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: 8644239
• 负责人: Martha Ann Askins
• 金额: $ 14.91万
• 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/8644239
• 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

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.

青少年和年轻人（AYA）造血干细胞移植（HSCT）患者面临各种有据可查的身体和情感挑战。除了涉及强烈治疗方案和漫长的住院治疗的危及生命的程序外，这些患者面临着旷日持久的12个月康复期，其标志着许多身体，情感和社会心理挑战，例如应对免疫选择及其社会隔离效应；疲劳，遵守复杂的药物方案；并满足水合和营养要求。未能应对这些挑战，不仅会导致困扰，焦虑和抑郁，而且还可能对健康造成严重的后果，例如器官损害和/或慢性，严重的移植物与宿主疾病。不幸的是，实际上，HSCT患者经常无法满足这些挑战或行为要求并不少见。对于AYA来说，尤其如此，他的发展自主性和同龄人的享受通常与癌症治疗的限制并置。需要采取帮助接收者成功完成HSCT恢复要求的干预措施，以最大程度地提高身体和心理健康成果。拟议的I期研究将评估基于Internet的，互动和个性化干预措施的可行性和患者接受，以促进AYA同种异体HSCT接受者之间的自我管理行为。我们将利用一种创新的方法，该方法将行为目标直接连接到干预措施中的游戏机制。干预将解决动机和依从性的关键，例如障碍，弹性，社会支持和积极的强化。通过在适当的时间表上完成结构化的“现实世界”行为任务，参与者将赚取积分，虚拟成就，项目，礼物和奖金，这些奖金将用于通过在线游戏环境中推进。该干预措施将提供一系列相关的社交网络功能，包括用于患者到患者沟通，竞争和协作解决问题的机制。总体目标是最大化积极的心理和身体健康成果。第一阶段的研究参与者包括30名AYA同种异体HSCT患者，年龄在MD Anderson 15-29岁。在原型干预开发过程中，我们将与8个HSCT幸存者进行焦点小组，并进行非正式的迭代可用性分析。完成原型构建后，我们将对拟议系统进行接受评估，其中22位参与者在移植后门诊后的第一年内。我们将在3周的时间内衡量系统性能，对程序的看法，使用系统的意图以及实际系统使用情况。拟议的研究将进一步了解有关游戏机制和社交网络对行为的影响的科学知识，并将提供有关如何建立实际在线社会干预系统以支持行为改变的见解，证据和指导。