Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health

适应多种行为有效改善 (AMPLIFI) 癌症幸存者健康的干预措施

基本信息

批准号：
10247730
负责人：
Wendy Demark-Wahnefried
金额：
$ 141.41万
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/10247730
关键词：
Address Aftercare Aging Alabama Appalachian Region Area Behavior Behavior Therapy Behavioral Breast Cancer survivor Cancer Burden Cancer Center Cancer Prognosis Cancer Survivor Cancer Survivorship Cardiovascular Diseases Caring Centers for Disease Control and Prevention (U.S.)Collaborations Cost Analysis Country Data Diabetes Mellitus Diagnosis Diet Dietary Intervention Dissemination and Implementation Early Diagnosis Early treatment Eating Economics Future General Population Goals Guidelines Health Health Sciences Health behavior Health behavior change Home Individual Intervention Learning Life Life Style Life Style Modification Malignant Neoplasms Mediating Mississippi Modeling Obesity Osteoporosis Outcome Physical activity Population Prevalence Price Process Public Health Randomized Controlled Trials Regional Cancer Research Research Project Grants Resource Sharing Risk Rural Minority Sampling Science Scientist Screening for cancer Second Primary Cancers Second Primary Neoplasms Survival Rate Survivors Technology Tennessee Testing Time Transportation Travel Unhealthy Diet Universities Visiting Nurse Waiting Lists Weight Work arm behavior change cancer care cancer diagnosis cancer risk cancer therapy cancer type comorbidity comparative efficacy cost dissemination research effective intervention efficacious intervention efficacy testing exercise adherence exercise intervention functional decline good diet health disparity high risk implementation research improved neoplasm registry physical inactivity population based programs recruit treatment arm trend unhealthy lifestyle

项目摘要

Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health By 2020, the number of cancer survivors in the US will exceed 20 million due to trends toward aging, and improved cancer screening and treatment. Cancer survivorship is a victory, but it comes at a price. Once an individual is diagnosed with cancer, they are at much higher risk for second malignancies, cardiovascular disease, diabetes, osteoporosis, and functional decline (resulting in a loss of independence). Currently, the costs for these downstream effects are estimated to be at least $135 billion annually. Unhealthy lifestyle behaviors (e.g., a poor diet resulting in obesity and physical inactivity) associate with poorer outcomes after a cancer diagnosis. These behaviors also tend to cluster, i.e., people who practice one unhealthy behavior tend to practice another. It is hypothesized that cancer survivors may be able to improve their overall health and reduce comorbidity through lifestyle modification, particularly since estimates indicate that only 15-47% of cancer survivors adhere to national guidelines for weight status, diet and physical activity. While effective interventions in each of these domains exists, there has been little effort to disseminate these interventions broad scale and to survivors most in need (older, rural, minorities). Moreover, there is a relative dearth of research in determining optimal means of combining interventions, which is critical since many survivors practice more than one, or multiple suboptimal behaviors. The overarching aims AMPLIFI are to learn how to: 1) improve health behaviors in cancer survivors who practice multiple suboptimal health behaviors; and 2) adapt efficacious interventions to optimize their reach by the use of technology among cancer survivors, while also collecting data to inform the future dissemination and implementation (D&I) potential of these interventions. AMPLIFI involves 3 highly interrelated research projects supported by 4 highly integrated cores. It will enlist the efforts of 852 survivors of a broad array of cancers that have favorable 5-year cancer-free survival rates (oversampling those who are older, rural and minority) and gather the input of 48 key stakeholders to accomplish the following Specific Aims: 1) Understand how to adapt efficacious interventions for widespread dissemination through the use of technology, while maintaining the integrity of key components which drive behavior change; 2) Optimize acceptability and use of interventions (largely developed and tested in homogeneous samples of breast cancer survivors) to older, rural, minority survivors of many cancer types; 3) Test the efficacy of the adapted interventions delivered alone, in sequence, or combined; 4) Contribute to the science of D&I research by developing a new adaptation model; and 5) Determine factors that improve the D&I potential of distance-delivered health behavior change interventions by determining how they mediate behavior change and in whom they work best. Our ultimate goal is to improve the health of the highly vulnerable and ever increasing population of cancer survivors.

适应多种行为有效改善 (AMPLIFI) 癌症幸存者健康的干预措施到2020年，由于老龄化趋势，美国癌症幸存者人数将超过2000万，并改善癌症筛查和治疗。癌症幸存者是一种胜利，但这是有代价的。一次一个人被诊断患有癌症，他们患第二种恶性肿瘤、心血管疾病的风险要高得多疾病、糖尿病、骨质疏松症和功能衰退（导致丧失独立性）。目前，这些下游影响的成本估计每年至少为 1,350 亿美元。不健康的生活方式行为（例如，不良饮食导致肥胖和缺乏身体活动）与癌症诊断后结果较差。这些行为也倾向于聚集，即实践一种行为的人不健康的行为往往会导致另一种行为。据推测，癌症幸存者可能能够改善他们的整体健康状况并通过改变生活方式减少合并症，特别是因为估计表明只有 15-47% 的癌症幸存者遵守国家体重状况、饮食和身体活动指南。虽然在每个领域都存在有效的干预措施，但很少有人努力传播这些措施干预措施规模广泛，针对最需要的幸存者（老年人、农村人口、少数民族）。而且，还有一个亲戚缺乏确定结合干预措施的最佳方法的研究，这一点至关重要，因为许多干预措施幸存者会表现出不止一种或多种次优行为。 AMPLIFI 的总体目标是学习如何：1) 改善癌症幸存者的健康行为实行多种次优健康行为； 2) 采取有效的干预措施以优化其影响范围在癌症幸存者中使用技术，同时还收集数据为未来的传播和传播提供信息这些干预措施的实施（D&I）潜力。 AMPLIFI 涉及 3 个高度相关的研究项目由4个高度集成的核心支持。它将征集 852 名多种癌症幸存者的努力，具有良好的 5 年无癌生存率（对老年人、农村和少数族裔进行过抽样）并且收集 48 个关键利益相关者的意见，以实现以下具体目标：1) 了解如何适应通过使用技术进行有效的干预措施以进行广泛传播，同时保持驱动行为改变的关键组件的完整性； 2) 优化干预措施的可接受性和使用（主要是在乳腺癌幸存者的同质样本中开发和测试）针对老年人、农村、少数民族许多癌症类型的幸存者； 3) 按顺序单独测试经过调整的干预措施的有效性，或组合； 4）通过开发新的适应模型为D&I研究科学做出贡献；和 5) 通过以下方式确定提高远程健康行为改变干预措施的 D&I 潜力的因素：确定他们如何调解行为改变以及他们最适合谁。我们的最终目标是提高高度脆弱且不断增加的癌症幸存者群体的健康。