Peer Coaching for Physical Activity Promotion among Breast Cancer Survivors: Adapting an Efficacious Intervention to Prepare for Implementation

同伴辅导促进乳腺癌幸存者的身体活动：采用有效的干预措施为实施做好准备

• 批准号: 10558670
• 负责人: Bernardine M. Pinto
• 金额: $ 33.42万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10558670
• 关键词: 3-Dimensional; Accelerometer; Adoption; American; American Cancer Society; Award; Breast Cancer survivor; Businesses; Cancer Survivor; Chronic Disease; Clinical; Collaborations; Colorectal Cancer; Cost Effectiveness Analysis; Counseling; Country; Data; Data Collection; Diabetes Mellitus; Disease Management; Educational Intervention; Endometrial Carcinoma; Enhancement Technology; Ensure; Evaluation Studies; Evidence based intervention; Exercise; Fatigue; Feedback; Foundations; Future; Goals; HIV; Health Insurance Portability and Accountability Act; Home; Intervention; Interview; Learning; Letters; Malignant Neoplasms; Manuals; Measures; Methods; Mission; Modeling; Moods; Online Systems; Outcome; Patient Self-Report; Patients; Persons; Phase; Physical Function; Physical activity; Positioning Attribute; Practical Robust Implementation and Sustainability Model; Process; Quality of life; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Recovery; Research; Resources; Risk Reduction; Site; Small Business Innovation Research Grant; Speed; Sports Medicine; Structure; Suggestion; Supervision; Survivors; System; Telephone; Testing; Time; Training; Training Programs; Work; acceptability and feasibility; cancer care; college; contextual factors; cost; dietary; efficacious intervention; evidence base; exercise intervention; experience; fitness; implementation facilitators; implementation trial; improved; indexing; interest; intervention delivery; malignant breast neoplasm; medication compliance; moderate-to-vigorous physical activity; new technology; peer coaching; peer support; personalized approach; post intervention; pragmatic implementation; pragmatic trial; primary outcome; programs; psychosocial; public health relevance; randomized controlled design; randomized, controlled study; recruit; scale up; success; theories; user centered design; web platform

Interventions promoting physical activity among cancer survivors improve their functioning, reduce fatigue and offer other benefits in cancer recovery and risk reduction for future cancer. There is a need for interventions that can be implemented on a wider-scale than in research settings. Our 12-week theory-based exercise intervention that was delivered by research staff by telephone was efficacious in improving fitness, and increasing moderate-to-vigorous physical activity (MVPA) among breast, colorectal and endometrial cancer survivors. To widen the intervention’s reach, we trained peer coaches in the American Cancer Society’s Reach to Recovery program to deliver the same MVPA intervention called Moving Forward Together (MFT) to other breast cancer survivors. In a randomized controlled trial, MFT significantly increased MVPA and provided psychosocial benefits for these survivors (Pinto, Stein & Dunsiger, 2015). Now, our goal is to prepare for wider implementation of MFT by automating key resource-intensive components such as matching survivors with a coach by using a web-based peer mentoring platform and to collect key indices to prepare for large scale implementation. InquistHealth’s web platform (Mentor1to1™) has demonstrated to be effective in peer mentoring for chronic disease management (e.g., diabetes). We will partner with InquisitHealth to adapt their web platform for MFT. The aim is to streamline intervention delivery, assure fidelity and improve survivor outcomes. There will be two phases in this 4-year R01 application: in Phase 1, we will work with 6 peer coaches who have already delivered MFT (our original evidence-based MVPA intervention) in prior work. Using iterative user-centered design principles, we will modify the web platform for MFT, creating webMFT. In Phase 2, we will conduct a randomized controlled trial in which 10-12 peer coaches will deliver webMFT to 56 breast cancer survivors who will be randomized to receive either webMFT or MVPA Tracking. We will recruit and train coaches naïve to MFT from three cancer care organizations with peer mentoring programs. We will collect feasibility and acceptability data about webMFT from the coaches. We will examine survivor outcomes (objectively measured MVPA and self-reported fatigue, quality of life, physical functioning and mood) by using mixed effects regression models to compare groups at 12 weeks. We will obtain survivors’ feedback on their experience with webMFT. Based on the RE-AIM framework and PRISM, we will collect data on implementation indices at the organizational level by conducting key multi-level stakeholder interviews. Using newer technologies for enhanced intervention delivery, program management and automated data collection has the exciting promise of facilitating effective implementation by organizations with limited resources. Adapting evidence-based MFT to a customized web platform and collecting data at multiple-levels (coaches, survivors and organizations) along with costs will provide a strong foundation for a robust multi-site implementation trial to increase MVPA (and its benefits) among many more breast cancer survivors.

促进癌症幸存者身体活动的干预措施可改善他们的功能、减少疲劳和 为癌症康复和降低未来癌症风险提供其他益处，因此需要采取干预措施。 我们为期 12 周的基于理论的练习可以在更广泛的范围内实施。 研究人员通过电话进行的干预对于改善健康状况有效，并且 增加乳腺癌、结直肠癌和子宫内膜癌患者的中度至剧烈体力活动 (MVPA) 为了扩大干预的范围，我们在美国癌症协会的范围内培训了同伴教练。 恢复计划，向其他人提供相同的 MVPA 干预措施，称为“共同前进”(MFT) 在一项随机对照试验中，MFT 显着增加了乳腺癌幸存者的 MVPA。 为这些幸存者带来心理社会益处（Pinto、Stein 和 Dunsiger，2015 年），现在，我们的目标是为更广泛的情况做好准备。 通过自动化关键的资源密集型组件（例如将幸存者与 教练通过使用基于网络的同伴指导平台收集关键指标，为大规模培训做好准备 InquistHealth 的网络平台 (Mentor1to1™) 已被证明在同行中有效。 我们将与 InquisitHealth 合作调整他们的慢性病管理指导。 MFT 的网络平台的目的是简化干预实施、确保保真度并改善幸存者。 这个为期 4 年的 R01 申请将分为两个阶段：在第 1 阶段，我们将与 6 个同行合作。 已经在之前的工作中提供过 MFT（我们最初的基于证据的 MVPA 干预）的教练。 使用以用户为中心的迭代设计原则，我们将修改 MFT 的 Web 平台，创建 webMFT In。 第 2 阶段，我们将进行一项随机对照试验，其中 10-12 名同伴教练将向 56 名参与者提供 webMFT 我们将招募将随机接受 webMFT 或 MVPA 跟踪的乳腺癌幸存者。 我们将通过同伴指导计划培训来自三个癌症护理组织的 MFT 新手教练。 从教练那里收集有关 webMFT 的可行性和可接受性数据 我们将检查幸存者的结果。 （客观测量 MVPA 和自我报告的疲劳、生活质量、身体机能和情绪）通过使用 混合效应回归模型在 12 周时比较各组，我们将获得幸存者对其的反馈。 基于 RE-AIM 框架和 PRISM，我们将收集有关 webMFT 的数据。 通过进行关键的多层次利益相关者访谈，在组织层面制定实施指标。 使用更新的技术来增强干预实施、项目管理和自动化数据 集合具有令人兴奋的承诺，可以促进资源有限的组织有效实施 将基于证据的 MFT 应用于定制的网络平台并收集多个级别的数据。 （教练、幸存者和组织）以及成本将为强大的多站点提供坚实的基础 实施试验，以增加更多乳腺癌幸存者的 MVPA（及其益处）。