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Steigerung der körperlichen Aktivität durch personalisierte Motivationsnachrichten zur Verbesserung der kognitiven Funktion bei Lungenkrebsüberlebenden

2. Juni 2026 aktualisiert von: The University of Hong Kong

Steigerung der körperlichen Aktivität durch personalisierte Motivationsnachrichten zur Verbesserung der kognitiven Funktion bei Lungenkrebsüberlebenden mit krebsbedingter kognitiver Beeinträchtigung: eine randomisierte kontrollierte Studie

Ziele: Untersuchung der Wirksamkeit einer personalisierten Motivations-Messaging-Intervention zur Verbesserung der kognitiven Funktion bei Lungenkrebsüberlebenden.

Zu prüfende Hypothese: Überlebende von Lungenkrebs, die personalisierte Motivationsnachrichten erhalten, haben eine bessere kognitive Funktion als die übliche Pflege.

Design und Probanden: Eine randomisierte kontrollierte Studie mit 196 Lungenkrebsüberlebenden mit krebsbedingter kognitiver Beeinträchtigung.

Intervention: Die Interventionsgruppe wird 3 Monate lang mit einem tragbaren Aktivitäts-Tracker ausgestattet und erhält personalisierte Motivationsnachrichten über Instant-Messaging-Anwendungen (z. B. WhatsApp), um körperliche Bewegung zu fördern. Die Intervention umfasst 1) regelmäßige Nachrichten, die zu bevorzugten Zeiten und Häufigkeiten gesendet werden und es den Teilnehmern ermöglichen, vorgeschlagene Ziele für körperliche Aktivität auszuwählen, und 2) Unterstützung über Chat-Nachrichten wie Zielsetzung, Echtzeitberatung und praktische Ratschläge. Die Kontrollgruppe erhält eine Broschüre zum Thema kognitive Beeinträchtigung mit Erinnerungstextnachrichten für Folgebefragungen.

Hauptergebnismaße: Die Daten werden zu Studienbeginn (T0), 3 Monate (T1; unmittelbar nach der Intervention) und 6 Monate (T2; Langzeit-Follow-up) erhoben. Das primäre Ergebnis wird die kognitive Funktion sein, die anhand der HK-MoCA-Skala (objektiv) und der FACT-Cog-Skala (Functional Assessment of Cancer Therapy-Cognitive Function) (subjektiv) gemessen wird. Sekundäre Ergebnisse sind körperliche Aktivität (IPAQ-SF), Selbstwirksamkeit beim Sport (SEE), psychisches Wohlbefinden (PHQ-4) und Lebensqualität (EORTC QLQ-C30).

Datenanalyse: Es werden Intention-to-Treat-Analysen, qualitative Post-Trial-Analysen (Einhaltung der Intervention) und Kostenwirksamkeitsanalysen durchgeführt. Wir werden die CONSORT-EHEALTH-Checkliste befolgen.

Erwartete Ergebnisse: Diese Studie wird Beweise für die Wirksamkeit der vorgeschlagenen Intervention zur Verbesserung der kognitiven Funktion und Steigerung der körperlichen Aktivität bei Lungenkrebsüberlebenden liefern.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

  1. Background of the Research Project Lung cancer is a leading cause of cancer-related mortality worldwide. In Hong Kong, it accounts for over 26% of all cancer deaths, with 80% to 85% being non-small cell lung cancers (NSCLC). While cancer-related symptoms affecting overall survival and quality of life have been extensively studied, cancer-related cognitive impairment (CRCI) remains a critical yet under-researched complication. CRCI refers to cognitive dysfunction, including impaired working or short-term memory, inattention, disorientation, and declines in executive function, language comprehension, and processing speed. More than 50% of patients with non-central nervous system (CNS) cancers present with CRCI after primary treatments. Our preliminary pilot data indicated that the prevalence of cognitive impairment in attention and memory among lung cancer patients was 35.4% and 58.4%, respectively. CRCI significantly impacts patients' functional independence and can lead to anxiety, depression, and sleep disorders, highlighting an urgent need for effective, accessible interventions.

