Project 2: Reaching Cancer Survivors with Distance-delivered Support for Physical Activity Behavior Change (REACH)

项目 2：为癌症幸存者提供远程身体活动行为改变支持 (REACH)

基本信息

批准号：
10247781
负责人：
LAURA Q ROGERS
金额：
$ 5.02万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10247781
关键词：
Accelerometer Accountability Address African American Aftercare Age Aging Attention Behavior Behavior Therapy Biological Markers Breast Cancer survivor Cancer Intervention Cancer Survivor Cancer Survivorship Caring Cessation of life Confidence Intervals Counseling Diagnosis Dissemination and Implementation Electronic Mail Elements Enrollment Exercise Facebook Goals Health Health Benefit Health Care Costs Individual Interferon Type II Interleukin-10 Interleukin-6 Internet Intervention Knowledge Malignant Neoplasms Marital Status Measures Mediating Mediator of activation protein Medical Monitor Odds Ratio Online Systems Outcome Participant Patient Self-Report Personal Satisfaction Physical Function Physical activity Positioning Attribute Public Health Quality of life Quality-Adjusted Life Years Race Randomized Controlled Trials Recommendation Research Research Personnel Rural Rural Minority Sampling Second Primary Cancers Self Efficacy Site Societies Subgroup Supervision Survivors Technology Telomerase Testing Time Translating Treatment Efficacy Ursidae Family Waiting Lists Woman Work arm base behavior change biopsychosocial cancer diagnosis cancer therapy cancer type comorbidity cost cost effective cost effectiveness cost-effectiveness evaluation effectiveness measure efficacy testing exercise adherence exercise intensity exercise training expectation experience falls immunological status improved intervention cost intervention effect intrinsic motivation lean body mass meetings men mortality mortality risk post intervention primary outcome programs psychosocial randomized controlled design randomized trial rural dwellers secondary outcome survivorship symposium systemic inflammatory response theories treatment arm vigorous intensity waist circumference

项目摘要

Reaching Cancer Survivors with Distance-delivered Support for Physical Activity Behavior Change Cancer is the second leading cause of mortality in the U.S., resulting in over a half a million deaths each year. Furthermore, cancer survivors are more likely to suffer from second cancers, medical comorbidities, and reduced quality of life. Vulnerable cancer survivors (e.g., older, rural residents, underserved) bear a disproportionate burden of suffering after a cancer diagnosis related to greater mortality and poorer health and well-being. Exercise is an important aspect of survivorship care that can reduce this burden of suffering. However, the majority of cancer survivors do not engage in regular exercise, and behavior change interventions aimed at increasing exercise behavior often fall short of achieving the recommended exercise amount of ≥ 150 weekly minutes of moderate-to-vigorous intensity exercise. Moreover, such interventions are rarely tested for cost-effectiveness or translated into broader use. This proposal addresses this research gap by adapting the BEAT Cancer intervention, proven to be efficacious in significantly improving the odds of meeting exercise recommendations in cancer survivors, to web-based delivery that will increase its dissemination and implementation (D&I) potential. Core intervention components (i.e., elements responsible for intervention efficacy) identified during efficacy testing will also be adapted to improve acceptability among diverse cancer survivors (e.g., older, rural residents, African-Americans). The adapted intervention will be called Reaching out for Exercise Adherence to improve Cancer survivors' Health (REACH). The 6-month REACH intervention will then be tested in 326 survivors of a variety of cancers and in whom significant proportions will be older, rural, and minority. Investigators will employ a 2-arm randomized controlled design in which survivors will be assigned with equal allocation to receive REACH or wait-list control. Our primary aim will be to determine between-arm differences with regard to meeting current exercise recommendations (≥ 150 weekly minutes of ≥ moderate intensity physical activity) measured by accelerometer. Our secondary aims will include REACH's effects on self-reported physical activity and on anthropometrics (e.g., waist circumference), lean body mass, physical function, quality of life, and biomarkers (i.e., telomerase [marker of successful aging], IFNγ [immune status], and high sensitivity CRP, IL-6, and IL-10 [systemic inflammation]). Intervention cost- effectiveness will also be assessed. This proposal is critical to improving the D&I potential and public health impact of the core intervention components identified in an efficacious exercise behavior change program for cancer survivors. Increasing access to efficacious exercise behavior change interventions is critical to addressing the significant mortality, comorbidity, and psychosocial burden experienced by millions of cancer survivors each year.

为癌症幸存者提供远程身体活动行为改变支持癌症是美国第二大死亡原因，每年导致超过 50 万人死亡。此外，癌症幸存者更有可能罹患第二种癌症、合并症和弱势癌症幸存者（例如老年人、农村居民、服务不足）的生活质量下降。癌症诊断后的痛苦负担与更高的死亡率和更差的健康状况有关锻炼是幸存者护理的一个重要方面，可以减轻这种痛苦的负担。然而，大多数癌症幸存者不进行定期锻炼，并且行为发生改变旨在增加运动行为的干预措施往往达不到建议的运动量每周 ≥ 150 分钟的中度至剧烈强度运动此外，此类干预措施是有效的。该提案很少经过成本效益测试或转化为更广泛的用途，以解决这一研究空白。通过采用 BEAT Cancer 干预措施，事实证明可有效显着提高癌症患病率满足癌症幸存者的锻炼建议，基于网络的交付将增加其传播和实施 (D&I) 潜力核心干预组成部分（即负责的要素）在功效测试期间确定的干预功效）也将进行调整，以提高人们的可接受性不同的癌症幸存者（例如，老年人、农村居民、非裔美国人）。名为“坚持锻炼以改善癌症幸存者的健康”(REACH) 6 个月。 REACH 干预措施随后将在 326 名各种癌症的幸存者中进行测试，其中显着比例将是老年人、农村人口和少数族裔。研究人员将采用 2 组随机对照设计。我们的主要目标是为哪些幸存者分配平等的分配以接受 REACH 或等候名单控制。将确定在满足当前运动建议方面的臂间差异（≥ 150 每周 ≥ 中等强度体力活动的分钟数）由加速度计测量我们的次要目标将是。包括 REACH 对自我报告的身体活动和人体测量（例如腰围）的影响，去脂体重、身体机能、生活质量和生物标志物（即端粒酶[成功衰老的标志物]， IFNγ [免疫状态]，以及高敏感性 CRP、IL-6 和 IL-10 [全身炎症]）。还将评估该提案的有效性对于提高 D&I 潜力和公共卫生至关重要。有效运动行为改变计划中确定的核心干预组成部分的影响癌症幸存者获得有效的运动行为改变干预措施至关重要。解决数百万癌症患者所经历的重大死亡率、合并症和社会心理负担每年都有幸存者。