Testing scalable, IVR-supported cancer prevention interventions in the rural Alabama Black Belt

在阿拉巴马州黑带农村地区测试可扩展的、IVR 支持的癌症预防干预措施

基本信息

批准号：
10397154
负责人：
Dorothy W. Pekmezi
金额：
$ 57.81万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
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：
2019-06-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10397154
关键词：
Accelerometer Accountability Address Adherence Adopted Adult Aerobic African American African American population Alabama American American Cancer Society Anxiety Black race Breast Cancer Burden Cancer Control Cancer Death Rates Cancer Prevention Intervention Cessation of life Clinic Visits Collaborations Colon Colon Carcinoma Communities Community Health Community Health Aides County Data Deep South Education Educational Background Endometrial Fatigue Feedback Focus Groups Friends Funding Future HIV Incidence Income Informal Social Control Internet Intervention Link Maintenance Malignant Neoplasms Mediator of activation protein Mental Depression Minority Modeling Neighborhoods Not Hispanic or Latino Organizational Policy Participant Patient Self-Report Physical Performance Physical activity Population Preparation Psychosocial Factor Randomized Controlled Trials Reporting Research Resources Review Literature Risk Risk Reduction Rural Rural Population Sleep disturbances Social support Southeastern United States Support System System Technology Telephone Testing Transportation Treatment Efficacy Voice Waiting Lists acceptability and feasibility active lifestyle arm base built environment cancer health disparity cancer prevention cancer risk community organizations cost cost effectiveness efficacy testing exercise intervention family support healthy lifestyle high risk improved improvement on sleep intervention cost intervention effect intervention participants lifestyle intervention literacy malignant breast neoplasm member mortality neighborhood disadvantage participant retention personalized approach pilot trial post intervention preference prevent recruit response rural African American rural counties rural dwellers satisfaction scale up sedentary lifestyle social cognitive theory success telephone-based theories treatment arm vigorous intensity

项目摘要

Regular physical activity (PA) is linked to lower risk for several cancers (breast, colon, endometrial) . Yet, most Americans are inactive, particularly in the Deep South. Cancer incidence/mortality is also generally higher in this region, with underserved (rural, African American) populations reporting even less PA and disproportionate cancer burden. Factors related to culture, distance from PA facilities, income, literacy, and Internet connectivity in the Deep South may limit access to PA information/resources and contribute to existing cancer disparities. Telephone-supported interventions have shown success in increasing PA, do not require clinic visits, literacy, or costly technology, and thus may represent a promising strategy for promoting PA for cancer risk reduction in the Deep South, especially when automated with Interactive Voice Response (IVR) systems for improved cost- effectiveness and reach. Thus, we adapted an existing IVR system, used in past HIV studies, for PA promotion and cancer prevention in the Deep South through extensive literature review and formative research [11 focus groups on PA intervention needs/preferences with Deep South Network For Cancer Control community health advisors (CHAs) and community members]. A pilot trial of the resulting Deep south IVR-supported Active Lifestyle (DIAL) intervention!(R03CA177538) found high retention and participant satisfaction at 12 weeks. Moreover, DIAL produced larger increases in MVPA (42.5 more min/week) from baseline to 12 weeks than a waitlist control, along with significantly greater improvements in PA self-regulation and social support. Results have informed intervention enhancements in preparation for scale up and dissemination in rural counties (using IVR-initiated calls and wristbands to facilitate adherence; further targeting unchanged Social Cognitive Theory constructs; incorporating more interpersonal, community/organizational and policy level strategies for increased encouragement and accountability and to assess and address built environment). The current study will involve a fully powered randomized controlled trial of the refined, multi-level 12 month DIAL intervention with a waitlist control condition (N=240 rural, mostly African American adults). Recruitment will be led by Deep South Network for Cancer Control CHAs in Black Belt counties (involved in project since initial formative research). Primary aims include examining arm differences in changes in moderate intensity or greater aerobic physical activity from baseline to 6 and 12 months. Exploratory aims include examining intervention effects on physical performance and psychosocial variables; changes in physical activity from 12- 18 months; intervention costs; potential mediators (social support from family, friends, CHAs) and moderators of treatment efficacy (neighborhood/ environmental features); and potential barriers/facilitators to widespread implementation of DIAL intervention in rural Black belt counties by Deep South Network for Cancer Control. !

定期体力活动 (PA) 可降低多种癌症（乳腺癌、结肠癌、子宫内膜癌）的风险。然而，大多数美国人不活跃，尤其是在南方腹地。癌症发病率/死亡率通常也较高该地区服务水平低下的人口（农村、非裔美国人）报告的 PA 更少且不成比例癌症负担。与文化、距公共广播设施的距离、收入、识字率和互联网连接相关的因素南部腹地可能会限制对 PA 信息/资源的获取，并导致现有的癌症差异。电话支持的干预措施已在增加 PA 方面取得了成功，不需要去诊所、扫盲、或昂贵的技术，因此可能是促进 PA 降低癌症风险的有前途的策略南方腹地，特别是通过交互式语音应答 (IVR) 系统实现自动化，以提高成本有效性和影响力。因此，我们采用了过去 HIV 研究中使用的现有 IVR 系统来促进 PA 推广通过广泛的文献回顾和形成性研究，在南方腹地预防癌症 [11 重点与深南癌症控制网络社区健康小组讨论 PA 干预需求/偏好顾问 (CHA) 和社区成员]。由此产生的 Deep South IVR 支持的 Active 的试点试验生活方式 (DIAL) 干预！(R03CA177538) 在 12 周时发现参与者的保留率和满意度很高。此外，从基线到 12 周，DIAL 的 MVPA 增加幅度更大（每周增加 42.5 分钟）。候补名单控制，以及 PA 自我监管和社会支持方面的显着改善。结果已通知加强干预措施，为农村县的扩大和传播做好准备（使用 IVR 发起的呼叫和腕带来促进遵守；进一步针对未改变的社会认知理论建构；纳入更多的人际、社区/组织和政策层面的战略增加鼓励和问责，并评估和解决建筑环境问题）。目前的研究将涉及一项完善的、多层次的、为期 12 个月的全动力随机对照试验。具有等候名单控制条件的 DIAL 干预（N = 240 名农村居民，大部分是非裔美国成年人）。招聘将由黑带县癌症控制 CHA 的深南网络领导（自初步形成性研究）。主要目的包括检查手臂在中等强度或从基线到 6 个月和 12 个月的有氧运动量增加。探索性目标包括检查对身体表现和心理社会变量的干预效果；体力活动的变化从12- 18个月；干预成本；潜在调解员（来自家人、朋友、CHA 的社会支持）和调解员治疗效果（邻里/环境特征）；以及广泛传播的潜在障碍/促进因素由深南癌症控制网络在农村黑带县实施 DIAL 干预措施。！