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

• 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
• 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

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.

项目摘要 癌症幸存者中的体育锻炼水平（PA）很低，但PA可能会改善困难影响 治疗。我们将重点放在PA上，遵循最密集的癌症治疗形式，造血细胞 移植（HCT）。虽然潜在的治愈性，但该过程要求高度要求，有多个后遗症 包括化学疗法和辐射诱导的细胞减少症，以及心血管和肺部并发症。 PA移植后减少，这种减少与身体功能较差有关。缓和 运动被认为是对HCT患者的安全性，并且PA干预可行。有关功效的发现， 然而，部分是由于干预成分和结果的异质性而混合的。最大的试验 报告的日期报告了无效的发现，但锻炼干预是自我指导的（可以说是轻的）和PA的评估 通过自我报告。其他研究的发现表明，PA可以改善心肺健康，身体 HCT患者的性能和疲劳。 HCT设置中的所有PA干预措施都完全集中在 在患者上，忽略参与和使家庭护理人员受益的机会，24/7的角色需要 提供医疗和后勤支持。在HCT护理人员及其自身健康中，困扰很常见 晋升被忽略。我们旨在利用患者保养者的关系来改善双方的PA 患者及其护理配偶/伴侣。为此，我们将测试一对夫妇的可行性和可接受性 - 为普通癌症幸存者和护理人员开发的基于PA的干预措施，但可翻译为HCT。指导 通过社会认知理论和相互依存/公共应对观点，这种干预提供了 培训沟通技巧和解决问题的共同解决方案，以帮助合作伙伴支持一个 另一个在PA。我们已将此协议适应了早期的HCT设置，并将使用Actigraph设备来 监视PA并告知每周个性化的步骤处方。具体目的是：（1）确定可行性 招聘[同意参加的合格夫妇的百分比]，依从性[干预会议的百分比，＃ 有效的行动式磨损天，治疗师涵盖的治疗元素％]和保留率[％随访百分比 评估完成]在单个站点的飞行员RCT中。 （2）确定干预措施的可接受性 患者和看护人（治疗满意度的多个维度）。 （3）描述PA的变化模式 以及针对干预措施相对于通常护理的公共应对（干预目标）。调查结果会 通知全面RCT的设计，以测试干预措施改善身体健康的功效，测试 作用机理，并确定治疗反应的潜在调节剂。调查结果也将为努力提供信息 为了优化将整合到标准移植护理中的干预措施，扩大了提供商的曲目 支持护理选项。更广泛地，可以针对不同类型的患者护理人员进行调整 二元与疾病环境。