Mates in Motion: Feasibility and Acceptability of a Couple-Based Physical Activity Intervention

运动中的伴侣：基于夫妻的身体活动干预的可行性和可接受性

基本信息

批准号：
10721446
负责人：
Shelby Langer
金额：
$ 41.93万
依托单位：
ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-20 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10721446
关键词：
Achievement Adherence Adoption Agreement Benchmarking Cancer Survivor Cardiopulmonary Cardiovascular system Caregiver Burden Caregivers Caring Categories Clinic Communication Communities Couples Data Devices Dimensions Disease Distress Elements Eligibility Determination Emotional Exercise Family Caregiver Family member Fatigue Frequencies Goals Health Promotion Health behavior Health behavior change Hematologic Neoplasms Hematological Disease Heterogeneity Home Hour Immune Individual Infection Infusion procedures Intervention Joints Light Link Lung Maintenance Medical Moderate Exercise Monitor Motion Muscle Outcome Outcome Measure Pain Participant Partner in relationship Patient Care Patient Self-Report Patients Pattern Personal Satisfaction Physical Endurance Physical Function Physical Performance Physical activity Pilot Projects Problem Solving Procedures Protocols documentation Provider Quality of life Radiation Randomized Reporting Role Self Care Self Direction Services Shortness of Breath Site Spouses Supportive care Techniques Testing Therapeutic Training Transplant Recipients Transplantation Treatment Efficacy Walking Whole-Body Irradiation acceptability and feasibility actigraphy behavior change behavioral outcome cancer care cancer therapy cardiorespiratory fitness caregiving chemotherapy commune coping cytopenia design efficacy testing exercise intensity exercise intervention feasibility testing fitbit fitness follow up assessment follow-up graft vs host disease hematopoietic cell transplantation improved informal caregiver malignant breast neoplasm member mortality neglect physical conditioning physical symptom pilot test poor sleep post-transplant programs prostate cancer survivors recruit satisfaction sedentary skills sleep quality social cognitive theory stem cells treatment as usual treatment effect treatment response

项目摘要

PROJECT SUMMARY Levels of physical activity (PA) among cancer survivors are low, yet PA may ameliorate difficult effects of treatment. We focus here on PA following the most intensive form of cancer treatment, hematopoietic cell transplantation (HCT). While potentially curative, the procedure is highly demanding, with multiple sequelae including chemotherapy- and radiation-induced cytopenia, and cardiovascular and pulmonary complications. PA is diminished post-transplant, and this decrease is associated with poorer physical functioning. Moderate exercise has been deemed safe for HCT patients, and PA interventions feasible. Findings regarding efficacy, however, are mixed, in part due to heterogeneity of intervention components and outcomes. The largest trial to date reported null findings but the exercise intervention was self-directed (arguably light) and PA was assessed via self-report. Findings from other studies suggest that PA may improve cardiorespiratory fitness, physical performance, and fatigue among HCT patients. All PA interventions in the HCT setting have focused entirely on patients, ignoring an opportunity to engage and benefit the family caregiver, a 24/7 role requiring the provision of medical and logistical support. Distress is common among HCT caregivers and their own health promotion is neglected. We aim to leverage the patient-caregiver relationship to improve PA among both patients and their caregiving spouses/partners. To do so, we will test feasibility and acceptability of a couple- based PA intervention developed for general cancer survivors and caregivers but translatable to HCT. Guided by social cognitive theory and interdependence/ communal coping perspectives, this intervention provides training in communication skills and joint problem-solving in the service of helping partners support one another in PA. We have adapted this protocol for the early post-HCT setting and will use Actigraph devices to monitor PA and inform weekly individualized step prescription. Specific aims are to: (1) Determine feasibility of recruitment [% of eligible couples agreeing to participate], adherence [% of intervention sessions attended, # valid Actigraph wear days, % therapeutic elements covered by therapist], and retention [% follow-up assessments completed] in a single-site pilot RCT. (2) Determine acceptability of the intervention among patients and caregivers (multiple dimensions of treatment satisfaction). (3) Describe patterns of change in PA and communal coping (intervention targets) for those in the intervention relative to usual care. Findings will inform the design of a full-scale RCT to test efficacy of the intervention to improve physical well-being, test mechanisms of action, and identify potential moderators of treatment response. Findings will also inform efforts to optimize the intervention for integration into standard transplant care, expanding providers' repertoire of supportive care options. More broadly, the intervention could be adapted for different types of patient-caregiver dyads and illness contexts.

项目概要癌症幸存者的体力活动 (PA) 水平较低，但 PA 可能会改善癌症带来的困难影响治疗。我们在此关注最强化的癌症治疗形式——造血细胞后的 PA 移植（HCT）。虽然有可能治愈，但手术要求很高，会产生多种后遗症包括化疗和放疗引起的血细胞减少，以及心血管和肺部并发症。移植后 PA 会减少，这种减少与身体功能较差有关。缓和运动对于 HCT 患者来说被认为是安全的，PA 干预措施也是可行的。关于功效的调查结果，然而，这些结果是混杂的，部分原因是干预措施和结果的异质性。最大的试验日期报告无效结果，但运动干预是自我指导的（可以说是轻微的）并且评估了 PA 通过自我报告。其他研究结果表明，PA 可以改善心肺健康、身体素质 HCT 患者的表现和疲劳。 HCT 环境中的所有 PA 干预措施都完全集中于对患者而言，忽视了让家庭护理人员参与并使其受益的机会，这是一个 24/7 的角色，需要提供医疗和后勤支持。 HCT 护理人员及其自身健康状况普遍存在困扰推广被忽视。我们的目标是利用患者与护理人员的关系来改善双方的 PA 患者及其照顾者配偶/伴侣。为此，我们将测试以下几个方案的可行性和可接受性：为一般癌症幸存者和护理人员开发的基于 PA 的干预措施，但可转化为 HCT。引导通过社会认知理论和相互依赖/共同应对的观点，这种干预提供了沟通技巧和联合解决问题的培训，以帮助合作伙伴支持一个人另一个在宾夕法尼亚州。我们已针对 HCT 后的早期设置调整了该协议，并将使用 Actigraph 设备来监测 PA 并告知每周个性化步骤处方。具体目标是： (1) 确定可行性招募[同意参加的合格夫妇的百分比]，坚持[参加干预会议的百分比，# 有效的 Actigraph 佩戴天数、治疗师涵盖的治疗元素百分比] 和保留率 [% 随访评估已完成]在单地点试点随机对照试验中。 (2) 确定干预措施的可接受性患者和护理人员（治疗满意度的多个维度）。 (3) 描述 PA 的变化模式以及与常规护理相关的干预对象的公共应对（干预目标）。调查结果将告知全面随机对照试验的设计，以测试干预措施的有效性，以改善身体健康，测试作用机制，并确定治疗反应的潜在调节因素。研究结果还将为努力提供信息优化干预措施以融入标准移植护理，扩大提供者的能力支持性护理选择。更广泛地说，干预措施可以适应不同类型的患者护理人员成对和疾病背景。