  2. Theoretical and Clinical Background Clinically, several studies and systematic reviews have demonstrated that exercise and physical activity interventions can alleviate CRCI in cancer patients. However, traditional exercise programs often suffer from poor long-term adherence and a lack of sustained motivation once the formal intervention period ends. To address this translational gap, this study utilizes an Ecological Momentary Intervention (EMI) approach via mobile health (mHealth) technology. EMI delivers health interventions through instant messaging (IM) applications (e.g., WhatsApp) in a personalized, real-time, and in-situ format.

    Theoretically, the intervention is rigorously grounded in Social Cognitive Theory (SCT), which posits that personal and environmental factors influence health behaviors. The intervention design operationalizes key SCT constructs:

    Behavioral Capability: Providing tailored information to increase physical activity based on self-care needs.

    Outcome Expectations: Educating participants on how physical activity improves neurocognitive function.

    Observational Learning: Utilizing case vignettes of other survivors. Self-efficacy: Fostering belief in behavioral change through collaborative goal-setting and chat-based support.

    Reinforcement: Providing systematic feedback and positive validation on behavioral changes.

  3. Objectives The primary objective of this randomized controlled trial (RCT) is to evaluate the effectiveness of an SCT-based, personalized motivational messaging intervention delivered via an instant messaging application in improving cognitive function among lung cancer survivors with CRCI. The secondary objectives are to assess the intervention's impact on physical activity levels, exercise self-efficacy, psychological well-being, and health-related quality of life, as well as to evaluate the cost-effectiveness and participants' qualitative experiences of the intervention.

  4. Main Research Questions and Hypotheses Research Question: Does a personalized motivational messaging intervention, utilizing wearable activity trackers and real-time IM support, effectively mitigate cognitive decline and promote physical activity in lung cancer survivors compared to standard care?

    Hypotheses: We hypothesize that lung cancer survivors with CRCI receiving the personalized motivational messaging intervention will demonstrate (1) significantly greater improvements in objective and subjective cognitive function, and (2) significantly increased physical activity levels compared to those receiving standard care.

  5. Study Design and Methods This study is a randomized controlled trial (RCT) comprising 124 lung cancer survivors, augmented by a post-trial qualitative process evaluation.

    Randomization and Blinding: Participants will be randomly allocated to either the intervention or control arm. A computer-generated randomization sequence will be created by an independent statistician using block randomization with varying block sizes (blocks of 4, 6, and 8). Allocation concealment will be maintained using sequentially numbered, opaque, sealed envelopes. Outcome assessors and the trial statistician will be blinded to group allocation.

    Intervention Arm: Participants will be equipped with a wearable activity tracker for 3 months. They will receive personalized motivational messages from a comprehensive message library developed by an oncology specialist and a research nurse trained in motivational interviewing. The intervention features two components: (a) regular message delivery whose frequency and timing are tailored to participant preferences, and (b) interactive chat-type support facilitating goal setting, real-time counseling, and practical advice.

    Control Arm: Participants will receive an informational leaflet containing basic CRCI education and standard text message reminders for follow-up assessments, without the personalized motivational or interactive chat components.

    Data Collection & Analysis: Quantitative assessments will occur at baseline (T0), 3 months (T1), and 6 months (T2). An Intention-to-Treat (ITT) analysis will be performed. Generalized Estimating Equations (GEE) will be utilized to estimate between-group and within-group differences across time points, adjusting for baseline covariates. GEE robustly handles missing longitudinal data without manual imputation.

    Economic & Qualitative Evaluation: A cost-effectiveness analysis will calculate the Incremental Cost-Effectiveness Ratio (ICER) using Quality-Adjusted Life Years (QALYs) derived from EORTC QLQ-C30 scores. Additionally, a post-trial qualitative study using purposive maximum variation sampling will conduct in-depth interviews (analyzed via 7-step thematic analysis in NVivo) to understand intervention compliance and participant experience.

