A digital intervention to improve skin self-examination among melanoma survivors

改善黑色素瘤幸存者皮肤自我检查的数字干预

基本信息

批准号：
10593971
负责人：
Carolyn Heckman
金额：
$ 63.81万
依托单位：
RUTGERS BIOMEDICAL AND HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10593971
关键词：
Address Adoption Behavior Behavioral Cancer Science Cancer Survivor Cancer Survivorship Caring Clinical Collaborations Community Healthcare Consent Cost Analysis Cost Effectiveness Analysis Cutaneous Melanoma Data Detection Diagnosis Disease Disease Progression Dissemination and Implementation Early Diagnosis Early treatment Education Effectiveness Eligibility Determination Ensure Future General Population Goals Guidelines Healthcare Immunotherapy Incidence Intervention Interview Lesion by Stage Maintenance Malignant Neoplasms Methods Modeling New Jersey Newly Diagnosed Participant Performance Persons Physicians Population Prevention Process Professional Organizations Provider Randomized Randomized, Controlled Trials Recommendation Recurrence Recurrent Malignant Neoplasm Recurrent disease Research Resources Risk Risk Factors Risk Reduction Self-Examination Skin Skin Cancer Survivors Target Populations Techniques Testing Theory of Change Thinness Time Treatment Cost Underserved Population United States Work behavior change cancer diagnosis cancer recurrence care providers clinical examination contextual factors cost cost effective cost effectiveness design digital intervention effective therapy effectiveness evaluation effectiveness/implementation design effectiveness/implementation trial efficacy trial experience follow-up future implementation health care settings high risk implementation evaluation implementation framework implementation outcomes implementation science improved informant innovation intervention delivery melanoma models and simulation neoplasm registry online intervention program costs programs recruit scale up social media treatment as usual trial design usability web page

项目摘要

ABSTRACT With incidence rates more than tripling in the last 45 years, the population of melanoma survivors in the US is estimated at more than a million persons. Survivors are at elevated risk for recurrence and new primary cancers. Most recurrent melanomas are found by survivors themselves, which is why physicians educate survivors about the importance of regular, thorough skin self-exams (SSE) and why professional guidelines for follow-up surveillance recommend regular, thorough (SSE). More than two thirds of melanoma survivors do not perform regular, thorough SSE. To address this significant problem, our experienced team developed a digital intervention, called mySmartSkin (MSS), and tested it in an RCT against usual care in New Jersey. MSS illustrated promising effects on thorough SSE. In this application, we propose to prepare MSS for large-scale dissemination using an innovative Type 1 hybrid effectiveness-implementation trial. A Type 1 hybrid effectiveness-implementation design allows us to engage multilevel stakeholders throughout the research process, evaluate the effectiveness of the enhanced MSS, and identify critical factors for wide-scale implementation. The study’s three aims are guided by implementation frameworks and behavior change theories. In Aim 1, we will enhance MSS using multi-level stakeholder engagement by collaborating with key stakeholders in enhancing MSS through qualitative interviews and usability testing of potential enhancements. Potential enhancements are based on empirically-validated behavior change techniques (BCTs) and findings from our prior study. We will utilize an iterative process that includes key informant interviews with survivors, providers, and relevant professional organizations regarding proposed enhancements, conversion to an enhanced mobile-based intervention delivery platform, usability testing with survivors, and iterative program refinements. Aim 2 compares the effects of enhanced MSS vs. a non-interactive educational webpage on comprehensive SSE in an RCT with survivors recruited through two state cancer registries and social media (N=300). In Aim 3, we identify factors relevant to future scale-up for widespread dissemination and implementation using mixed methods to assess selected implementation outcomes from the RCT and explore perspectives from survivors, care providers, and professional organizations about how to best disseminate and implement MSS on a broad scale. We will estimate program costs and assess cost-effectiveness of MSS. This project addresses a documented gap in care for melanoma survivors by enhancing effects of a promising survivor-facing intervention and proactively identifying barriers and facilitators to future implementation. We innovatively “design for dissemination” by ensuring that enhancements are designed with the target population of potential users. Serving as a model for optimizing promising fully-automated online interventions for cancer survivors for dissemination, this project will provide important information about potentially cost-effective ways to reach survivors as well as about how to adapt such an intervention for dissemination.

抽象的在过去45年中，事件率的增加三倍，美国黑色素瘤冲浪者的种群是估计超过一百万。幸存者的复发风险较高和新主要的风险癌症。大多数复发性黑色素瘤都是由生存本身发现的，这就是为什么医生进行教育的原因幸存者关于常规，彻底的皮肤自我检查（SSE）的重要性以及为什么专业准则诚实（SSE）建议进行后续监视。超过三分之二的黑色素瘤幸存者没有执行定期，彻底的SSE。为了解决这个重大问题，我们经验丰富的团队开发了一个数字干预措施，称为Mysmartskin（MSS），并在新泽西州的常规护理中对其进行了测试。 MSS 插图对彻底SSE的有希望的影响。在此应用程序中，我们建议为大规模准备MSS 使用创新的1型混合有效性试验进行传播。 1型混合动力车有效性实施设计使我们能够在整个研究中吸引多级利益相关者处理，评估增强的MSS的有效性，并确定广泛的关键因素执行。该研究的三个目标以实施框架和行为改变为指导理论。在AIM 1中，我们将通过与Key合作使用多层利益相关者参与来增强MSS 利益相关者通过定性访谈和潜在增强的可用性测试来增强MSS。潜在的增强基于经验验证的行为变化技术（BCT）和发现从我们的先前研究。我们将利用一个迭代过程，其中包括与生存的关键线人访谈，提供者和有关拟议增强功能的相关专业组织转换为增强基于移动的干预交付平台，可用性的可用性测试以及迭代计划改进。 AIM 2比较增强MSS与非交互式教育网页的影响通过两个州癌症注册表和社交媒体招募的生存的RCT中的全面SSE （n = 300）。在AIM 3中，我们确定了与未来扩大范围相关的因素，以进行广泛传播和使用混合方法的实施来评估RCT中选定的实现结果并探索表面人物，护理提供者和专业组织的观点如何最好地传播和大规模实施MS。我们将估算计划成本并评估MSS的成本效益。这项目通过增强承诺的影响来解决对黑色素瘤生存的记录差距面向幸存者的干预措施，并主动确定未来实施的障碍和促进者。我们通过确保使用目标人群设计增强功能，以创新的“传播设计” 潜在用户。用作优化癌症完全自动化的在线干预措施的模型传播幸存者，该项目将提供有关潜在具有成本效益的方式的重要信息到达生存以及如何适应这种干预措施以进行传播。