The COACH Study: A Framework for individualized COaching in young Adult Cancer survivors to encourage Healthy behaviors

COACH 研究：对年轻成人癌症幸存者进行个性化辅导以鼓励健康行为的框架

基本信息

批准号：
10617742
负责人：
Sylvia Crowder
金额：
$ 8.71万
依托单位：
H. LEE MOFFITT CANCER CTR & RES INST
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：
2022-05-04 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10617742
关键词：
Address Adherence Adult African American African American population Age Age Years American Cancer Society Area Awareness Behavior Behavior Therapy Behavioral Belief Body Weight Body Weight decreased Breast Cancer survivor Cancer Survivor Cancer Survivorship Cardiovascular Diseases Clinical Constipation Cultural Characteristics Data Development Diabetes Mellitus Diagnosis Diet Enrollment Ensure Environmental Risk Factor Ethnic Origin Fatigue Food Future Gender Goals Growth and Development function Guidelines Habits Health Disparities Research Health behavior Hispanic Hispanic Americans Individual Intervention Interview Knowledge Late Effects Life Life Style Malignant Neoplasms Metabolic syndrome Methods Modality Movement National Cancer Institute Not Hispanic or Latino Nutritional Obesity Overweight Patients Physical activity Physical assessment Population Publishing Quality of life Race Randomized Recommendation Reporting Research Risk Risk Factors Sampling Structure Survivors Time Vulnerable Populations age related approach behavior behavior influence cancer diagnosis cancer risk comorbidity dietary guidelines ethnic minority exercise intervention experience fitbit frailty gender difference health care delivery healthy lifestyle healthy weight high body mass index human old age (65+)improved lifestyle intervention obesity prevention phenomenological models preference programs psychosocial public health priorities racial minority randomized, clinical trials recruit reduced muscle mass sedentary sedentary lifestyle social cognitive theory social culture sociocultural determinant symptomatology walking speed wearable sensor technology weight gain prevention young adult

项目摘要

PROJECT SUMMARY When a young adult (YA) is diagnosed with cancer, normal growth and development is disrupted, heightening nutritional needs in a vulnerable population. YA Hispanic and African Americans survivors are particularly vulnerable as they are more likely to have a higher body mass index (BMI) pre-treatment, further increasing the risk of late effects of cancer and comorbidities. Following treatment, YA survivors report worse quality of life (QOL) and greater symptomatology, including fatigue, constipation, frailty, low muscle mass, slow walking speed, and weakness similar to adults aged 65 and older. As a result of treatment, changes in body weight and limitations in physical movement are a major concern in 30-60% of survivors. While a number of lifestyle interventions have been published, only two published YA cancer survivor studies have incorporated a diet and PA bundled health behavior approach. Each study followed different dietary guidelines and both studies were conducted in YA breast cancer survivors who may have different needs as a result of treatment and gender differences. There is a lack of understanding of YA from racial/ethnic minority backgrounds as the aforementioned studies did not include Hispanic survivors and recruited only a small handful of African American survivors, an important gap we plan to address in this application. Thus, healthy lifestyle interventions encompassing diet and physical activity (PA) to prevent obesity-related late effects are warranted. The goal of the current study is to take a sequential mixed methods approach addressing this knowledge gap to gain essential quantitative and qualitative information that will serve as the framework for our next steps; a healthy lifestyle intervention for YA cancer survivors that are diverse in terms of race, ethnicity, gender, cancer diagnosis, time since diagnosis, and treatment. In Aim 1, we will recruit a diverse sample of YA cancer survivors currently between 20-30 years of age to obtain objective and subjective lifestyle behavior data on current diet quality, PA, and quality of life. For Aim 2, we will recruit a subset of Aim 1 survivors to participate in phenomenological based semi-structured interviews guided by the Social Cognitive Theory to (a) explore sociocultural, environmental, and individual factors associated with lifestyle behaviors; (b) explore awareness of ACS guidelines, current practices, and essential intervention modules (e.g., integrating cultural foods and preferences) to inform intervention content and modality. There is an urgent need to develop health behavior interventions for YA cancer survivors that are effective and easily disseminated. Successful completion of this study will provide the information needed to create and enhance the framework for our proposed intervention “COACH: Individualized COaching in young Adult Cancer survivors to encourage Healthy behaviors” in terms of format and module content, with desirable patient-level preferences for sociocultural and environmental factors. The intervention framework created at the end of the study will be easily modified to best suit an individual’s background, taking into consideration their worldview, increasing the potential to be widely disseminated and effective.

项目概要当年轻人 (YA) 被诊断患有癌症时，正常的生长和发育就会受到干扰，从而加剧弱势群体的营养需求尤其是西班牙裔和非裔美国人。易受伤害，因为他们更有可能在治疗前拥有较高的体重指数 (BMI)，从而进一步增加治疗后，YA 幸存者报告生活质量较差。 (QOL) 和更大的症状，包括疲劳、便秘、虚弱、肌肉质量低、步行速度慢、和 65 岁及以上成年人相似的虚弱症状由于治疗，体重和体重发生变化。身体活动受限是 30-60% 的幸存者的主要担忧，而许多生活方式。干预措施已经发表，只有两项已发表的 YA 癌症幸存者研究纳入了饮食和 PA 捆绑健康行为方法。每项研究均遵循不同的饮食指南，并且两项研究均遵循不同的饮食指南。在 YA 乳腺癌幸存者中进行，他们可能因治疗和性别而有不同的需求人们对少数族裔背景的青少年缺乏了解。讨论的研究不包括西班牙裔幸存者，只招募了少数非裔美国人幸存者，我们计划在此应用程序中解决一个重要的差距，因此，健康的生活方式干预。包括饮食和体力活动（PA）以预防肥胖相关的后期影响是有必要的。当前的研究是采用顺序混合方法来解决这一知识差距，以获得重要的定性信息将作为我们下一步健康发展的框架；针对种族、民族、性别、癌症诊断、在目标 1 中，我们将招募目前 YA 癌症幸存者的不同样本。 20-30岁之间，以获得有关当前饮食质量、PA、对于目标 2，我们将招募一部分目标 1 幸存者参与基于现象学的活动。以社会认知理论为指导的半结构化访谈，旨在 (a) 探索社会文化、环境、以及与生活方式行为相关的个人因素；(b) 探索对当前 ACS 指南的认识；实践和基本干预模块（例如，整合文化食品和偏好）来提供信息迫切需要制定针对YA癌症的健康行为干预措施。成功完成这项研究将提供有效且易于传播的幸存者。创建和增强我们提议的干预框架“COACH：个性化”所需的信息在格式和模块方面指导年轻的成年癌症幸存者鼓励健康行为” 内容，以及患者对社会文化和环境因素的期望偏好。研究结束时创建的框架将很容易修改，以最适合个人的背景，考虑到他们的世界观，增加广泛传播和有效的潜力。