  6. Expected Outcomes The trial is expected to yield robust quantitative evidence that personalized EMI significantly improves cognitive domains (such as attention, verbal learning, and executive function) and sustains moderate-to-vigorous physical activity in lung cancer survivors. Furthermore, the trial is expected to demonstrate high feasibility, user acceptability, and cost-effectiveness compared to standard oncological supportive care.
  7. Significance of the Study This study addresses a critical gap in cancer survivorship by targeting CRCI-a prevalent but frequently overlooked symptom. If proven effective, this intervention provides an efficient, highly scalable, real-world, and cost-effective digital health solution. Furthermore, the chat-log data and user preference profiles generated from this study will establish a foundational database for the future development of Artificial Intelligence (AI) chatbot services for physical activity management, aligning with global smart-city healthcare blueprints and advancing the implementation science of mHealth in oncology.

Studientyp

Interventionell

Einschreibung (Tatsächlich)

124

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Hongkong
    • Hong Kong
      • Hong Kong, Hong Kong, Hongkong
        • School of Nursing, The University of Hong Kong

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Einschlusskriterien:

  1. im Alter ≥ 18 Jahre;
  2. bei denen ein nicht metastasierter NSCLC-Krebs im Stadium I–III diagnostiziert wurde;
  3. abgeschlossene Primärbehandlung mit kurativer Absicht (Operation, Chemotherapie und/oder Strahlentherapie) 6 Monate bis 5 Jahre vor der Basisbewertung ohne Wiederauftreten oder Auftreten weiterer Krebserkrankungen;
  4. gemäß HK-MoCA 5-Minuten-Protokoll eine leichte kognitive Beeinträchtigung festgestellt (≤ 7. alters- und bildungskorrigierter Perzentil-Cut-off-Score);
  5. nicht regelmäßig Sport treiben (definiert als < 150 Minuten mäßig intensives Training pro Woche).

Ausschlusskriterien:

  1. unzureichendes Lese- und Sprachverständnis für Kantonesisch für die Lernaktivitäten;
  2. mit Demenz diagnostiziert;
  3. nicht in der Lage, SMS-Anwendungen für Mobiltelefone (z. B. WhatsApp) zu verwenden.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Versorgungsforschung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Doppelt

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Motivational Personalized Messaging + Regular Health Education
The intervention group will receive personalised motivational messages (according to their physical activity levels and preferences screened during the baseline measurement) using instant messaging applications (e.g., WhatsApp). They will be equipped with a wearable activity tracker for 3 months to monitor their physical activity level. In accordance with the guidelines for mobile instant messageing development, we will develop a message content library and protocol for intervention delivery.
Verhalten: Regular message of health education
Regular messages will be sent regularly to each participant over the 12-week study period. As personalisation is a core process in enabling behavioural change, the intervention content, frequency, and timing of the messages will be based on the participants' self-care needs and preferences, which will be surveyed at baseline. If no specific preferences are provided, we will plan the message delivery to decrease in frequency over time as this trend has shown the highest effectiveness in existing studies. The format of messages will be mainly texts, but other formats such as pictures and voice messages will also be considered for addition to the content library to suit a wide range of preferences.
Verhalten: Chat-type motivational personalized messaging support
Chat-based support will be given to the participants in addition to the regular message delivery. Instant messaging will be used to communicate directly with the participants. We plan to recruit 10 student RAs who have been trained in the delivery of interactive instant messages (IMs) to provide chat-type support to encourage increased physical activity and interaction. Participants will be invited to set physical activity goals and action plans through the chat-type support. Participants will receive a personalised summary of their physical activity weekly and will be encouraged to reflect on this through a real-time chat (around 5 minutes). They will also be encouraged to establish a plan of how they can adjust their physical activity goal going forward. When addressing the participants' queries or any ethical concerns, the student RAs will be instructed to immediately report to the Principal Applicant and supervisors who are experienced and trained research nurses.
Aktiver Komparator: Regular Health Education
Control group 1 will receive regular message delivery (as mentioned in the intervention) without personalised motivational messaging for better evaluation of the effect of personalized motivational messaging.
Verhalten: Regular message of health education
Regular messages will be sent regularly to each participant over the 12-week study period. As personalisation is a core process in enabling behavioural change, the intervention content, frequency, and timing of the messages will be based on the participants' self-care needs and preferences, which will be surveyed at baseline. If no specific preferences are provided, we will plan the message delivery to decrease in frequency over time as this trend has shown the highest effectiveness in existing studies. The format of messages will be mainly texts, but other formats such as pictures and voice messages will also be considered for addition to the content library to suit a wide range of preferences.
Kein Eingriff: Self-management
Control group 2 (self-management) will only receive a leaflet containing basic information about CRCI distributed during the recruitment process and text message reminders for follow-up surveys. Regular and real-time support (i.e., chat-type) messages will not be made available to the control group.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Hong Kong Montreal Cognitive Assessment
Zeitfenster: at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
It measures objective cognitve function. It consists of 4 dimensions (attention, memory, language/executive function, and orientation). The total score ranges from a minimum of 0 to a maximum of 30. Higher scores indicate better cognitive function, while lower scores suggest cognitive decline or impairment. The categorization of subject scores are corrected by years of education and age.
at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
Functional Assessment of Cancer Therapy-Cognitive Function
Zeitfenster: at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)

