Peer Coaching for Physical Activity Promotion among Breast Cancer Survivors: Adapting an Efficacious Intervention to Prepare for Implementation

同伴辅导促进乳腺癌幸存者的身体活动：采用有效的干预措施为实施做好准备

• 批准号: 10558670
• 负责人: Bernardine M. Pinto
• 金额: $ 33.42万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10558670
• 关键词: 3-Dimensional; Accelerometer; Adoption; American; American Cancer Society; Award; Breast Cancer survivor; Businesses; Cancer Survivor; Chronic Disease; Clinical; Collaborations; Colorectal Cancer; Cost Effectiveness Analysis; Counseling; Country; Data; Data Collection; Diabetes Mellitus; Disease Management; Educational Intervention; Endometrial Carcinoma; Enhancement Technology; Ensure; Evaluation Studies; Evidence based intervention; Exercise; Fatigue; Feedback; Foundations; Future; Goals; HIV; Health Insurance Portability and Accountability Act; Home; Intervention; Interview; Learning; Letters; Malignant Neoplasms; Manuals; Measures; Methods; Mission; Modeling; Moods; Online Systems; Outcome; Patient Self-Report; Patients; Persons; Phase; Physical Function; Physical activity; Positioning Attribute; Practical Robust Implementation and Sustainability Model; Process; Quality of life; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Recovery; Research; Resources; Risk Reduction; Site; Small Business Innovation Research Grant; Speed; Sports Medicine; Structure; Suggestion; Supervision; Survivors; System; Telephone; Testing; Time; Training; Training Programs; Work; acceptability and feasibility; cancer care; college; contextual factors; cost; dietary; efficacious intervention; evidence base; exercise intervention; experience; fitness; implementation facilitators; implementation trial; improved; indexing; interest; intervention delivery; malignant breast neoplasm; medication compliance; moderate-to-vigorous physical activity; new technology; peer coaching; peer support; personalized approach; post intervention; pragmatic implementation; pragmatic trial; primary outcome; programs; psychosocial; public health relevance; randomized controlled design; randomized, controlled study; recruit; scale up; success; theories; user centered design; web platform

Interventions promoting physical activity among cancer survivors improve their functioning, reduce fatigue and offer other benefits in cancer recovery and risk reduction for future cancer. There is a need for interventions that can be implemented on a wider-scale than in research settings. Our 12-week theory-based exercise intervention that was delivered by research staff by telephone was efficacious in improving fitness, and increasing moderate-to-vigorous physical activity (MVPA) among breast, colorectal and endometrial cancer survivors. To widen the intervention’s reach, we trained peer coaches in the American Cancer Society’s Reach to Recovery program to deliver the same MVPA intervention called Moving Forward Together (MFT) to other breast cancer survivors. In a randomized controlled trial, MFT significantly increased MVPA and provided psychosocial benefits for these survivors (Pinto, Stein & Dunsiger, 2015). Now, our goal is to prepare for wider implementation of MFT by automating key resource-intensive components such as matching survivors with a coach by using a web-based peer mentoring platform and to collect key indices to prepare for large scale implementation. InquistHealth’s web platform (Mentor1to1™) has demonstrated to be effective in peer mentoring for chronic disease management (e.g., diabetes). We will partner with InquisitHealth to adapt their web platform for MFT. The aim is to streamline intervention delivery, assure fidelity and improve survivor outcomes. There will be two phases in this 4-year R01 application: in Phase 1, we will work with 6 peer coaches who have already delivered MFT (our original evidence-based MVPA intervention) in prior work. Using iterative user-centered design principles, we will modify the web platform for MFT, creating webMFT. In Phase 2, we will conduct a randomized controlled trial in which 10-12 peer coaches will deliver webMFT to 56 breast cancer survivors who will be randomized to receive either webMFT or MVPA Tracking. We will recruit and train coaches naïve to MFT from three cancer care organizations with peer mentoring programs. We will collect feasibility and acceptability data about webMFT from the coaches. We will examine survivor outcomes (objectively measured MVPA and self-reported fatigue, quality of life, physical functioning and mood) by using mixed effects regression models to compare groups at 12 weeks. We will obtain survivors’ feedback on their experience with webMFT. Based on the RE-AIM framework and PRISM, we will collect data on implementation indices at the organizational level by conducting key multi-level stakeholder interviews. Using newer technologies for enhanced intervention delivery, program management and automated data collection has the exciting promise of facilitating effective implementation by organizations with limited resources. Adapting evidence-based MFT to a customized web platform and collecting data at multiple-levels (coaches, survivors and organizations) along with costs will provide a strong foundation for a robust multi-site implementation trial to increase MVPA (and its benefits) among many more breast cancer survivors.

促进癌症生存中体育活动的干预措施可以改善其功能，减少疲劳和 为未来癌症提供癌症恢复和降低风险的其他好处。需要干预 与研究环境相比，这可以在大规模上实施。我们基于12周的理论练习 通过电话进行的研究人员提供的干预措施有效地改善了健身和 在乳腺癌，结直肠癌和子宫内膜癌中增加现代到剧烈的体育锻炼（MVPA） 幸存者。为了扩大干预措施，我们培训了美国癌症协会的同伴教练 恢复计划，以提供相同的MVPA干预措施，称为前进（MFT） 乳腺癌存活。在一项随机对照试验中，MFT显着增加了MVPA并提供了 这些生存的心理益处（Pinto，Stein＆Dunsiger，2015年）。现在，我们的目标是为怀尔德做准备 通过自动化关键资源密集型组件（例如匹配的表面）来实现MFT 通过使用基于网络的同伴心理平台并收集关键指数以大规模准备的教练 执行。 Injisthealth的Web平台（Mentor1to1™）已证明对同行有效 慢性疾病管理的指导（例如糖尿病）。我们将与Incoisithealth合作，以适应他们的 MFT的网络平台。目的是简化干预措施，确保保真度并提高生存 结果。在此4年R01应用程序中将有两个阶段：在第1阶段，我们将与6个同行一起工作 已经在先前工作中提供了MFT（我们最初基于证据的MVPA干预）的教练。 使用以用户为中心的迭代设计原理，我们将修改MFT的Web平台，创建WebMFT。在 第2阶段，我们将进行一项随机对照试验 乳腺癌存活将随机接收WebMFT或MVPA跟踪。我们将招募 并从三个具有同伴心理计划的癌症护理组织的MFT幼稚的火车教练。我们将 从教练那里收集有关WebMFT的可行性和可接受性数据。我们将检查生存结果 （客观测量的MVPA和自我报告的疲劳，生活质量，身体功能和情绪）通过使用 混合效应回归模型在12周时比较组。我们将获得生存的反馈 有WebMft的经验。根据Re-Aim框架和棱镜，我们将收集有关的数据 通过进行关键的多级利益相关者访谈，在组织层面的实施指数。 使用较新的技术来增强干预交付，程序管理和自动数据 收集有一个令人兴奋的希望，即促进有限的组织有效实施 资源。将基于证据的MFT调整到定制的Web平台上，并在多层收集数据 （教练，幸存和组织）以及成本将为强大的多站点提供坚实的基础 实施试验，以增加许多乳腺癌存活中MVPA（及其益处）。