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Chronic disease self-management is the ability of the individual, in conjunction with family, community and healthcare professionals to manage symptoms, treatments, lifestyle changes and psychosocial, cultural and spiritual consequences associated with a chronic condition. Self-management strategies have been successfully used in supportive care and survivorship in oncology. Stepping On, a multi-component program using a small-group learning environment, reduces falls by 31%. It empowers participants with knowledge about fall-risk, exercise, medications and environmental hazards to self-manage their risk of falls over 7 weeks of educational sessions, followed by a home visit. The research in this proposal will yield the adaptation of the effective group-education-based fall-prevention intervention Stepping On, tailored to cancer patients, feasible for testing in a multi-institutional trial, and ultimately scalable in the oncology setting.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1: STEPPING ON | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stepping On Education Program | Other |
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| Home visit |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of participants who completed the 7 education sessions | -The Pilot Waves will only be looked at for this outcome measure | Completion of all participants in the Pilot Wave groups (approximately 85 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of participants consented among approached potential participants | -The Pilot Waves will only be looked at for this outcome measure | Completion of accrual (approximately 18 months) |
| Fall rate during participation |
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Inclusion Criteria for Patient Participants:
Exclusion Criteria for Patient Participants:
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| Name | Affiliation | Role |
|---|---|---|
| Katherine Clifton, M.D. | Washington University School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Washington University School of Medicine | St Louis | Missouri | 63110 | United States |
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| Label | URL |
|---|---|
| Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine | View source |
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| Patient Questionnaire | Other | -Includes questions about demographics, activity level, performance status, falls, medication, comorbidities, hearing, vision, pain, and neuropathy |
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| Mini-Balance Evaluation Systems Test | Other |
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| GAITRite | Other |
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| Precise measure of movement testing | Other | We will conduct additional movement-based testing with participants wearing small, portable sensors (APDM, Inc., Portland, OR). These sensors allow for precise measurement of movement characteristics. The sensors will be worn on the outside of clothing and will be placed on the following body locations: 1) sternum, 2) low back, 3) right wrist, 4) left wrist, 5) right ankle, and 6) left ankle. The participants will wear these sensors during the following movement tasks: 1) Two Minute Walk Test, 2) Timed Up & Go, 3) Dual Timed Up & Go, 4) Stand and Walk (SAW), and 5) 360 Degree Turn test. These sensors will allow for capture of precise measures postural sway, arm swing, gait variability, and many other variables the proposed movement tasks. |
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-The Pilot Waves will only be looked at for this outcome measure
| Completion of participation (approximately 20 weeks) |
| Changes in score in the Falls-Efficacy Scale - International as measured by fear-of-falling | -The Pilot Waves will only be looked at for this outcome measure | Completion of participation (approximately 20 weeks) |
| Behavior change intention in preventing falls |
| Completion of participation (approximately 20 weeks) |
| Change in Pain Patient Reported Outcome (PRO) | -5 questions to ask participant about their pain levels and how the pain interfered with their daily lives, answers range from not at all to very much | Completion of participation (approximately 20 weeks) |
| Measure changes in balance waves | -The Gait & Balance Waves will only be looked at for this outcome measure | Baseline and 1 month after completion of participation (approximately 20 weeks) |
| Measure changes in gait waves | -The Gait & Balance Waves will only be looked at for this outcome measure | Baseline and 1 month after completion of participation (approximately 20 weeks) |
| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D006792 | House Calls |
| D000073222 | Patient Health Questionnaire |
| ID | Term |
|---|---|
| D011364 | Professional Practice |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
| D011795 | Surveys and Questionnaires |
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D011581 | Psychological Tests |
| D004191 | Behavioral Disciplines and Activities |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
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