Feasibility trial of STRONG: A digital intervention to improve nutritional management for individuals with esophageal and gastroesophageal junction cancer.

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Contemporary Clinical Trials Communications Pub Date : 2024-12-23 eCollection Date: 2025-02-01 DOI:10.1016/j.conctc.2024.101421
Yu Chen Lin, Jose M Pimiento, Jeanine Milano, Diane Riccardi, Nakesha Mckinnie, Emma Hume, Olivia Sprow, Sophia Diaz-Carraway, Mara Budnetz, Ryan Hagen, Mohammed Al-Jumayli, Allan Lima Pereira, Andrew J Sinnamon, Ashwin Somasundaram, Jennifer B Permuth, Amir Alishahi Tabriz, Kea Turner
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Abstract

Introduction: Individuals with esophageal and gastroesophageal junction (GEJ) cancers are at especially high risk of malnutrition. However, most patients with malnutrition do not receive adequate nutritional support. We conducted a single-arm trial to test the implementation of Support Through Remote Observation and Nutrition Guidance (STRONG), a multilevel digital intervention to improve nutritional outcomes for patients with locally advanced esophageal and gastroesophageal junction cancer.

Methods: Participants received five nutritional counseling sessions with a dietitian, logged daily food intake through the Fitbit app, and completed five study assessments related to patient malnutrition, nutrition-related symptoms, and quality-of-life outcomes. We assessed the feasibility, acceptability, and usability of STRONG against a priori benchmarks.

Results: Participants (N = 17) had a median age of 68 years, and 71 % were male. Feasibility benchmarks were met for participants completing the baseline assessment (94 %), completing four out of five assessments (82 %), and participant retention (85 %). Among participants who only received an oral diet during the study period, adherence to dietetic appointments (89 %) and food intake tracking (78 %) were high. Participant recruitment rate (47 %) was slightly below the benchmark (50 %). All participants found the intervention to be acceptable. Usability of the intervention was high, with 69 % and 92 % of participants reporting high satisfaction with tracking food intake through the Fitbit and the dietitian-led nutrition counseling sessions, respectively.

Conclusion: Our study demonstrated that STRONG could be implemented with high feasibility, acceptability, and usability for esophageal and GEJ cancer patients. Findings from this study can guide a future efficacy study to assess the impact of STRONG on patient outcomes.

Clinical trial registration: The Support Through Remote Observation and Nutrition Guidance Program for Gastroesophageal Cancer Patients (STRONG-GEC) study was registered on clinicaltrials.gov (NCT05438940) in June 2022 prior to participant enrollment.

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STRONG的可行性试验:数字干预改善食管癌和胃食管癌患者的营养管理。
食管癌和胃食管癌(GEJ)患者营养不良的风险特别高。然而,大多数营养不良患者没有得到足够的营养支持。我们进行了一项单臂试验,以测试远程观察和营养指导支持(STRONG)的实施情况,这是一种多级数字干预,可改善局部晚期食管癌和胃食管结癌患者的营养结局。方法:参与者接受营养师的五次营养咨询,通过Fitbit应用程序记录每日食物摄入量,并完成与患者营养不良、营养相关症状和生活质量结果相关的五项研究评估。我们根据先验基准评估了STRONG的可行性、可接受性和可用性。结果:参与者(N = 17)的中位年龄为68岁,71%为男性。参与者完成基线评估(94%)、完成五项评估中的四项(82%)和参与者保留率(85%)的可行性基准得到满足。在研究期间只接受口服饮食的参与者中,遵守饮食预约(89%)和食物摄入跟踪(78%)的比例很高。参与者招募率(47%)略低于基准(50%)。所有参与者都认为干预是可以接受的。干预的可用性很高,69%和92%的参与者分别对通过Fitbit和营养师主导的营养咨询会议跟踪食物摄入量表示高度满意。结论:我们的研究表明STRONG在食管癌和胃食管癌患者中具有较高的可行性、可接受性和可用性。本研究的结果可以指导未来的疗效研究,以评估STRONG对患者预后的影响。临床试验注册:通过远程观察和营养指导计划支持胃食管癌患者(STRONG-GEC)研究于参与者入组前的2022年6月在clinicaltrials.gov (NCT05438940)上注册。
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来源期刊
Contemporary Clinical Trials Communications
Contemporary Clinical Trials Communications Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
2.70
自引率
6.70%
发文量
146
审稿时长
20 weeks
期刊介绍: Contemporary Clinical Trials Communications is an international peer reviewed open access journal that publishes articles pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from a wide range of disciplines including medicine, life science, pharmaceutical science, biostatistics, epidemiology, computer science, management science, behavioral science, and bioethics. Contemporary Clinical Trials Communications is unique in that it is outside the confines of disease specifications, and it strives to increase the transparency of medical research and reduce publication bias by publishing scientifically valid original research findings irrespective of their perceived importance, significance or impact. Both randomized and non-randomized trials are within the scope of the Journal. Some common topics include trial design rationale and methods, operational methodologies and challenges, and positive and negative trial results. In addition to original research, the Journal also welcomes other types of communications including, but are not limited to, methodology reviews, perspectives and discussions. Through timely dissemination of advances in clinical trials, the goal of Contemporary Clinical Trials Communications is to serve as a platform to enhance the communication and collaboration within the global clinical trials community that ultimately advances this field of research for the benefit of patients.
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