6-month follow-up. MOST is a framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of intervention components to determine which ones can be reduced, eliminated, or replaced to improve efficiency. Inactive BCS (n=304) will receive a core intervention consisting of the FIt2ThriveMIND app and Fitbit and be randomly assigned to four components under consideration for inclusion in the optimized intervention: 1) general mindfulness training; 2) MVPA-specific mindfulness training; 3) text-coaching; and 4) engagement of a buddy. We will also examine the effects of increasing MVPA on symptom burden, other intensity activities (i.e. light and sedentary), and sleep quality and duration and potential mediators and moderators of component effects. All components with have a 6-month duration except text coaching which will include “boosters” personalized to an individual's MVPA goal- attainment during the 6-month follow-up period. The proposed study represents the first systematic effort to use MOST to design an optimized, scalable mHealth MVPA intervention in BCS that incorporates mindfulness and specifically tests a maintenance strategy. Knowledge gained from this study will inform the development of more effective and scalable interventions to improve health and disease outcomes among BCS. This study will lead to an improved understanding of how to effectively change and maintain BCS' MVPA and inform the development of more effective and scalable interventions to improve health and disease outcomes among BCS.

项目摘要/摘要 美国大约有400万乳腺癌幸存（BC），预计该人口将 在未来十年中，增长了100万。增加现代性强度的体育活动（MVPA）是 与治疗相关副作用减少，癌症复发和死亡率以及 BCS中的QoL增加。但是，大多数BC（〜70％）不符合MVPA建议（即150 分钟/周）。 BC中MVPA的现有研究在很大程度上是资源密集的，昂贵的，并且提供了多个 组件（即教练电话，监督练习）仅限制可扩展性。三个证据 - 已经确定了基于基于的策略，可能对于克服这些障碍和 在BCS中增加MVPA：1）MVPA计划的电子传递，2）社会支持，3）正念 训练。但是，关于社会支持和正念在MVPA促销中的独特作用知之甚少。 需要有关这些组件的离散效果的更多详细信息才能优化干预 配置为了最大程度地提高BCS有效且可扩展的MVPA程序。这项研究的目的 是应用多相优化策略（大多数），以确定哪种类型的社会支持和 正念训练干预组件在6个月的MHealth中最佳增加和维护MVPA MVPA干预，随访6个月。大多数是根据高度使用工程改编的框架 有效的阶乘实验，以评估干预组件的个体和结合的影响 确定可以降低，消除或更换哪些以提高效率。非活动的BC（n = 304）将 接受由Fit2Thrivemind应用和Fitbit组成的核心干预措施，并随机分配给四个 正在考虑的组成部分，以纳入优化的干预措施：1）一般的正念训练； 2） MVPA特定的正念训练； 3）教练； 4）伙伴的订婚。我们还将检查 增加MVPA对症状，其他强度活动（即光和久坐的）和睡眠的影响 质量和持续时间以及组件效应的潜在介体和主持人。所有组件都有一个 持续6个月的持续时间，除文本教练外，还包括个性化的“助推器”到个人的MVPA目标 - 在6个月的随访期内达成。拟议的研究代表了第一个系统的努力 大多数用于设计合并正念的BCS中优化，可扩展的MHealth MVPA干预 并专门测试维护策略。从这项研究中获得的知识将为发展 更有效，更可扩展的干预措施，以改善BC之间的健康和疾病结果。这项研究会 对如何有效改变和维护BCS的MVPA并告知如何有效地了解 开发更有效和可扩展的干预措施，以改善健康和疾病结果 BCS。