在威斯康星州将体力活动干预措施融入乳腺癌和结直肠癌幸存者的临床护理中：一项随机对照试点试验。
Building a physical activity intervention into clinical care for breast and colorectal cancer survivors in Wisconsin: a randomized controlled pilot trial.
机构信息
Department of Kinesiology, University of Wisconsin - Madison, 2000 Observatory Drive, Madison, WI, 53706, USA.
Carbone Comprehensive Cancer Center, University of Wisconsin - Madison, Madison, WI, USA.
出版信息
J Cancer Surviv. 2019 Aug;13(4):593-602. doi: 10.1007/s11764-019-00778-6. Epub 2019 Jul 1.
BACKGROUND
Cancer survivorship care plans ("care plans") often recommend an active lifestyle yet are rarely accompanied by programs to help patients enact the prescribed behavior change. As a step towards bridging this gap, this trial tested the feasibility of augmenting care planning with a multi-level physical activity intervention.
METHODS
Breast and colorectal cancer survivors were enrolled alongside a self-selected support partner (e.g., spouse, friend). Survivors received a care plan alone (comparison group) versus one augmented with a 12-week physical activity module (intervention group). For the intervention group dyads, both members received a multi-component program including Fitbit trackers, with the survivor's Fitbit linked to his/her electronic health record (EHR). Treating clinicians received periodic updates regarding the survivors' physical activity. The primary outcome was ActiGraph-measured physical activity, analyzed using mixed models. Feedback questionnaires were administered to participants and clinicians at 12 weeks.
RESULTS
Survivors (n = 50) were 54.4 ± 11.2 years of age and 2.0 ± 1.5 years post-diagnosis. Survivors in the intervention group increased moderate-to-vigorous-intensity physical activity (MVPA) by 69 ± 84 min/week vs. a 20 ± 71 min/week decrease in the comparison group (p = .001). Likewise, daily steps increased by 1470 ± 1881 vs. a 398 ± 1751 decrease (P = .002). Among responding clinicians, 100% looked at survivors' activity data within the EHR at least once and 80% said it provided insight into their patients' lifestyles.
CONCLUSIONS
Augmenting a standard care plan with a multi-level, technology-based intervention increased physical activity among cancer survivors.
IMPLICATIONS FOR CANCER SURVIVORS
Technology-based approaches, including activity trackers, can be used by individuals to work towards an active lifestyle after cancer.
背景
癌症生存者护理计划（“护理计划”）通常建议患者保持积极的生活方式，但很少有计划帮助患者实施规定的行为改变。作为弥合这一差距的一步，本试验测试了通过多层次的身体活动干预来增强护理计划的可行性。
方法
招募乳腺癌和结直肠癌幸存者以及他们自行选择的支持伙伴（例如配偶、朋友）。幸存者单独接受护理计划（对照组）或接受 12 周的身体活动模块增强的护理计划（干预组）。对于干预组的二人组，双方都接受了一个包括 Fitbit 追踪器的多组件计划，幸存者的 Fitbit 与他们的电子健康记录（EHR）相连。治疗临床医生定期收到关于幸存者身体活动的更新。主要结果是通过 ActiGraph 测量的身体活动，使用混合模型进行分析。在 12 周时向参与者和临床医生发放反馈问卷。
结果
幸存者（n=50）年龄为 54.4±11.2 岁，诊断后 2.0±1.5 年。干预组的幸存者每周增加中等至剧烈强度的身体活动（MVPA）69±84 分钟，而对照组则减少 20±71 分钟（p=0.001）。同样，每天的步数增加了 1470±1881 步，而对照组减少了 398±1751 步（P=0.002）。在回应的临床医生中，100%的人至少在 EHR 中查看了一次幸存者的活动数据，80%的人表示这提供了对患者生活方式的了解。
结论
通过多层次、基于技术的干预措施来增强标准护理计划可以增加癌症幸存者的身体活动。
对癌症幸存者的意义
包括活动追踪器在内的基于技术的方法可以被个人用于在癌症后努力保持积极的生活方式。
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