RENEW Research-out to Enhance Wellness Older Survivors

更新研究以增强老年幸存者的健康

• 批准号: 6764705
• 负责人: WENDY DEMARK-WAHNEFRIED
• 金额: $ 60.28万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-15 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6764705
• 关键词: behavior therapy; behavioral /social science research tag; breast neoplasms; clinical research; clinical trials; colorectal neoplasms; comorbidity; counseling; depression; diet; exercise; functional ability; human old age (65+); human subject; human therapy evaluation; long term survivor; longitudinal human study; patient oriented research; prostate neoplasms; quality of life; self help; social support network; statistics /biometry; telemedicine; therapy compliance; weight control

DESCRIPTION (provided by applicant): American women have a 1 in 3 lifetime risk of developing cancer; for men the risk is even higher (1 in 2). While cancer is a leading cause of death, survival rates are ever increasing - 62 percent of those diagnosed with cancer will be alive at least 5 years after diagnosis. Yet, a large proportion are left with significant morbidity, either from the cancer or its treatment. This population also is at increased risk for secondary cancers, diabetes, osteoporosis and cardiovascular disease - compounded comorbidities that manifest themselves in accelerated functional decline, especially among older survivors. With >60 percent of cancer survivors being age 65+, there is large public health potential for interventions that stabilize or positively reorient the functional decline trajectory. A multidisciplinary team representing the fields of aging, oncology, exercise, nutrition, nursing, behavioral psychology and biostatistics at Duke Univ. Med. Ctr. is well-postured to test if a distance medicine-based diet and exercise program will improve physical functioning among older cancer survivors who are >5 yrs out from a diagnosis of colorectal, breast or prostate cancer. The proposed study builds upon our preliminary work which shows that functional decline may be attenuated through such intervention. A total of 640 survivors will be recruited and block randomized into: 1) an arm that receives a 1-yr telephonecounseling+ mailed material program that promotes exercise and a healthful portion-controlled diet (<10 percent of kcal from saturated fat, >= 5 svgs/day of vegetables and fruit); and 2) a delayed intervention arm that receives the intervention after a 1-year observation period. Specific aims of this randomized controlled trial are to: 1)Determine the efficacy of the intervention in reorienting the physical function trajectory among elders who are long term survivors of cancer; 2) determine differences between arms with regard to other endpoints (physical activity, diet quality, BMI, depression, etc); 3) identify factors that influence program efficacy (self efficacy, etc); and 4) characterize functional decline over a 2-year period in survivors who receive the initial intervention vs. those who are intervened upon after a 1-year delay. Results of this study will increase our knowledge of the use of distance-medicine to deliver multiple risk factor interventions among older cancer survivors - an ever expanding population in which historically little research has been conducted.

描述（由申请人提供）： 美国女性一生中有三分之一的人患癌症；对于男性来说，这种风险甚至更高（二分之一）。虽然癌症是导致死亡的主要原因，但存活率却在不断提高 - 62% 的癌症患者在确诊后至少还能存活 5 年。然而，很大一部分人因癌症或其治疗而患有显着的发病率。该人群患继发性癌症、糖尿病、骨质疏松症和心血管疾病的风险也增加，这些复合症表现为功能加速衰退，尤其是老年幸存者。由于超过 60% 的癌症幸存者年龄在 65 岁以上，因此稳定或积极重新调整功能衰退轨迹的干预措施在公共卫生方面具有巨大潜力。杜克大学代表衰老、肿瘤学、运动、营养、护理、行为心理学和生物统计学领域的多学科团队。医学。中心。已经准备好测试基于远程医学的饮食和锻炼计划是否会改善距离诊断为结直肠癌、乳腺癌或前列腺癌 5 岁以上的老年癌症幸存者的身体机能。拟议的研究建立在我们的初步工作的基础上，该工作表明通过这种干预可以减轻功能衰退。总共 640 名幸存者将被招募并随机分为：1）接受为期 1 年的电话咨询 + 邮寄材料计划的手臂，该计划促进锻炼和健康的份量控制饮食（< 10% 的千卡来自饱和脂肪，> = 5 svgs/天的蔬菜和水果）； 2) 延迟干预组，在 1 年观察期后接受干预。这项随机对照试验的具体目的是： 1) 确定干预措施在重新调整癌症长期幸存者的身体功能轨迹方面的功效； 2) 确定各组之间在其他终点（体力活动、饮食质量、BMI、抑郁等）方面的差异； 3）识别影响项目效能的因素（自我效能等）； 4) 描述接受初始干预的幸存者与延迟 1 年后接受干预的幸存者在 2 年期间的功能衰退特征。这项研究的结果将增加我们对使用远程医疗对老年癌症幸存者进行多种危险因素干预的认识——这一群体不断扩大，但历史上对此进行的研究很少。