Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent Therapy

经验丰富的肺癌幸存者在意向治疗后进行远程康复

• 批准号: 10609501
• 负责人: Duc M. Ha
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 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/10609501
• 关键词: Activities of Daily Living; Address; Adherence; Adverse effects; Adverse event; Aftercare; Authorship; Behavioral; Cancer Biology; Cancer Survivor; Cancer Survivorship; Caring; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Colorado; Conduct Clinical Trials; Data; Data Analyses; Diagnosis; Doctor of Philosophy; Education; Elderly; Eligibility Determination; Enrollment; Environment; Equilibrium; Excision; Exercise; Exercise Physiology; Feeling; Funding; Goals; Health; Health Sciences; Health Technology; Impaired health; Impairment; Improve Access; Intervention; Interview; K-Series Research Career Programs; Knowledge; Learning; Leisures; Longevity; Lung; Malignant neoplasm of lung; Master of Science; Medical; Medical Oncology; Medical center; Medicine; Mentors; Modeling; Non-Small-Cell Lung Carcinoma; Operative Surgical Procedures; Outcome; Participant; Patient Outcomes Assessments; Patient Participation; Patient Self-Report; Patients; Physical Function; Physical activity; Physical therapy; Physicians; Postdoctoral Fellow; Program Accessibility; Publishing; Qualitative Research; Quality of life; Radiation; Randomized; Recommendation; Recording of previous events; Rehabilitation therapy; Reporting; Research; Research Personnel; Safety; Self Efficacy; Services; Stage at Diagnosis; Structure; Supportive care; Survival Rate; Survivors; Symptoms; System; Teacher Professional Development; Techniques; Technology; Testing; Time; Training; Translational Research; Transportation; Travel; United States Department of Veterans Affairs; Universities; Veterans; Work; arm; behavior change; behavioral health; cancer diagnosis; cancer rehabilitation; cancer therapy; career; career development; chemoradiation; clinical center; cost effective; curative treatments; design; exercise capacity; exercise program; exercise rehabilitation; exercise training; expectation; experience; experimental arm; functional improvement; health goals; improved; innovation; loss of function; mid-career faculty; oncology program; precision oncology; professor; programs; psychosocial; pulmonary rehabilitation; randomized trial; rehabilitation research; rehabilitation science; rehabilitation service; research and development; screening; social cognitive theory; systematic review; telehealth; telerehabilitation; uptake; usability

This project entitled “Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent Therapy”, is a Career Development Award (CDA) – 2 resubmission to the Veterans Affairs (VA) Rehabilitation Research and Development (RR&D) Service (RFA RX-20-006). The candidate, Dr. Duc M. Ha, MD, MAS, is a Staff Pulmonologist at the Rocky Mountain Regional VA Medical Center (RMR VAMC) and Assistant Professor at the University of Colorado Anschutz Medical Campus (CU AMC). Dr. Ha has completed a master’s degree in clinical research, postdoctoral research in pulmonary exercise physiology and patient-reported outcomes, and published first-authorship, original research articles on the health impairments of Veteran lung cancer survivors following curative intent therapy. Dr. Ha’s career development goals are to acquire in-depth training in 1) qualitative research, 2) behavioral health science, and 3) the design and conduct of clinical trials focused on rehabilitation and exercise. His longer-term goals are to evaluate rehabilitation services to improve the lives of Veteran lung cancer survivors as a VA physician investigator. Dr. Ha’s primary mentor, Dr. Robert L. Keith, MD, is Professor of Medicine and Cancer Biology at CU AMC and Associate Chief of Staff for Research at RMR VAMC. Dr. Keith is a national leader in lung cancer with a proven track record of research funding and mentoring. Dr. Ha’s co-mentors (and their relevant expertise) are Drs. David B. Bekelman, MD, MPH, Associate Professor of Medicine (qualitative research, supportive care), Jamie L. Studts, PhD, Professor of Medical Oncology (behavioral health science, lung cancer survivorship), and Jennifer E. Stevens-Lapsley, PT, PhD, Professor of Physical Therapy (rehabilitation science). The environment is collaborative with a long history of faculty development. This includes the RMR Geriatric Research, Education and Clinical Center; Center of Innovation for Veteran-Centered and Value-Driven Care; Lung Precision Oncology Program; and the University of Colorado Clinical and Translational Sciences Institute. Lung cancer is the second-most commonly diagnosed cancer among U.S. Veterans – over 8,200 incident cases are diagnosed each year. Approximately 50% of lung cancers are diagnosed at stage I-III and therefore eligible for curative intent therapy. Survival rates among Veterans with early stage lung cancer have increased along with advances in surgical and radiation techniques. Following curative intent therapy, many Veterans experience physical function loss and increased symptom burden. Consequently, approaches are needed to improve their function and quality of life (QoL). We hypothesize that telerehabilitation could mitigate these adverse effects. Therefore, we seek to: (Aim 1) Conduct a qualitative study to assess (a) Veteran lung cancer survivors’ health goals following curative intent therapy, (b) knowledge of outcome expectations for exercise and rehabilitation, and (c) perceived self-efficacy and impediments towards technology. Participants (N=30) will undergo semi-structured interviews guided by the Social Cognitive Theory. Qualitative data analysis will be guided by thematic analysis. Results will be used to guide telerehabilitation programming. (Aim 2) Conduct a pilot randomized study to examine the (a) feasibility, (b) acceptability, and (c) explore the effects of a telerehabilitation intervention with these patients. Participants (N=40) will be randomized (1:1) to receive 12 weeks of telerehabilitation (experimental arm) or assessment only (control arm). Feasibility will be assessed by enrollment, adherence, and retention; acceptability by System Usability Scales; and exploratory effects by linear mixed effects models comparing changes in function, symptom control, and QoL between groups. This CDA-2 project will inform strategies to tailor telerehabilitation and provide pilot data and training for an early career physician investigator to establish independence, with a goal of a large-scale randomized trial (VA Merit) of an optimized telerehabilitation program to improve the physical and psychosocial function, independence, and QoL of Veteran lung cancer survivors following curative intent therapy.

