Efficacy of a self-advocacy serious game intervention for women with advanced cancer

自我倡导严肃游戏干预对晚期癌症女性的疗效

基本信息

批准号：
10273535
负责人：
Teresa Hagan Thomas
金额：
$ 64.69万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10273535
关键词：
3-Dimensional Address Adult Advanced Malignant Neoplasm Advocacy Advocate Age Behavioral Behavioral Mechanisms Belief Breast Caring Communication Complex Decision Making Educational process of instructing Elements Emergency Situation Ensure Exposure to Face Feedback Future Goals Health Health Personnel Healthcare Healthcare Systems Hospitalization Immersion Individual Intervention Interview Knowledge Lead Learning Life Malignant Female Reproductive System Neoplasm Malignant Neoplasms Modeling Motivation Newly Diagnosed Outcome Paper Participant Patient Education Patient Preferences Patient Self-Report Patient-Centered Care Patient-Focused Outcomes Patients Personal Satisfaction Provider Public Health Quality of Care Quality of life Randomized Randomized Clinical Trials Reporting Research Rewards Risk Sampling Social support Surveys Symptoms Technology Testing Theory of Change Training Transference Video Games Visit Woman Work advanced breast cancer base behavior change cancer care cancer diagnosis cancer therapy care coordination efficacy evaluation efficacy testing experience experimental group health care service utilization improved improved outcome individualized feedback innovation intervention effect learning outcome novel pilot trial preference primary outcome programs provider-level barriers secondary outcome skill acquisition skills skills training success symptom management theories treatment adherence

项目摘要

Project Summary Individuals with cancer must overcome multiple, ongoing challenges (“self-advocate”) related to their cancer experience to receive patient-centered care. Women with metastatic breast or advanced gynecologic cancer often face significant challenges managing their quality of life concerns and cancer- and treatment-related symptoms. If they do not self-advocate to manage these concerns, they risk having poor quality of life, high symptom burden, and care that is not patient-centered. Serious games (video games that teach) are effective health interventions that allow users to vicariously engage in situations reflecting their personal experiences, receive meaningful information, and learn personally relevant skills that they can apply in real life. The long- term objective of this work is to prepare patients with cancer to engage in patient-centered care by teaching them self-advocacy skills using immersive, accessible technologies. The goal of the current study is to test the efficacy of a novel intervention using a serious game platform to teach self-advocacy skills to women with metastatic breast or advanced gynecologic cancer. The Strong Together intervention consists of a multi- session, interactive serious game application with tailored self-advocacy goal-setting and training. The serious game is based on a self-advocacy conceptual framework and applies behavior change theories and serious game mechanisms to promote skill development and implementation. The game works by immersing users in the experiences of characters who are women with advanced cancer; requiring users to make decisions about how the characters self-advocate; demonstrating the positive and negative consequences of self-advocating or not, respectively; and providing multiple, individualized feedback mechanisms and game features to enforce self-advocacy skill acquisition and transference to real life. This study evaluates the efficacy of the Strong Together intervention by conducting a randomized clinical trial in 336 adult (ages >18 years) women within three months of a metastatic breast or Stage III or IV gynecologic cancer diagnosis. Participants will be randomly assigned to receive the 3-month Strong Together intervention or a paper self-advocacy guide. The primary outcome is patient self-advocacy. Secondary outcomes include quality of life, symptom burden, and patient-centered care. The central hypothesis is that the experimental group will have higher self-advocacy, quality of life, and patient-centered care and lower symptom burden compared to the paper self-advocacy guide group. As an exploratory outcome, we will determine if the intervention reduces suboptimal healthcare utilization. The study will also evaluate the behavioral and game mechanisms that influence the efficacy of the Strong Together intervention. This study provides the first theoretically based self-advocacy intervention for adult women with cancer and clarifies the mechanisms by which serious games teach skills and assist in transferring those skills to real life. Self-advocacy interventions have the potential to advance patient-centered care by providing patients with tangible skills that prepare them to meaningful engage in their cancer care.

项目摘要患有癌症的人必须克服与癌症有关的多个持续的挑战（“自我吸引”）接受以患者为中心的护理的经验。患有转移性乳房或晚期妇科癌症的妇女经常面临重大挑战，以管理其生活质量问题以及癌症和治疗相关的挑战症状。如果他们不自我审核来管理这些问题，他们可能会有生活质量差，高的风险症状伯恩（Burnen）和不以患者为中心的护理。认真的游戏（教导的视频游戏）有效健康干预措施使用户可以替代地参与反映其个人经历的情况，接收有意义的信息，并学习可以在现实生活中应用的个人相关技能。长期这项工作的术语目标是使患者通过教学做好准备以患者为中心的护理他们使用沉浸式，可访问的技术的自我顾问技能。当前研究的目的是测试新颖干预使用严肃的游戏平台的功效转移性乳腺癌或晚期妇科癌。强烈的干预包括多个会议，互动式认真的游戏应用程序，并带有量身定制的自我倡导目标设定和训练。认真游戏基于自我顾问概念框架，并应用行为改变理论和严重促进技能发展和实施的游戏机制。游戏是通过将用户浸入中的患有晚期癌症的女性角色的经历；要求用户做出决定角色如何自我互发；证明自顾问或不分别；并提供多种个性化的反馈机制和游戏功能来执行自我倡导技能获取并转移到现实生活中。这项研究评估了强大的效率通过在336名成人（年龄> 18岁）妇女中进行随机临床试验一起进行干预三个月的转移性乳房或III期或IV妇科癌症诊断。参与者会随机分配以接收3个月的强度干预或纸张自我倡导指南。这主要结果是患者自我顾问。次要结果包括生活质量，症状伯恩和以患者为中心的护理。中心假设是实验组将具有较高的自我倡导率，与纸自我顾问相比指南小组。作为探索性结果，我们将确定干预措施是否减少了次优医疗保健利用率。该研究还将评估影响影响效率的行为和游戏机制强烈的干预。这项研究为理论上提供了第一个基于理论上的自我顾问干预措施成年女性患有癌症的女性，并阐明了认真的游戏教师技能和协助的机制将这些技能转移到现实生活中。自我顾问干预措施有可能提高以患者为中心的通过为患者提供有意义的有意义从事癌症护理的有意义的技能来护理。