Self-Advocacy Serious Game in Advanced Cancer
| Status: | Recruiting |
|---|---|
| Conditions: | Ovarian Cancer, Cervical Cancer, Cervical Cancer, Women's Studies, Women's Studies |
| Therapuetic Areas: | Oncology, Reproductive |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/6/2019 |
| Start Date: | March 9, 2018 |
| End Date: | December 31, 2023 |
Piloting a Serious Game to Improve Self-Advocacy Among Women With Advanced Cancer
Self-advocacy, defined as the ability of a patient to get her needs and priorities met in the
face of a challenge, is an essential skill but not all women with advanced cancer are able to
do it. We want to instruct women with advanced cancer who have low self-advocacy to
self-advocate for their health and well-being. We will test a new "serious game" or video
program that teaches self-advocacy skills through interactive, situation-based activities.
The goal of the Strong Together serious game is to engage participants in challenges commonly
experienced by women with advanced cancer, offer them choices to self-advocate or not, and
directly show them the health and social benefits of self-advocating and the negative
consequences of not self-advocating. Through engaging in the Strong Together program,
participants vicariously learn the essential skills of self-advocacy, understand the
downstream effects of using or not using these skills, and learn distinct behaviors that they
can then use to address their own challenges.
face of a challenge, is an essential skill but not all women with advanced cancer are able to
do it. We want to instruct women with advanced cancer who have low self-advocacy to
self-advocate for their health and well-being. We will test a new "serious game" or video
program that teaches self-advocacy skills through interactive, situation-based activities.
The goal of the Strong Together serious game is to engage participants in challenges commonly
experienced by women with advanced cancer, offer them choices to self-advocate or not, and
directly show them the health and social benefits of self-advocating and the negative
consequences of not self-advocating. Through engaging in the Strong Together program,
participants vicariously learn the essential skills of self-advocacy, understand the
downstream effects of using or not using these skills, and learn distinct behaviors that they
can then use to address their own challenges.
Background: When faced with the challenges of advanced cancer, women must advocate (or stand
up) for their needs and priorities. However, there are no interventions to promote
self-advocacy among female patients with advanced cancer. Preliminary work has developed a
theoretically-based, psychometrically-strong measure of self-advocacy (the Female
Self-Advocacy in Cancer Survivorship (FSACS) Scale) and demonstrated correlations with
symptom burden and healthcare utilization. Serious games offer a novel mechanism by which to
deliver interactive, engaging health education that links users' choices to consequences so
that users learn a desired skill. The fully-automated Strong Together self-advocacy serious
game may allow women with advanced cancer to learn self-advocacy skills and therefore improve
their health outcomes.
Objective/Hypothesis: The purpose of this pilot randomized controlled trial (RCT) is to
evaluate the feasibility, acceptably, and preliminary efficacy of the Strong Together serious
game.
Specific Aims:
Specific Aim 1: To evaluate the feasibility and acceptability of the 3-month Strong Together
intervention.
- Benchmark 1: At least 75% of participants will engage in at least 8 out of the 12
serious game sessions.
- Benchmark 2: At least 80% of participants will find the intervention acceptable based on
ratings of perceived satisfaction and ease of use, as well as feedback from qualitative
exit interviews.
Specific Aim 2: To explore the differences in self-advocacy and symptom burden between groups
over time.
• Research Question: Do patients who receive the intervention report improved self-advocacy
and lower symptom burden compared to those assigned to enhanced care as usual?
Study Design: This pilot RCT will recruit (N=84) women from cancer clinics at the University
of Pittsburgh Medical Center. Eligibility criteria include: female; age ≥ 18 years; diagnosis
of Stage III or IV gynecological or Stage IV breast cancer within the past 3 months; 6-month
prognosis; Eastern Cooperative Oncology Group score of 0-1; and ability to read and write in
English. Measures will be collected at baseline, 3 months, and 6 months. Randomization (2:1)
will occur to the 3-month Strong Together intervention group or the enhanced care as usual
group. Feasibility will be assessed by calculating percentages of the intervention's dosage,
engagement, recruitment, retention, and data completion. Acceptability will be assessed
through exit interviews and an acceptability scale. Preliminary efficacy will be measured by
exploring differences in self-advocacy and symptom burden scores and calculating point and
interval estimates between the groups at 3 and 6 months.
