Using game mechanics to improve outcomes among stem cell transplant survivors

利用游戏机制改善干细胞移植幸存者的结果

• 批准号: 8315506
• 负责人: Martha Ann Askins
• 金额: $ 30万
• 依托单位: RADIANT CREATIVE GROUP, LLC
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8315506
• 关键词: Achievement; Address; Adherence; Adolescent; Age; Allogenic; Ambulatory Care; Anxiety; Behavior; Behavioral; Cancer Patient; Cancer Survivor; Chronic; Chronically Ill; Communication; Complex; Distress; Electronics; Emotional; Environment; Evaluation; Face; Failure; Fatigue; Focus Groups; Gifts; Goals; Health; Health Communication; Health Personnel; Hematopoietic Stem Cell Transplantation; Hydration status; Individual; Intention; Internet; Intervention; Knowledge; Length of Stay; Life; Link; Measures; Mechanics; Mediating; Medical; Mental Depression; Mental Health; Methods; Metric; Modeling; Motivation; National Cancer Institute; Organ; Outcome; Outpatients; Participant; Patients; Perception; Performance; Pharmaceutical Preparations; Phase; Physical activity; Population; Positive Reinforcements; Problem Solving; Procedures; Process; Program Evaluation; Recovery; Regimen; Research; Rewards; Schedule; Self Care; Self Management; Small Business Technology Transfer Research; Social Network; Social support; Stem cell transplant; Structure; Survivors; System; Technology; Testing; Transplant Recipients; Transplantation; Treatment Protocols; base; cancer therapy; cancer type; coping; design; graft vs host disease; improved; innovation; insight; interest; leukemia/lymphoma; medication compliance; meetings; nutrition; oncology; peer; phase 1 study; physical conditioning; programs; prototype; psychosocial; social; therapy development; usability; virtual; young adult

DESCRIPTION (provided by applicant Adolescent and young adult (AYA) hematopoietic stem cell transplantation (HSCT) patients face a variety of well-documented physical and emotional challenges. In addition to undergoing a life-threatening procedure that involves an intense treatment regimen and lengthy hospital stay, these patients face a protracted 12-month recovery period marked by numerous physical, emotional and psychosocial challenges, such as coping with immunosupression and its socially isolating effects; fatigue, adherence to complex medication regimens; and meeting hydration and nutrition requirements. Failure to meet these challenges not only engenders distress, anxiety and depression, but can also result in serious consequences to health such as organ damage and/or chronic, severe graft versus host disease. Unfortunately, in reality, it is not uncommon that HSCT patients often fail to meet these challenges or behavioral requirements. This is especially true for AYAs, whose developing autonomy and enjoyment of peers is often juxtaposed with the constraints of cancer treatment. Interventions that assist recipients in successfully completing the requirements of HSCT recovery are needed to maximize physical and psychological health outcomes. The proposed Phase I study will evaluate the feasibility and patient acceptance of an internet-based, interactive and personalized intervention to promote self-management behaviors among AYA allogeneic HSCT recipients during their extended outpatient recovery period. We will utilize an innovative approach that directly links behavioral objectives to game mechanics within the intervention. The intervention will address constructs key to motivation and adherence such as barriers, resiliency, social support, and positive reinforcement. By completing structured "real world" behavioral tasks on an appropriate schedule, participants will earn points, virtual achievements, items, gifts and bonuses that will be utilized to advance through an online game environment. The intervention will offer a set of relevant social network features, including mechanisms for patient-to-patient communication, competition, and collaborative problem solving. The overall goal is to maximize positive psychological and physical health outcomes. Phase I study participants include 30 AYA allogeneic HSCT patients age 15-29 years from MD Anderson. We will conduct focus groups and informal, iterative usability analysis with 8 HSCT survivors during the prototype intervention development process. Upon completion of prototype construction, we will conduct acceptance evaluation of the proposed system with 22 participants who are within their first year of post-transplant outpatient care. We will measure system performance, user perceptions of the program, intention to use the system, and actual system usage over a 3-week period. The proposed study will further scientific knowledge on the impact of game mechanics and social networking on behavior, and will provide insights, evidence, and guidance on how to build practical online social intervention systems to support behavioral change. PUBLIC HEALTH RELEVANCE: The importance of focusing on the unique medical and psychosocial needs of adolescent and young adult (AYA) cancer patients and survivors has been recognized by the National Cancer Institute and oncology experts in recent years.13 The rate of adherence to medical regimens among chronically ill AYAs is approximately 50 percent.8 This project seeks to evaluate an innovative psychosocial intervention strategy that is intended to promote more effective medical adherence behavior among a specific population of cancer survivors. The proposed study will potentially make significant contributions to research on the impact of game mechanics and social networking on behavior, and will provide insights, evidence, and guidance on how to build practical online social intervention systems to support behavioral change.

