Find your BEAT: Toolkit to increase physical activity in rural cancer survivors

找到你的 BEAT：增加农村癌症幸存者身体活动的工具包

• 批准号: 9070557
• 负责人: LAURA Q ROGERS
• 金额: $ 15.99万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9070557
• 关键词: Accelerometer; Adoption; Adverse effects; Aftercare; Alabama; Behavior; Breast; Breast Cancer survivor; Cancer Center; Cancer Etiology; Cancer Intervention; Cancer Survivor; Cancer Survivorship; Caring; Chronic; Chronic Disease; Client; Clinical effectiveness; Colon; Communities; Community Hospitals; Community Networks; Comorbidity; County; Data; Development; Diffusion of Innovation; Dose; Effectiveness; Exercise; Faculty; Focus Groups; Health; Hybrids; Intervention; Intervention Studies; Intervention Trial; Life; Malignant Neoplasms; Measures; Medical; Mental Health; Modeling; Neoplasm Metastasis; Network Infrastructure; Observational Study; Outcome; Participant; Patient Self-Report; Personal Satisfaction; Physical activity; Population; Preparation; Process; Quality of life; Randomized; Recommendation; Reporting; Research; Research Infrastructure; Risk; Rural; Rural Community; Rural Population; Second Primary Neoplasms; Self-Administered; Services; Site; Surveys; Techniques; Testing; Translational Research; Translations; Treatment Efficacy; Universities; Voice; Washington; Well in self; Wit; Woman; base; behavior change; cancer care; cancer recurrence; cancer type; community center; cost; design; efficacy testing; efficacy trial; exercise adherence; experience; implementation research; implementation science; improved; intervention effect; meetings; mortality; multidisciplinary; physical conditioning; post intervention; psychologic; theories; tool

 DESCRIPTION (provided by applicant): Physical activity (PA) can ameliorate many long term side effects and the increased risk of primary cancer recurrence (i.e., colon and breast), second neoplasm, and chronic non-cancer medical comorbidities experienced by cancer survivors. Because the majority of cancer survivors do not engage in regular PA, it is critical to increase the translation of efficacious PA behavior change interventions (BCIs) from research into cancer survivorship care, especially for rural cancer survivors who suffer poorer physical and mental health compared with urban counterparts. Our BEAT Cancer (Better Exercise Adherence after Treatment for Cancer) PA BCI for breast cancer survivors significantly improved PA behavior in a multicenter randomized controlled efficacy trial with the odds of meeting PA recommendations being double that reported by any previous BCI in cancer survivors, to date. A next translational step for the BEAT Cancer intervention is preparation for implementation within a Cancer Community Network (CCN). An implementation toolkit integrating planned adaptations for cancer types other than breast and a rural CCN site is needed before submitting an R01 application proposing an effectiveness-implementation hybrid type 1 trial (i.e., tests clinical effectiveness in a real world setting such as the CCN while also improving understanding of the implementation context). Such a trial is anticipated to occur within the University of Alabama at Birmingham (UAB) CCN which includes multiple community hospitals and cancer centers including those in rural settings. Therefore, we propose the following specific aims with the overall objective of improving implementation of the BEAT Cancer PA BCI within a CCN: 1) develop an implementation toolkit that adapts the intervention to a rural CCN site and cancer types other than breast, 2) test feasibility of implementing the toolkit, and 3) evaluate the toolkit's acceptability, adoption, appropriateness, fidelity, cost, and impact on service and clien outcomes. Our proposal is based on the Consolidated Framework for Implementation Research and Rogers' Diffusion of Innovations theory. Qualitative and quantitative input will be obtained from three organizational levels in the targeted rural Alabama County (i.e., potential intervention participants, community-level stakeholders, and potential intervention delivery staff). Qualitative data (i.e., focus groups, nominal group technique groups, photo voice, and ground trothing) will be used for planned adaptation and creation of the implementation toolkit. After development, the implementation toolkit will be pilot tested at the CCN site with 20 women cancer survivors. Feasibility measures will be obtained by survey and administrative data. Acceptability, adoption, appropriateness, and implementation cost will be assessed by survey, focus groups, and administrative data. Fidelity will be assessed with direct observation and survey. Outcomes (i.e., service and client) important to stakeholders and PA (self-report and accelerometer) will also be assessed. Improving the implementation of this efficacious PA BCI within a CCN serving rural populations will increase the reach of the intervention and its beneficial effects on PA and health.

 描述（由适用提供）：体育活动（PA）可以改善许多长期副作用，并增加了原发性癌症复发的风险（即结肠和乳腺癌），第二次肿瘤和慢性非癌症医学合并症。由于大多数癌症生存期不从事常规PA，因此至关重要的是，从对癌症生存护理的研究中增加有效的PA行为变化干预措施（BCI）的翻译至关重要，尤其是对于与城市同行相比，身体和心理健康较差的粗糙癌症生存。在多中心随机对照有效性试验中，我们的乳腺癌存活率PA BCI的BEAT癌症（治疗后的更好的运动依从性）显着改善了PA行为，迄今为止，任何以前的BCI都报告了PA建议的几率，迄今为止，任何先前的BCI都报告了两倍。 Beat癌症干预的下一个翻译步骤是准备在癌症社区网络（CCN）内实施。在提交R01应用程序提案提案之前，需要进行乳腺癌以外的癌症类型和粗糙CCN站点的计划改编的实施工具包（即有效性实施混合1型试验）（即，在CCN等现实世界中测试临床有效性，同时还提高了对实施背景的理解）。预计将在伯明翰CCN的阿拉巴马大学内进行此类试验，其中包括多家社区医院和癌症中心，包括在农村环境中。 Therefore, we propose the following specific aims with the overall objective of improving implementation of the BEAT Cancer PA BCI within a CCN: 1) develop an implementation toolkit that adapts the intervention to a rural CCN site and cancer types other than breast, 2) test feasibility of implementing the toolkit, and 3) evaluate the toolkit's acceptability, adoption, appropriateness, fidelity, cost, and impact on service and clien outcomes.我们的建议基于实施研究的合并框架和罗杰斯的创新理论的传播。定性和定量投入将从目标农村县的三个组织级别获得（即潜在的干预措施 参与者，社区级利益相关者和潜在的干预送达人员）。定性 数据（即焦点组，名义组技术组，照片语音和地面trothing）将用于计划适应和创建实施工具包。开发后，实施工具包将在CCN部位进行试点测试，其中有20个女性癌症存活。可行性措施将通过调查和行政数据获得。可接受性，采用，适当性和实施成本将通过调查，焦点小组和行政数据进行评估。忠诚度将通过直接观察和调查进行评估。还将评估结果（即服务和客户）对利益相关者和PA（自我报告和加速度计）重要的结果。改善在服务农村人群中的CCN中的这种有效PA BCI的实施将增加干预措施的影响及其对PA和健康的有益影响。