A Mobile TXT-based Intervention to Improve Adherence to Adjuvant Hormone Therapy and Symptom Management for BCa Survivors

基于移动 TXT 的干预措施可提高 BCa 幸存者对辅助激素治疗和症状管理的依从性

基本信息

批准号：
10310855
负责人：
Kuang-Yi Wen
金额：
$ 18.45万
依托单位：
THOMAS JEFFERSON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-06-11 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10310855
关键词：
Address Adherence Adjuvant Adopted Affect Affective Area Behavioral Belief Breast Cancer Patient Breast Cancer survivor Clinical Cognitive Communication Cues Data Discrimination Disease Distress Dose Educational workshop Estrogens Ethnic group Evaluation Focus Groups Foundations Fright Goals Grant Health Hispanics Institutes Intervention Libraries Linguistics Mentors Mentorship Methodology Minority Groups Modeling Oral Outcome Patients Perception Pharmaceutical Preparations Population Process Provider Recurrence Recurrent disease Regimen Reporting Research Research Methodology Research Personnel Research Project Grants Social support Subgroup Technology Testing Text Text Messaging Time Training Training Activity Translating Trust Woman anti-cancer base bilingualism breast cancer survival cancer care cancer diagnosis cancer health disparity cancer recurrence career career development clinical efficacy cognitive interview compliance behavior cost effective design digital digital health disparity reduction effective intervention empowerment ethnic disparity evidence base experience family support formative assessment health communication health disparity hormone receptor-positive hormone therapy improved improved outcome information processing innovation mHealth malignant breast neoplasm medication compliance mortality overtreatment parent grant patient oriented patient-level barriers prevent programs prototype racial and ethnic research study side effect skills social social cognitive theory socioeconomics successful intervention survival outcome symptom management systematic review text messaging intervention theories therapy adherence therapy design tool uptake

项目摘要

Breast cancer (BCa) is the leading cause of mortality in Hispanic women and the most commonly diagnosed cancer in this minority group, the largest and fastest growing ethnic group in the US. Compared with other racial/ethnic groups, Hispanic women have a higher rate of discontinuation of adjuvant hormone therapy (AHT) treatment. This finding is particularly relevant because the gap between Hispanic and NHW women in BCa survival is known to be largest among estrogen-sensitive subtypes in whom prolonged AHT treatment over years is key to improving outcomes. Because nonadherence has been shown to affect survival outcomes and increase mortality, differential utilization of AHT may contribute in part to the disparities in Hispanic BCa outcomes. Guided by our team's Cognitive-Social Health Information Processing Model and health communication best practices, an evidence-based mobile text messaging intervention (Txt2Adhere), designed to promote adherence to AHT, was iteratively developed with patient-centered input and clinical and behavioral evaluation during year 1 of the Parent Grant. The proposed supplement research study is a logical extension of this line of research in the area of adherence promotion to anticancer oral treatment, while at the same time adding Dr. Clara Granda-Cameron's (the supplement grant candidate) expertise by providing training in the intersection of BCa health disparities and mHealth research, and adapting a theory-guided and carefully-tested intervention prototype of use with an underserved segment of BCa population. We will first examine Hispanic BCa survivors' perceived barriers and facilitators on adherence to AHT through a qualitative study. Guided by a Hispanic community advisory board and the qualitative findings, we will adapt the Parent Grant intervention “Txt2Adhere” to a linguistically-appropriate and culturally-informed intervention (MeCuido) for Hispanic BCa survivors through a 3-stage cultural adaptation and formative evaluation process. Three priority training areas, 1) qualitative and quantitative research methodologies, 2) health disparities in minority populations, and 3) mHealth and health communication, are identified to enhance Dr. Granda-Cameron's understanding of the methodologies and results of the proposed supplement study. Training will be implemented through formal coursework, local and national workshops, seminars and training institutes, as well as continuous interaction with mentors and advisors with relevant expertise. Dr. Kuang-Yi Wen (PI of the Parent Grant) and Dr. Ana Maria Lopez will provide their mentorship and guidance to 1) facilitate the progression of Dr. Granda- Cameron's training activities, 2) guide the implementation of the proposed supplement research project, and 3) promote Dr. Granda-Cameron's transition to an independent investigator. This study is significant because MeCuido has the potential to reduce disparities in AHT adherence among Hispanic BCa women and will provide Dr. Granda-Cameron with the necessary theoretical and methodological foundation from which to build a highly successful and independent career in reducing cancer care disparities using digital technologies.

乳腺癌（BCA）是西班牙裔妇女死亡的主要原因，也是最常见的诊断这个少数群体的癌症是美国最大，最快的种族。与其他种族/族裔，西班牙裔妇女对可调骑马疗法（AHT）的中断率更高治疗。这一发现尤其重要，因为西班牙裔和NHW妇女在BCA之间的差距众所周知，在雌激素敏感的亚型中，生存是最大的，其中延长了AHT治疗几年是改善结果的关键。因为已证明不遵守会影响生存结果，并且增加死亡率，AHT的差异利用可能会导致西班牙裔BCA的差异结果。在我们团队的认知社会健康信息处理模型和健康的指导下沟通最佳实践，基于证据的移动文本消息干预（TXT2Adhere），设计通过以患者为中心的输入以及临床和行为促进依从性AHT的依从性父母赠款第一年期间的评估。拟议的补充研究研究是逻辑扩展依从性促进抗癌口服治疗领域的这一研究线，同时通过在 BCA健康差异与MHealth研究的交集，并适应一个理论和仔细测试的理论干预原型与服务不足的BCA人群。我们将首先检查西班牙裔 BCA生存的障碍和促进者通过定性研究遵守AHT。指导西班牙裔社区顾问委员会和定性调查结果，我们将适应父母的赠款干预措施西班牙裔BCA的“ TXT2Adhere” 幸存者通过三阶段的文化适应和形成性评估过程。三个优先培训领域， 1）定性和定量研究方法，2）少数民族的健康差异，3）确定MHealth和Health Communication，以增强Granda-Cameron博士对拟议的补充研究的方法和结果。培训将通过公式实施课程工作，本地和国家研讨会，半小伙和培训机构以及持续互动具有相关专业知识的导师和顾问。 Kuang-Yi Wen博士（父母赠款的PI）和ANA博士玛丽亚·洛佩兹（Maria Lopez 卡梅伦的培训活动，2）指导拟议的补充研究项目的实施，3）促进格兰达 - 卡梅隆博士向独立调查员的过渡。这项研究很重要，因为 Mecuido有可能减少西班牙裔BCA妇女遵守AHT的分布，并将为格兰达·卡梅隆博士提供建立必要的理论和方法论基础使用数字技术减少癌症护理分布的非常成功和独立的职业。