描述（由申请人提供 青少年和年轻成人 (AYA) 造血干细胞移植 (HSCT) 患者面临着各种有据可查的身体和情感挑战。除了要接受危及生命的手术外，还需要接受密集的治疗方案和长时间的住院治疗住院期间，这些患者面临着长达 12 个月的恢复期，其中包括许多身体、情感和社会心理挑战，例如应对免疫抑制及其社交孤立效应、坚持复杂的药物治疗；不幸的是，未能满足这些挑战不仅会导致痛苦、焦虑和抑郁，还会对健康造成严重后果，例如器官损伤和/或慢性、严重的移植物抗宿主病。事实上，HSCT 患者常常无法满足这些挑战或行为要求，这对于 AYA 来说尤其如此，他们的自主性和同龄人的乐趣往往与癌症治疗的限制并存。需要采取干预措施帮助受助者成功完成造血干细胞移植恢复的要求，以最大限度地提高身心健康结果。拟议的第一阶段研究将评估基于互联网的交互式个性化干预的可行性和患者接受度，以促进 AYA 异体 HSCT 接受者在延长门诊康复期间的自我管理行为。我们将利用一种创新方法，将行为目标与干预中的游戏机制直接联系起来。干预措施将解决动机和依从性的关键因素，例如障碍、弹性、社会支持和积极强化。通过按适当的时间表完成结构化的“现实世界”行为任务，参与者将获得积分、虚拟成就、物品、礼物和奖金，这些将用于在在线游戏环境中取得进步。该干预措施将提供一系列相关的社交网络功能，包括患者之间的沟通、竞争和协作解决问题的机制。总体目标是最大限度地提高积极的心理和身体健康结果。 I 期研究参与者包括来自 MD 安德森的 30 名年龄 15-29 岁的 AYA 同种异体 HSCT 患者。在原型干预开发过程中，我们将与 8 名 HSCT 幸存者进行焦点小组讨论和非正式的迭代可用性分析。原型构建完成后，我们将与 22 名处于移植后门诊护理第一年的参与者一起对拟议系统进行验收评估。我们将测量系统性能、用户对程序的看法、使用系统的意图以及 3 周内的实际系统使用情况。拟议的研究将进一步了解游戏机制和社交网络对行为影响的科学知识，并将为如何构建实用的在线社交干预系统以支持行为改变提供见解、证据和指导。 公共卫生相关性：近年来，国家癌症研究所和肿瘤学专家已经认识到关注青少年和青年 (AYA) 癌症患者和幸存者独特的医疗和社会心理需求的重要性。 13 医疗方案的依从率慢性病 AYA 中的这一比例约为 50%。8 该项目旨在评估一种创新的社会心理干预策略，该策略旨在促进特定癌症幸存者群体中更有效的医疗依从行为。拟议的研究可能会对游戏机制和社交网络对行为的影响的研究做出重大贡献，并将为如何构建实用的在线社交干预系统以支持行为改变提供见解、证据和指导。