Using MOST to EMPOWER: Optimizing an Emotion Regulation Intervention to Enhance Well-being Among Young Adult Cancer Survivors

利用 MOST 赋权：优化情绪调节干预措施以增强年轻癌症幸存者的福祉

• 批准号: 9973213
• 负责人: JUDITH T MOSKOWITZ
• 金额: $ 35.6万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-05 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9973213
• 关键词: Address; Affect; Aftercare; Age; Anxiety; Attention; Cancer Survivor; Caring; Cellular Phone; Chronically Ill; Cognitive; Consumption; Creativeness; Data; Development; Diabetes Mellitus; Diagnosis; Distress; Elderly; Event; Face; Fatigue; Future; Gender; Goals; HIV; Health; Health behavior; Individual Differences; Intervention; Life; Life Expectancy; Malignant Neoplasms; Mediator of activation protein; Mental Depression; Metastatic breast cancer; Methodology; Modality; Nature; Online Systems; Outcome; Participant; Patients; Personal Satisfaction; Physical Function; Pilot Projects; Randomized Clinical Trials; Research; Research Design; Resources; Risk; Role; Self Efficacy; Site; Social Responsibility; Social support; Stress and Coping; Supportive care; Survival Rate; Survivors; Testing; United States; Well in self; Work; cancer diagnosis; community setting; comparative; coping; design; digital; eHealth; emotion regulation; experience; experimental study; gratitude; innovation; intervention effect; malignant breast neoplasm; mindfulness; mortality risk; multi-component intervention; multiphase optimization strategy; novel; patient engagement; physical conditioning; positive emotional state; preference; primary outcome; psychologic; psychological distress; psychological outcomes; psychosocial; satisfaction; secondary outcome; survivorship; young adult

PROJECT SUMMARY Young adult cancer survivors (YAs) are an important underserved group at risk for significant psychological distress. There are approximately 70,000 new diagnoses of cancer annually in YAs (ages 18-39), and currently nearly 2 million people in the United States are living with or have survived being diagnosed with cancer as a YA. Five-year survival rates of YAs are high (>80%) and YAs have approximately 35 to 59 years of life expectancy remaining, underscoring the importance of post-treatment survivorship care. YAs face unique challenges given the physical, cognitive, and psychosocial developmental milestones disrupted as a result of cancer and are at greater risk of psychological distress compared to older adults (ages ≥40) with cancer. Accordingly, YAs can benefit from targeted, supportive care interventions to decrease distress and enhance well-being as they navigate post-treatment survivorship. Few psychosocial interventions have been developed for YAs or leverage eHealth modalities to provide supportive care and none have included a focus on enhancing psychological well-being through positive emotions. eHealth interventions represent promising options for patient engagement, especially with “digital natives” such as YAs. Given the ubiquitous nature of smartphones among YAs and their preference for remotely delivered interventions, the paucity of eHealth interventions among YAs is a missed opportunity. Moreover, although the deleterious effects of psychological distress are well-known, less attention has been focused on the benefits of psychological well-being. Psychological well-being is associated with better health outcomes, unique from the influence of distress, and includes domains inherently valued by young patients. Our team has developed a novel, multicomponent intervention to enhance psychological well-being that shows promise among patients with HIV, diabetes, and breast cancer. We have piloted the intervention for YAs in an eHealth delivery format (EMPOWER: Enhancing Management of Psychological Outcomes With Emotion Regulation) to demonstrate feasibility and acceptability. By leveraging an innovative methodological design, the Multiphase Optimization Strategy (MOST), the main objective of our proposed study is to optimize EMPOWER for YAs and prepare for a future randomized clinical trial (RCT). To accomplish this, we propose the following specific aims: (1) Using a MOST framework, examine which of five components contributes meaningfully to well-being among YA cancer survivors; and (2) Identify mediators and moderators of component efficacy for well-being outcomes. Upon completion of the testing, we will have a fully optimized, eHealth intervention to enhance psychological well-being among YA cancer survivors. This optimized intervention will be primed for a large, multi-site RCT and, as a scalable intervention, it will be ideally-suited for YA survivors who would otherwise not have access to supportive care interventions to help manage post-treatment distress and enhance well-being.

项目摘要 年轻的成人癌症存活（YAS）是一个重要的不足的群体，面临重大心理的风险 YAS（18-39岁）每年大约有70,000个新的癌症诊断，目前 在美国，近200万人与被诊断为癌症一起生活或幸存为 是的YA的五年生存率很高（> 80％），YA的生存率约为35至59年 剩余的期望，强调了治疗后生存护理的重要性。是的，面对独特 鉴于由于身体，认知和社会心理发展里程碑的挑战，由于 与老年人（年龄≥40岁）相比，癌症和心理困扰的风险更大。 据认为，YA可以从针对性的，支持性的护理干预措施中受益，以减少困扰并增强 他们在治疗后的生存期间进行福祉。 为YAS或利用EHealth模式提供了很少的社会心理干预措施 支持性护理，没有一个专注于通过积极来增强心理健康 情绪。 eHealth干预措施代表了患者参与的承诺选择，尤其是“数字 诸如Yas。鉴于Yas智能手机的无处不在及其偏爱 YAS中的eHealth干预措施遥远的干预措施是一个错过的机会。 而且，尽管心理困扰的有害影响是众所周知的，但关注较少 专注于心理健康的好处。心理健康与改善健康有关 结果是遇险的影响，包括年轻患者固有价值的领域。 我们的团队开发了一种新颖的多组分干预措施，以增强心理健康状况，以表明 艾滋病毒，糖尿病和乳腺癌患者的承诺。我们已经试行了YAS的干预措施 eHealth交付格式（授权：通过情感增强心理成果的管理 法规）以证明可行性和可接受性。通过利用创新的方法论设计， 多相优化策略（大多数），我们提出的研究的主要目的是优化 赋予YAS的能力，并为将来的随机临床试验（RCT）做准备。为此，我们提出 以下具体目的：（1）使用大多数框架，检查五个组件中的哪个贡献 有意义地对YA癌症生存中的幸福感； （2）确定调解人和主持人 福祉结果的组成效率。 测试完成后，我们将进行全面优化的eHealth干预措施，以增强心理 YA癌症生存中的幸福感。该优化的干预措施将用于大型多站点RCT 而且，作为可扩展的干预，它将非常适合YA冲浪者 支持护理干预措施，以帮助管理治疗后的困扰并增强幸福感。