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：
10705095
负责人：
Teresa Hagan Thomas
金额：
$ 61.75万
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/10705095
关键词：
3-Dimensional Address Adult Advanced Malignant Neoplasm Advocacy Advocate Age Applied Skills Behavioral Behavioral Mechanisms Belief Breast Caring Communication Complex Decision Making Education Educational process of instructing Elements Emergency Situation Ensure Exposure to Face Feedback Future Goals Health Health Personnel Healthcare Healthcare Systems Hospitalization Individual Intervention Interview Knowledge Learning Learning Skill Life Malignant Female Reproductive System Neoplasm Malignant Neoplasms Measures Modeling Motivation Newly Diagnosed Outcome Paper Participant Patient Education Patient Preferences Patient Self-Report Patient-Centered Care Patient-Focused Outcomes Patients Personal Satisfaction Public Health Quality of Care Quality of life Randomized Reporting Research Rewards Risk Sampling Social support Surveys Symptoms Technology Testing Theory of Change Training Transference Video Games Visit Woman Work advanced breast cancer behavior change cancer care cancer diagnosis care coordination efficacy evaluation efficacy testing enhanced care experience experimental group health care service utilization improved improved outcome individualized feedback innovation intervention effect learning outcome novel pilot trial poor health outcome preference primary outcome programs provider communication randomized, clinical trials secondary outcome skill acquisition skills skills training success symptom management theories treatment adherence treatment as usual

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.

项目概要癌症患者必须克服与其癌症相关的多重持续挑战（“自我倡导”）患有转移性乳腺癌或晚期妇科癌症的女性接受以患者为中心的护理的经验。经常面临管理生活质量问题以及癌症和治疗相关的重大挑战如果他们不自我主张解决这些问题，他们就会面临生活质量差、高的风险。症状负担和不以患者为中心的护理是有效的。健康干预措施允许用户间接参与反映他们个人经历的情况，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。这项工作的长期目标是通过教学让癌症患者做好以患者为中心的护理的准备当前研究的目的是测试他们使用沉浸式、可访问的技术的自我宣传技能。使用严肃的游戏平台向女性传授自我倡导技能的新颖干预措施的有效性转移性乳腺癌或晚期妇科癌症 The Strong Together 干预措施包括多种治疗。会话，交互式严肃游戏应用程序，具有定制的自我倡导目标设定和培训。游戏基于自我倡导的概念框架，并应用行为改变理论和严肃的促进技能发展和实施的游戏机制游戏通过让用户沉浸其中来发挥作用。患有晚期癌症的女性角色的经历要求用户做出决定；人物如何自我主张；展示自我主张或行为的积极和消极后果；分别不；并提供多种个性化的反馈机制和游戏功能来强制执行本研究评估了强者自我倡导技能的获取和转移到现实生活中的效果。通过对 336 名成年（年龄 >18 岁）女性进行一项随机临床试验来共同干预参与者将被诊断为转移性乳腺癌或 III 期或 IV 期妇科癌症的三个月。随机分配接受为期 3 个月的 Strong Together 干预或纸质自我倡导指南。主要结局是患者的自我倡导，次要结局包括生活质量、症状负担和。以患者为中心的护理的中心假设是实验组将有更高的自我主张，与纸质自我宣传相比，生活质量、以患者为中心的护理和症状负担更低作为探索性结果，我们将确定干预措施是否可以减少次优的医疗保健。该研究还将评估影响效果的行为和游戏机制。这项研究提供了第一个基于理论的自我倡导干预。患有癌症的成年女性，并阐明了严肃的游戏教授技能和协助的机制将这些技能转化为现实生活中的自我倡导干预措施有可能促进以患者为中心的发展。通过为患者提供切实的技能来帮助他们做好有意义地参与癌症护理的准备。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A Conceptual Framework of Self-advocacy in Women With Cancer.

癌症女性自我倡导的概念框架。

DOI：
发表时间：
2021-01-01
期刊：
影响因子：
0
作者：
Thomas, Teresa H;Donovan, Heidi S;Rosenzweig, Margaret Q;Bender, Catherine M;Schenker, Yael
通讯作者：
Schenker, Yael

"I pretty much followed the law, and there weren't any decisions to make": A qualitative study of self-advocacy experiences of men with cancer.

“我基本上遵守了法律，没有任何决定要做”：一项针对癌症男性自我倡导经历的定性研究。

DOI：
发表时间：
2022-03
期刊：
影响因子：
2.7
作者：
Thomas, Teresa Hagan;Hadley, Makenna L;Nilsen, Marci Lee
通讯作者：
Nilsen, Marci Lee

Game Changer: Is Palliative Care Ready for Games?

游戏规则改变者：姑息治疗准备好迎接游戏了吗？

DOI：
发表时间：
2022-03
期刊：
影响因子：
4.2
作者：
Azizoddin, Desiree R;Thomas, Teresa H
通讯作者：
Thomas, Teresa H

What are We Asking Patients to Do? A Critical Ethical Review of the Limits of Patient Self-Advocacy in the Oncology Setting.

我们要求患者做什么？

DOI：
发表时间：
2023-06
期刊：
影响因子：
0
作者：
Wilkenfeld, Daniel A;Hagan Thomas, Teresa
通讯作者：
Hagan Thomas, Teresa

Empowerment through technology: A systematic evaluation of the content and quality of mobile applications to empower individuals with cancer.

通过技术赋权：对移动应用程序的内容和质量进行系统评估，以增强癌症患者的能力。

DOI：
发表时间：
2022-07
期刊：
影响因子：
4.9
作者：
Thomas, Teresa Hagan;Go, Kailey;Go, Kelsey;McKinley, Natalie Jane;Dougherty, Kayla R;You, Kai;Lee, Young Ji
通讯作者：
Lee, Young Ji

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Teresa Hagan Thomas其他文献

A Qualitative Exploration of Self-Advocacy Experiences of Black Women in the Perinatal Period: Who Is Listening?

对围产期黑人女性自我倡导经历的定性探索：谁在倾听？

DOI：
发表时间：
2024
期刊：
Journal of midwifery & women's health
影响因子：
0
作者：
Teresa Hagan Thomas;Savannah Vetterly;Elizabeth B Kaselitz;Willa Doswell;Betty Braxter
通讯作者：
Betty Braxter