IVR-Supported Interventions for Cancer Prevention in the Deep South

IVR 支持的南方腹地癌症预防干预措施

基本信息

批准号：
8700045
负责人：
Dorothy W. Pekmezi
金额：
$ 7.35万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-04-07 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8700045
关键词：
Address Adherence Aerobic African American Alabama Algorithms American Area Body Composition Body Weight Body fat Cancer Control Cancer Prevention Intervention Cessation of life Clinic Visits Colon Carcinoma Communities Community Health Computers Consumer Satisfaction Counseling County Data Deep South Diet Education Energy Metabolism Feedback Focus Groups Funding Future Goals Gonadal Steroid Hormones Guidelines HIV risk Home environment Hour Incidence Income Individual Insulin Internet Intervention Life Link Malignant Neoplasms Minority Groups Monitor Outcome Participant Pathway interactions Physical activity Preparation Process Public Health Reporting Research Resources Review Literature Risk Risk Behaviors Risk Reduction Rural Self Efficacy Social support Support System System Technology Telephone Test Result Testing Time Voice Walking Weight Weight maintenance regimen arm base cancer health disparity cancer risk cost cost effectiveness efficacy testing efficacy trial expectation fitness health disparity improved innovation literacy malignant breast neoplasm meetings member mortality outreach preference prevent programs public health relevance response rural area sedentary social cognitive theory success telehealth therapy development willingness

项目摘要

DESCRIPTION (provided by applicant): Each year, more than 572,000 Americans die of cancer and approximately a third of these deaths are linked to physical inactivity, poor diet, and excess weight and thus can be prevented. While exact mechanisms have yet to be determined, physical activity (PA) may impact breast and colon cancer risk by promoting weight control or perhaps independently by altering biologic pathways related to such cancers (improving energy metabolism, reducing circulating concentrations of sex hormones and insulin). ACS guidelines emphasize the importance of > 150 min/week of moderate-intensity PA in reducing cancer risk. However, most of the U.S. is inactive, with particularly low PA levels found in the South. Low education and income levels in this largely rural area, along with cultural differences regarding PA and barriers (childcare, costs) reported by African Americans (largest racial minority group in U.S., most of whom live in the South and report high rates of inactivity) may limit access to PA information and/or contribute to related cancer disparities. Telehealth interventions can overcome such obstacles by not requiring frequent clinic visits, expensive technology, or literacy and thus may represent a promising approach to promoting PA in the Deep South and extending ongoing community health worker efforts by the Deep South Network for Cancer Control. Most telehealth interventions have relied on staff counseling, but such processes can be automated using an Interactive Voice Response (IVR) system to enhance cost-effectiveness, reach, and potential disseminability. Given our team's past success using IVR systems for self monitoring of HIV risk behaviors and the paucity of research in this area on PA, we adapted the existing IVR system format for PA promotion and cancer risk reduction in the Deep South through extensive formative research (11 focus groups on PA barriers, intervention needs/preferences with Deep South Cancer Control community health advisors and community members from rural and urban AL counties) and now propose to test the resulting Home-based IVR-supported PA (HIP) intervention in a pilot RCT (N=60) with a waitlist control. Study goals are to document willingness to call IVR system, vet newly developed intervention modules addressing the PA barriers identified in focus groups, and beta-test Social Cognitive Theory (SCT) based tailoring algorithms in preparation for an R01-funded fully powered RCT to test the efficacy of the program and eventual dissemination through the Deep South Network for Cancer Control. PA (7-Day PAR, accelerometers), fitness (6MWT), and body weight and composition (% body fat, BIA) will be assessed at baseline and 3 months. Primary aims include assessing the feasibility, acceptability, and preliminary efficacy of the HIP intervention for cancer risk reducton in the Deep South. Secondary aims include exploring arm differences in changes in fitness, body weight/composition, and SCT variables from baseline to 3 months and assessing the relationship between min/week of >moderate intensity PA reported via IVR system vs. accelerometers at 2 time points (7 days before baseline and 3 month assessment).

描述（由申请人提供）：每年，有572,000多名美国人死于癌症，其中大约三分之一的死亡与身体上的不活动，饮食不良和体重增加有关，因此可以预防。尽管尚未确定确切的机制，但体育活动（PA）可能通过促进体重控制或可能通过改变与此类癌症相关的生物学途径（改善能量代谢，降低性激素和胰岛素的循环浓度）来影响乳腺癌和结肠癌的风险。 ACS指南强调了> 150分钟/周中强度PA在降低癌症风险中的重要性。但是，美国大多数人都是不活跃的，南方的PA水平尤其低。在这个主要农村地区的低教育和收入水平，以及关于PA和障碍（育儿，成本）的文化差异（美国最大的种族少数群体，其中大多数生活在南方，并且报告较高的不活动率）可能会限制对PA信息的访问和/或导致相关癌症的差异。远程医疗干预措施可以通过不需要频繁的诊所就诊，昂贵的技术或扫盲来克服此类障碍，因此可能代表着在深南部促进PA的有前途的方法，并扩大了Deep South Network癌症控制的持续社区卫生工作者的努力。大多数远程医疗干预措施都依赖于员工咨询，但是可以使用交互式语音响应（IVR）系统自动化此类过程，以增强成本效益，覆盖范围和潜在的不可贬值。 Given our team's past success using IVR systems for self monitoring of HIV risk behaviors and the paucity of research in this area on PA, we adapted the existing IVR system format for PA promotion and cancer risk reduction in the Deep South through extensive formative research (11 focus groups on PA barriers, intervention needs/preferences with Deep South Cancer Control community health advisors and community members from rural and urban AL counties) and now propose to test the resulting Home-based IVR支持的PA（髋关节）干预措施（n = 60）具有候补名单控制。研究目标是记录致电IVR系统的意愿，兽医新开发的干预模块，以解决焦点小组中确定的PA屏障，以及基于Beta检验的社会认知理论（SCT）的裁缝算法，以准备R01资助的完全有能力的RCT通过测试程序和最终消散南方网络的癌症对照的RCT的功能。 PA（7天PAR，加速度计），健身（6MWT）和体重和成分（％体内脂肪，BIA）将在基线和3个月时进行评估。主要目的包括评估髋关节干预对癌症风险降低的可行性，可接受性和初步疗效。次要目的包括探索手臂的健身，体重/组成变化以及从基线到3个月的SCT变量的变化，并评估通过IVR系统与加速度计在2个时间点（基线前7天和3个月评估和3个月评估）报道的最小强度PA之间的关系>中等强度PA之间的关系。