电子健康干预可以帮助癌症幸存者在诊所外自我管理他们的健康。对于如何最好地吸引和帮助不同年龄和癌症治疗范围的幸存者，我们知之甚少。

美国癌症协会进行了一项随机对照试验，评估了针对癌症幸存者的电子健康自我管理计划“超越癌症跳板”的疗效和参与度。意向性治疗分析评估了干预参与治疗的总体效果(治疗中与完成治疗的对比)( n = 17688个对照组，88个干预组)，并分别按年龄(< 60岁对大于60岁)分类。使用多重插补来解释失访(n = 41)或在3个月随访时缺失自我效能数据(n = 1)的参与者。

控制癌症的自我效能(该试验的主要结果)在干预组和完成治疗的患者中显著增加(Cohen的d = 0.26，0.31)。此外，与对照组(n = 68)相比，中度到高度参与文本和/或网络干预的参与者(n = 30)在管理癌症相关问题方面具有显著更高的自我效能，具有中等效果大小(Cohen的d = 0.44)。在基线后3个月，干预组和对照组的自我效能没有差异。研究结果表明，癌症幸存者从电子健康工具中受益不一。为了最大限度地发挥这些工具的作用，必须针对事先确定的幸存者亚群体定制信息，并加大参与力度。

Abstract

Background: eHealth interventions can help cancer survivors self-manage their health outside the clinic. Little is known about how best to engage and assist survivors across the age and cancer treatment spectra.

Methods: The American Cancer Society conducted a randomized controlled trial that assessed efficacy of, and engagement with, Springboard Beyond Cancer, an eHealth self-management program for cancer survivors. Intent-to treat analyses assessed effects of intervention engagement for treatment (on-treatment vs completed) overall (n = 176; 88 control, 88 intervention arm) and separately by age (<60 years vs older). Multiple imputation was used to account for participants who were lost to follow-up (n = 41) or missing self-efficacy data (n = 1) at 3 months follow-up.

Results: Self-efficacy for managing cancer, the primary outcome of this trial, increased significantly within the intervention arm and for those who had completed treatment (Cohen's d = 0.26, 0.31, respectively). Additionally, participants with moderate-to-high engagement in the text and/or web intervention (n = 30) had a significantly greater self-efficacy for managing cancer-related issues compared to the control group (n = 68), with a medium effect size (Cohen's d = 0.44). Self-efficacy did not differ between the intervention and control arm at 3 months post-baseline.

Conclusions: Study results suggest that cancer survivors benefit variably from eHealth tools. To maximize effects of such tools, it is imperative to tailor information to a priori identified survivor subgroups and increase engagement efforts.

原文链接

pubmed.ncbi.nlm.nih.gov/34668569/

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