Cancer Relevance: This study represents a unique opportunity to address the lack of
self-advocacy interventions, reduce the risks of women with low self-advocacy, and guide an
adequately-powered RCT to educate women with advanced cancer to self-advocate.
up) for their needs and priorities. However, there are no interventions to promote
self-advocacy among female patients with advanced cancer. Preliminary work has developed a
theoretically-based, psychometrically-strong measure of self-advocacy (the Female
Self-Advocacy in Cancer Survivorship (FSACS) Scale) and demonstrated correlations with
symptom burden and healthcare utilization. Serious games offer a novel mechanism by which to
deliver interactive, engaging health education that links users' choices to consequences so
that users learn a desired skill. The fully-automated Strong Together self-advocacy serious
game may allow women with advanced cancer to learn self-advocacy skills and therefore improve
their health outcomes.
Objective/Hypothesis: The purpose of this pilot randomized controlled trial (RCT) is to
evaluate the feasibility, acceptably, and preliminary efficacy of the Strong Together serious
game.
Specific Aims:
Specific Aim 1: To evaluate the feasibility and acceptability of the 3-month Strong Together
intervention.
- Benchmark 1: At least 75% of participants will engage in at least 8 out of the 12
serious game sessions.
- Benchmark 2: At least 80% of participants will find the intervention acceptable based on
ratings of perceived satisfaction and ease of use, as well as feedback from qualitative
exit interviews.
Specific Aim 2: To explore the differences in self-advocacy and symptom burden between groups
over time.
• Research Question: Do patients who receive the intervention report improved self-advocacy
and lower symptom burden compared to those assigned to enhanced care as usual?
Study Design: This pilot RCT will recruit (N=84) women from cancer clinics at the University
of Pittsburgh Medical Center. Eligibility criteria include: female; age ≥ 18 years; diagnosis
of Stage III or IV gynecological or Stage IV breast cancer within the past 3 months; 6-month
prognosis; Eastern Cooperative Oncology Group score of 0-1; and ability to read and write in
English. Measures will be collected at baseline, 3 months, and 6 months. Randomization (2:1)
will occur to the 3-month Strong Together intervention group or the enhanced care as usual
group. Feasibility will be assessed by calculating percentages of the intervention's dosage,
engagement, recruitment, retention, and data completion. Acceptability will be assessed
through exit interviews and an acceptability scale. Preliminary efficacy will be measured by
exploring differences in self-advocacy and symptom burden scores and calculating point and
interval estimates between the groups at 3 and 6 months.
Cancer Relevance: This study represents a unique opportunity to address the lack of
self-advocacy interventions, reduce the risks of women with low self-advocacy, and guide an
adequately-powered RCT to educate women with advanced cancer to self-advocate.
Inclusion Criteria:
- Female
-≥18 years
- Diagnosed with Stage III or IV gynecological or Stage IV breast cancer within the past
3 months being treated with non-curative intent
- Have at least a 6-month life expectancy (as determined by their oncologist)
- Eastern Cooperative Oncology Group performance score of 0 to 2 (per health record or
oncologist)
- Able to read and write in English
Exclusion Criteria:
- On hospice at the time of recruitment
- Impaired cognition (per health record)
- Other active, unstable mental health disorder
We found this trial at
1
site
200 Lothrop St
Pittsburgh, Pennsylvania 15213
Pittsburgh, Pennsylvania 15213
Principal Investigator: Teresa H Thomas, PhD, RN
Phone: 412-624-3799
University of Pittsburgh Medical Center UPMC is one of the leading nonprofit health systems in...
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