Improving Oral Health and Quality of Life After Oral Cancer: A Web-based Approach

改善口腔健康和口腔癌后的生活质量：基于网络的方法

基本信息

批准号：
8211347
负责人：
Hoda J Badr
金额：
$ 23.66万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8211347
关键词：
Address Adherence Alcohol consumption Alcohols Behavior Behavior Therapy Behavioral Cancer Survivor Caregivers Clinic Communication Competence Computer Assisted Control Groups Data Deglutition Dental Disease Electronic Mail Exercise Family Caregiver Fluorides Future Goals Head and Neck Cancer Home environment Individual Interdisciplinary Study Internet Intervention Interview Knowledge Lead Life Style Link Malignant Neoplasms Malnutrition Measures Modeling Motivation Multimedia Nutritional Online Systems Oral cavity Oral health Participant Patient Self-Report Physicians Play Population Population Research Protocols documentation Quality of life Radiation Randomized Controlled Trials Recommendation Recruitment Activity Recurrence Regimen Rehabilitation therapy Relative (related person)Research Risk Risk Reduction Role Self Assessment Self Determination Self Efficacy Self Management Source Survivors Target Populations Testing Text Tobacco Volition base cancer risk caregiving design experience high risk improved innovation interactive multimedia malignant mouth neoplasm medical schools oral care programs prototype saliva secretion skills theories treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Survivors of oral cancers experience persistent sequelae, including abnormally reduced salivation or difficulty swallowing related to their disease and treatment. To minimize subsequent cancer risk and reduce these sequelae, survivors are advised to follow intensive home-based oral care protocols, swallowing rehabilitation regimens, and to make healthy lifestyle changes. Adherence, however, is poor. Although family caregivers can support adherence, they are often unprepared for their caregiving role and have significant knowledge gaps about oral care and rehabilitation. Behavioral interventions that actively involve survivors and their caregivers may prove effective in improving oral health and QOL in this population. This project seeks to establish the feasibility of an interactive, web-based, multimedia intervention called Computer Assisted oral health REhabilitation and Support (CARES). The intervention is based on Self Determination Theory (SDT), which focuses on individuals' needs for developing autonomy (a sense of choice and volition), competence (self-efficacy), and relatedness (a sense of belonging and connection to similar others). CARES seeks to deliver: 1) expert information and personalized behavioral self-assessment to improve motivation for adherence; 2) skills-building exercises to enhance competence for behavioral self- management; 3) reminders sent via text message and email to increase adherence; 4) strategies for caregivers to provide motivating support; and, 5) message boards to promote connection and support. Intervention content will be developed by the multidisciplinary research team, and evaluated by both an external advisory board and in-depth interviews with 18 oral cancer survivors/caregivers. Feasibility of the web-based prototype will be evaluated with 14 oral cancer survivors/caregivers. We will consider the project feasible if at least 75% of participants rate the program as easy to use and relevant to their concerns, easy to understand, and easy to navigate. Finally, 35 survivor-caregiver dyads will be recruited upon completion of radiation treatment (baseline) and we will assess whether those receiving the intervention (N=20) experience significant improvements 1 and 3 months later on self-report and objective measures of dental health, swallowing rehabilitation, and QOL relative to those in a usual care (UC) control group (N=15). Innovation: CARES is the first interactive multimedia intervention that targets oral cancer survivors and their caregivers. It is also the first that takes a multiple-behavioral approach to improving oral health and rehabilitation in this population. Simultaneously addressing oral care, swallowing, and nutritional issues may result in maximal risk reduction and improve QOL. Impact: By providing a personalized self-management and entertaining, interactive, and highly informative oral health modules, CARES holds great promise for motivating adherence and improving QOL for both oral cancer survivors and their caregivers. The web-based platform has great potential for nationwide dissemination and reach to the target population. PUBLIC HEALTH RELEVANCE: CARES is the first interactive multimedia intervention that targets oral cancer survivors and their caregivers. It is also the first that takes a multiple-behavioral approach to improving oral health and rehabilitation in this population. Simultaneously addressing oral care, swallowing, and nutritional issues may result in maximal risk reduction and improve QOL. The web-based platform has great potential for nationwide dissemination and reach to the target population.

描述（由申请人提供）：口腔癌幸存者会经历持续的后遗症，包括与其疾病和治疗相关的唾液分泌异常减少或吞咽困难。为了尽量减少随后的癌症风险并减少这些后遗症，建议幸存者遵循强化的家庭口腔护理方案、吞咽康复方案，并改变健康的生活方式。然而，依从性较差。尽管家庭护理人员可以支持依从性，但他们往往对自己的护理角色没有做好准备，并且在口腔护理和康复方面存在巨大的知识差距。积极让幸存者及其护理人员参与的行为干预措施可能会有效改善该人群的口腔健康和生活质量。该项目旨在建立一种称为计算机辅助口腔健康康复和支持（CARES）的交互式、基于网络的多媒体干预措施的可行性。该干预措施基于自我决定理论（SDT），该理论侧重于个人发展自主性（选择感和意志感）、能力（自我效能感）和关联性（归属感和与相似他人的联系感）的需求。 CARES 力求提供： 1) 专家信息和个性化行为自我评估，以提高遵守的动力； 2) 技能建设练习，以增强行为自我管理的能力； 3）通过短信和电子邮件发送提醒以提高遵守率； 4) 照顾者提供激励支持的策略； 5) 用于促进联系和支持的留言板。干预内容将由多学科研究团队开发，并由外部顾问委员会和对 18 名口腔癌幸存者/护理人员的深入访谈进行评估。基于网络的原型的可行性将由 14 名口腔癌幸存者/护理人员进行评估。如果至少 75% 的参与者认为该计划易于使用、与他们的关注点相关、易于理解且易于导航，我们将认为该项目可行。最后，在完成放射治疗（基线）后，将招募 35 名幸存者-护理人员二人组，我们将评估接受干预的人 (N=20) 1 个月和 3 个月后在自我报告和牙齿健康客观测量方面是否有显着改善、吞咽康复和生活质量相对于常规护理 (UC) 对照组 (N=15)。创新：CARES 是第一个针对口腔癌幸存者及其护理人员的交互式多媒体干预措施。这也是第一个采用多种行为方法来改善该人群的口腔健康和康复的方法。同时解决口腔护理、吞咽和营养问题可能会最大限度地降低风险并改善生活质量。影响：通过提供个性化的自我管理以及娱乐性、互动性和信息丰富的口腔健康模块，CARES 有望激发口腔癌幸存者及其护理人员的依从性并改善生活质量。该网络平台具有在全国范围内传播并覆盖目标人群的巨大潜力。公共卫生相关性：CARES 是第一个针对口腔癌幸存者及其护理人员的交互式多媒体干预措施。这也是第一个采用多种行为方法来改善该人群的口腔健康和康复的方法。同时解决口腔护理、吞咽和营养问题可能会最大限度地降低风险并改善生活质量。该网络平台具有在全国范围内传播并覆盖目标人群的巨大潜力。