It measures subjective cognitve function and its impact on quality of life in cancer patients.

It has 4 dimensions. 1. Perceived Cognitive Impairments (PCI): Range 0-72. 2. Perceived Cognitive Abilities (PCA): Range 0-36. 3. Comments from Others (Oth): Range 0-16. 4. Impact on Quality of Life (QoL): Range 0-16. Because negatively worded items are reverse-scored, higher scores across all sub-dimensions mean better outcomes: fewer perceived impairments, better perceived abilities, fewer negative comments from others, and less negative impact on quality of life.
at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
International Physical Activity Questionnaire-Short Form
Zeitfenster: at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
It measures the level of physical activity undertaken by adults. It covers 4 dimensions: vigorous-intensity activities, moderate-intensity activities, walking, and sitting. The score is calculated as continuous MET-minutes/week. The minimum value is 0 MET-minutes/week, and the maximum value is theoretically unlimited. Higher scores indicate a higher volume and intensity of physical activity, meaning the individual is more physically active.
at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
Exercise Self-efficacy Scale
Zeitfenster: at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
It measures an individual's self-confidence in their ability to continue exercising despite facing various barriers (e.g., fatigue, bad weather, lack of time). It is unidimensional (1 dimension). The total score typically ranges from a minimum of 0 to a maximum of 70 (depending on the exact version used). Higher scores indicate greater self-efficacy, meaning the person has stronger confidence and belief in their ability to maintain a regular exercise routine.
at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
Patient Health Questionnaire 4 item
Zeitfenster: at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
It measures the core symptoms of anxiety and depression. It consists of 2 dimensions: anxiety (2 items) and depression (2 items). The total score ranges from a minimum of 0 to a maximum of 12. Each individual dimension ranges from 0 to 6. Higher scores indicate a higher burden of psychological distress, meaning the patient is experiencing more frequent or severe symptoms of anxiety and depression.
at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire
Zeitfenster: at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)
It measures the health-related quality of life of cancer patients. It has 15 dimensions. All scores are linearly transformed to a range of 0 to 100. 1. Global Health Status/QoL (1 dimension): Range 0-100. Higher scores mean better overall health and quality of life. 2. Functional scales (5 dimensions: physical, role, emotional, cognitive, social): Range 0-100. Higher scores mean a higher/healthier level of functioning. 3. Symptom scales/items (9 dimensions: fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties): Range 0-100. Higher scores mean worse outcomes, indicating more severe symptoms or problems.
at baseline (T0), 3 months (T1; immediately after intervention delivery), and 6 months (T2; long-term follow up)

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

The University of Hong Kong

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. Februar 2024

Primärer Abschluss (Tatsächlich)

31. Januar 2026

Studienabschluss (Tatsächlich)

31. Januar 2026

Studienanmeldedaten

Zuerst eingereicht

15. August 2023

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

15. August 2023

Zuerst gepostet (Tatsächlich)

21. August 2023

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

4. Juni 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

2. Juni 2026

Zuletzt verifiziert

1. März 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • uhongkongc9ttii37

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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