Abstract
BackgroundOlder cancer survivors, faced with both age- and treatment-related morbidity, are at increased and premature risk for physical function limitations. Physical performance is an important predictor of disability, quality of life, and premature mortality, and thus is considered an important target of interventions designed to prevent, delay, or attenuate the physical functional decline. Currently, low-cost, valid, and reliable methods to remotely assess physical performance tests that are self-administered by older adults in the home-setting do not exist, thus limiting the reach, scalability, and dissemination of interventions.ObjectiveThis paper will describe the rationale and design for a study to evaluate the accuracy, reliability, safety, and acceptability of videoconferencing and self-administered tests of functional mobility and strength by older cancer survivors in their own homes.MethodsTo enable remote assessment, participants receive a toolkit and instructions for setting up their test course and communicating with the investigator. Two standard gerontologic performance tests are being evaluated: the Timed Up and Go test and the 30-second chair stand test. Phase 1 of the study evaluates proof-of-concept that older cancer survivors (age ≥60 years) can follow the testing protocol and use a tablet PC to communicate with the study investigator. Phase 2 evaluates the criterion validity of videoconference compared to direct observation of the two physical performance tests. Phase 3 evaluates reliability by enrolling 5-10 participants who agree to repeat the remote assessment (without direct observation). Phase 4 enrolls 5-10 new study participants to complete the remote assessment test protocol. Feedback from participants in each phase is used to refine the test protocol and instructions.ResultsEnrollment began in December 2019. Ten participants completed the Phase 1 proof-of-concept. The study was paused in mid-March 2020 due to the COVID-19 pandemic. The study is expected to be completed by the end of 2020.ConclusionsThis validity and reliability study will provide important information on the acceptability and safety of using videoconferencing to remotely assess two tests of functional mobility and strength, self-administered by older adults in their homes. Videoconferencing has the potential to expand the reach, scalability, and dissemination of interventions to older cancer survivors, and potentially other older adults, especially in rural areas.Trial RegistrationClinicalTrials.gov NCT04339959; https://clinicaltrials.gov/ct2/show/NCT04339959International Registered Report Identifier (IRRID)DERR1-10.2196/20834
Highlights
Over 16.9 million cancer survivors are living in the United States, and three-quarters are 60 years of age or older [1]
The majority of interventions that collect objective measures of physical functioning require the participant to travel to the research center or clinic for the assessment even when interventions are provided at home
We propose to use an existing, low-cost, and easy to use technology to remotely assess tests of functional mobility and strength that are self-administered by older (≥60 years) cancer survivors
Summary
Over 16.9 million cancer survivors are living in the United States, and three-quarters are 60 years of age or older [1]. The majority of interventions that collect objective measures of physical functioning require the participant to travel to the research center or clinic for the assessment even when interventions are provided at home. This requirement can result in selection and attrition bias and limits the reach, scalability, and dissemination of interventions. Older cancer survivors, faced with both age- and treatment-related morbidity, are at increased and premature risk for physical function limitations. Low-cost, valid, and reliable methods to remotely assess physical performance tests that are self-administered by older adults in the home-setting do not exist, limiting the reach, scalability, and dissemination of interventions
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