College of Nursing, University of South Carolina, Columbia, SC, United States.
Pyx Health, Tucson, AZ, United States.
JMIR Res Protoc. 2024 Jun 19;13:e52494. doi: 10.2196/52494.
Interventions promoting physical activity (PA) among survivors of cancer 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 that is possible in research settings. We have previously demonstrated that a 3-month peer-delivered PA program (Moving Forward Together [MFT]) significantly increased the moderate to vigorous PA (MVPA) of survivors of breast cancer.
Our goal is to scale up the MFT program by adapting an existing peer mentoring web platform, Mentor1to1. InquistHealth's web platform (Mentor1to1) has demonstrated efficacy in peer mentoring for chronic disease management. We will partner with InquisitHealth to adapt their web platform for MFT. The adaptation will allow for automating key resource-intensive components such as matching survivors with a coach via the web-based peer mentoring platform and collecting key indexes to prepare for large-scale implementation. The aim is to streamline intervention delivery, assure fidelity, and improve survivor outcomes.
In phase 1 of this 2-phase study, we will interview 4 peer mentors or coaches with experience in delivering MFT and use their feedback to create Mentor1to1 web platform adapted for MFT (webMFT). Next, another 4 coaches will participate in rapid, iterative user-centered testing of webMFT. In phase 2, we will conduct a randomized controlled trial by recruiting and training 10 to 12 coaches from cancer organizations to deliver webMFT to 56 survivors of breast cancer, who will be assigned to receive either webMFT or MVPA tracking (control) for 3 months. We will assess effectiveness with survivors' accelerometer-measured MVPA and self-reported psychosocial well-being at baseline and 3 months. We will assess implementation outcomes, including acceptability, feasibility, and program costs from the perspective of survivors, coaches, and collaborating organizations, as guided by the expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.
As of September 2023, phase 1 of the study was completed, and 61 survivors were enrolled in phase 2. 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 multisite implementation trial to increase MVPA and its benefits among many more survivors of breast cancer.
The quantitative and qualitative data collected from survivors of cancer, coaches, and organizations will be analyzed to inform a future larger-scale trial of peer mentoring for PA delivered by cancer care organizations to survivors.
ClinicalTrials.gov NCT05409664; https://clinicaltrials.gov/study/NCT05409664.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52494.
促进癌症幸存者进行身体活动(PA)的干预措施可改善其功能,减轻疲劳,并在癌症康复和降低未来癌症风险方面提供其他益处。需要干预措施,可以在比研究环境中更大的规模上实施。我们之前已经证明,为期 3 个月的同伴提供的 PA 计划(携手共进[MFT])可显著增加乳腺癌幸存者的中等到剧烈 PA(MVPA)。
我们的目标是通过调整现有的同伴指导网络平台(Mentor1to1)来扩大 MFT 计划。InquistHealth 的网络平台(Mentor1to1)在慢性病管理的同伴指导方面已显示出疗效。我们将与 InquisitHealth 合作,调整他们的网络平台以适应 MFT。该调整将允许通过基于网络的同伴指导平台自动完成关键资源密集型组件,例如通过网络匹配幸存者与教练,并收集关键指标以为大规模实施做准备。目的是简化干预措施的交付,确保保真度,并改善幸存者的结果。
在这项 2 阶段研究的第 1 阶段,我们将采访 4 名具有 MFT 经验的同伴导师或教练,并利用他们的反馈意见来创建适用于 MFT 的 Mentor1to1 网络平台(webMFT)。接下来,另外 4 名教练将参与快速、迭代的以用户为中心的 webMFT 测试。在第 2 阶段,我们将通过招募和培训来自癌症组织的 10 至 12 名教练来进行随机对照试验,为 56 名乳腺癌幸存者提供 webMFT,他们将被分配接受 webMFT 或 MVPA 跟踪(对照组)3 个月。我们将使用幸存者的加速度计测量的 MVPA 和自我报告的心理健康在基线和 3 个月时评估有效性。我们将根据扩展的可达性、有效性、采用、实施、维护(RE-AIM)框架,从幸存者、教练和合作组织的角度评估实施结果,包括可接受性、可行性和计划成本。
截至 2023 年 9 月,研究的第 1 阶段已经完成,第 2 阶段有 61 名幸存者入组。使用更新的技术进行增强的干预交付、项目管理和自动数据收集,有望为资源有限的组织提供有效的实施支持。将基于证据的 MFT 改编为定制的网络平台,并在多个层面(教练、幸存者和组织)收集数据以及成本,将为在更多乳腺癌幸存者中增加 MVPA 及其益处的大规模多站点实施试验提供坚实的基础。
从癌症幸存者、教练和组织收集的定量和定性数据将进行分析,为未来由癌症护理组织为幸存者提供的 PA 同伴指导的更大规模试验提供信息。
ClinicalTrials.gov NCT05409664;https://clinicaltrials.gov/study/NCT05409664。
国际注册报告标识符(IRRID):DERR1-10.2196/52494。