Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent Therapy

经验丰富的肺癌幸存者在意向治疗后进行远程康复

• 批准号: 10420876
• 负责人: Duc M. Ha
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10420876
• 关键词: Activities of Daily Living; Address; Adherence; Adverse effects; Adverse event; Authorship; Behavioral; Cancer Biology; Cancer Survivor; Cancer Survivorship; Caring; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Colorado; Conduct Clinical Trials; Data; Data Analyses; Diagnosis; Doctor of Philosophy; Education; Elderly; Enrollment; Environment; Equilibrium; Excision; Exercise; Exercise Physiology; Feeling; Funding; Goals; Health; Health Sciences; Impaired health; Impairment; Improve Access; Institutes; Intervention; Interview; K-Series Research Career Programs; Knowledge; Leisures; Longevity; Lung; Malignant neoplasm of lung; Master' s Degree; Medical; Medical Oncology; Medical center; Medicine; Mentors; Modeling; Non-Small-Cell Lung Carcinoma; Operative Surgical Procedures; Outcome; Participant; Patient Outcomes Assessments; Patient Participation; Patient Self-Report; Patients; Physical Function; Physical activity; Physical therapy; Physicians; Program Accessibility; Publishing; Qualitative Research; Quality of life; Radiation; Randomized; Recommendation; Recording of previous events; Rehabilitation therapy; Reporting; Research; Research Personnel; Safety; Self Efficacy; Services; Stage at Diagnosis; Structure; Supportive care; Survival Rate; Survivors; Symptoms; System; Teacher Professional Development; Techniques; Technology; Testing; Time; Training; Translational Research; Transportation; Travel; United States Department of Veterans Affairs; Universities; Veterans; Work; arm; base; behavior change; behavioral health; cancer diagnosis; cancer rehabilitation; cancer therapy; career; career development; chemoradiation; clinical center; cost effective; curative treatments; design; exercise capacity; exercise program; exercise rehabilitation; exercise training; expectation; experience; experimental arm; health goals; improved; improved functioning; innovation; loss of function; mid-career faculty; oncology program; precision oncology; professor; programs; psychosocial; pulmonary rehabilitation; randomized trial; rehabilitation research; rehabilitation science; rehabilitation service; research and development; screening; social cognitive theory; systematic review; telehealth; telerehabilitation; uptake; usability

This project entitled “Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent Therapy”, is a Career Development Award (CDA) – 2 resubmission to the Veterans Affairs (VA) Rehabilitation Research and Development (RR&D) Service (RFA RX-20-006). The candidate, Dr. Duc M. Ha, MD, MAS, is a Staff Pulmonologist at the Rocky Mountain Regional VA Medical Center (RMR VAMC) and Assistant Professor at the University of Colorado Anschutz Medical Campus (CU AMC). Dr. Ha has completed a master’s degree in clinical research, postdoctoral research in pulmonary exercise physiology and patient-reported outcomes, and published first-authorship, original research articles on the health impairments of Veteran lung cancer survivors following curative intent therapy. Dr. Ha’s career development goals are to acquire in-depth training in 1) qualitative research, 2) behavioral health science, and 3) the design and conduct of clinical trials focused on rehabilitation and exercise. His longer-term goals are to evaluate rehabilitation services to improve the lives of Veteran lung cancer survivors as a VA physician investigator. Dr. Ha’s primary mentor, Dr. Robert L. Keith, MD, is Professor of Medicine and Cancer Biology at CU AMC and Associate Chief of Staff for Research at RMR VAMC. Dr. Keith is a national leader in lung cancer with a proven track record of research funding and mentoring. Dr. Ha’s co-mentors (and their relevant expertise) are Drs. David B. Bekelman, MD, MPH, Associate Professor of Medicine (qualitative research, supportive care), Jamie L. Studts, PhD, Professor of Medical Oncology (behavioral health science, lung cancer survivorship), and Jennifer E. Stevens-Lapsley, PT, PhD, Professor of Physical Therapy (rehabilitation science). The environment is collaborative with a long history of faculty development. This includes the RMR Geriatric Research, Education and Clinical Center; Center of Innovation for Veteran-Centered and Value-Driven Care; Lung Precision Oncology Program; and the University of Colorado Clinical and Translational Sciences Institute. Lung cancer is the second-most commonly diagnosed cancer among U.S. Veterans – over 8,200 incident cases are diagnosed each year. Approximately 50% of lung cancers are diagnosed at stage I-III and therefore eligible for curative intent therapy. Survival rates among Veterans with early stage lung cancer have increased along with advances in surgical and radiation techniques. Following curative intent therapy, many Veterans experience physical function loss and increased symptom burden. Consequently, approaches are needed to improve their function and quality of life (QoL). We hypothesize that telerehabilitation could mitigate these adverse effects. Therefore, we seek to: (Aim 1) Conduct a qualitative study to assess (a) Veteran lung cancer survivors’ health goals following curative intent therapy, (b) knowledge of outcome expectations for exercise and rehabilitation, and (c) perceived self-efficacy and impediments towards technology. Participants (N=30) will undergo semi-structured interviews guided by the Social Cognitive Theory. Qualitative data analysis will be guided by thematic analysis. Results will be used to guide telerehabilitation programming. (Aim 2) Conduct a pilot randomized study to examine the (a) feasibility, (b) acceptability, and (c) explore the effects of a telerehabilitation intervention with these patients. Participants (N=40) will be randomized (1:1) to receive 12 weeks of telerehabilitation (experimental arm) or assessment only (control arm). Feasibility will be assessed by enrollment, adherence, and retention; acceptability by System Usability Scales; and exploratory effects by linear mixed effects models comparing changes in function, symptom control, and QoL between groups. This CDA-2 project will inform strategies to tailor telerehabilitation and provide pilot data and training for an early career physician investigator to establish independence, with a goal of a large-scale randomized trial (VA Merit) of an optimized telerehabilitation program to improve the physical and psychosocial function, independence, and QoL of Veteran lung cancer survivors following curative intent therapy.