该项目名为“治愈意图治疗后的老将肺癌幸存者的远程居民”， 是职业发展奖（CDA） - 2重新提交退伍军人事务（VA）康复研究 和开发（RR＆D）服务（RFA RX-20-006）。候选人Duc M. Ha博士医学博士，MAS是一名员工 落基山地区VA医疗中心（RMR VAMC）和助理教授的肺科医生 科罗拉多大学Anschutz大学医疗校园（CU AMC）。 HA博士完成了硕士学位 临床研究，肺运动生理学的博士后研究和患者报告的结果以及 发表了关于老将肺癌存活的健康障碍的原始研究文章 遵循治疗意图治疗。 HA博士的职业发展目标是在1中获得深入的培训） 定性研究，2）行为健康科学，以及3）临床试验的设计和行为。 康复和运动。他的长期目标是评估康复服务，以改善 资深肺癌作为VA物理研究者存活。 HA博士的主要导师Robert L. Keith博士医学博士是Cu AMC的医学和癌症生物学教授 RMR VAMC研究副总裁。基思博士是肺癌的国家领导者 经过验证的研究资金和心理记录。 Ha博士的联合体（及其相关专家）是 博士。 David B. Bekelman，医学博士，MPH，医学副教授（定性研究，支持护理）， Jamie L. Studts博士，医学肿瘤学教授（行为健康科学，肺癌生存）， 和詹妮弗·E·史蒂文斯·拉普斯利（Jennifer E.这 环境与教师发展的悠久历史是合作的。这包括RMR老年 研究，教育和临床中心；以资深和价值驱动的护理的创新中心； 肺部精度肿瘤学计划；以及科罗拉多大学临床与转化科学研究所。 肺癌是美国退伍军人中通常被诊断出的第二个癌症 - 超过8200次事件 病例每年被诊断出。在I-III期间诊断出约50％的肺癌，因此 有资格治疗意图治疗。早期肺癌的退伍军人的存活率增加了 以及手术和辐射技术的进步。遵循治疗意图治疗，许多退伍军人 经历身体功能丧失和症状增加。因此，需要方法 改善其功能和生活质量（QOL）。我们假设远程纤维可以减轻这些 不利影响。因此，我们寻求：（目标1）进行定性研究以评估（a）老兵肺癌 在治愈意图治疗后，幸存者的健康目标，（b）对锻炼结果期望的了解 和康复，以及（c）感知的自我效能和对技术的障碍。参与者（n = 30） 将接受社会认知理论指导的半结构化访谈。定性数据分析将是 在主题分析的指导下。结果将用于指导远程访问计划。 （AIM 2）进行 试点随机研究以检查（a）可行性，（b）可接受性，（c）探索a的影响 这些患者的远程居民干预。参与者（n = 40）将被随机分组​​（1：1）接收12 数周的通讯（实验组）或评估（对照组）。可行性将由 入学，依从性和保留；系统可用性量表的可接受性；和探索性效果 线性混合效应模型比较了组之间功能，症状控制和QOL的变化。 该CDA-2项目将为策略提供量身定制的策略，并提供试点数据和培训 早期的职业生理研究者建立独立性，目标是进行大规模随机试验（VA） 优化的远程居民计划，以改善身体和社会心理功能， 在治愈意图治疗后，独立性和老将肺癌幸存者的质量。