该项目题为“治疗性意向治疗后退伍军人肺癌幸存者的远程康复”， 是职业发展奖 (CDA) – 2 次重新提交给退伍军人事务部 (VA) 康复研究 候选人 Dr. Duc M. Ha，医学博士，MAS，是一名员工。 落基山地区退伍军人医疗中心 (RMR VAMC) 的肺科医生和助理教授 Ha 博士已获得科罗拉多大学安舒茨医学校区 (CU AMC) 的硕士学位。 肺运动生理学和患者报告结果的临床研究、博士后研究，以及 发表关于退伍军人肺癌幸存者健康损害的第一作者原创研究文章 接受治疗性意向治疗后，哈医生的职业发展目标是获得以下方面的深入培训： 定性研究，2) 行为健康科学，以及 3) 临床试验的设计和实施，重点关注 他的长期目标是评估康复服务以改善人们的生活。 作为退伍军人管理局医师调查员的资深肺癌幸存者。 Ha 博士的主要导师 Robert L. Keith 博士（医学博士）是 CU AMC 医学和癌症生物学教授 Keith 博士是 RMR VAMC 研究副主任，是全国肺癌领域的领军人物。 哈博士的共同导师（及其相关专业知识）拥有良好的研究资助和指导记录。 David B. Bekelman 博士，医学博士、公共卫生硕士、医学副教授（定性研究、支持性护理）， Jamie L. Studts 博士，肿瘤内科教授（行为健康科学，肺癌生存）， Jennifer E. Stevens-Lapsley，PT，博士，物理治疗教授（康复科学）。 环境与悠久的教师发展历史相结合，其中包括 RMR 老年病学。 研究、教育和临床中心；以退伍军人为中心和价值驱动的护理创新中心； 肺精准肿瘤学项目；以及科罗拉多大学临床和转化科学研究所。 肺癌是美国退伍军人中第二常见的癌症——超过 8,200 例 每年大约有 50% 的肺癌是在 I-III 期被诊断出来的。 患有早期肺癌的退伍军人的生存率有所提高。 随着手术和放射技术的进步，许多退伍军人接受了治疗性意向治疗。 经历身体功能丧失和症状负担增加。 我们认为远程康复可以改善他们的功能和生活质量（QoL）。 因此，我们寻求：（目标 1）进行定性研究来评估 (a) 退伍军人肺癌。 治疗性意向治疗后幸存者的健康目标，(b) 对运动结果预期的了解 和康复，以及（c）参与者的自我效能感和技术障碍（N = 30）。 将进行以社会认知理论为指导的半结构化访谈。 以主题分析为指导。结果将用于指导远程康复规划（目标 2）。 试点随机研究旨在检验 (a) 可行性、(b) 可接受性以及 (c) 探讨 参与者 (N=40) 将被随机 (1:1) 接受 12 名患者的远程康复干预。 几周的远程康复（实验组）或仅评估（对照组）的可行性将由以下人员进行评估。 入学率、依从性和保留率；系统可用性量表的可接受性和探索性效果； 线性混合效应模型比较组间功能、症状控制和生活质量的变化。 该 CDA-2 项目将为定制远程康复战略提供信息，并为远程康复提供试点数据和培训。 早期职业医师研究者建立独立性，目标是进行大规模随机试验（VA 优点）优化的远程康复计划，以改善身体和心理社会功能， 治疗性意向治疗后退伍军人肺癌幸存者的独立性和生活质量。