Kudos to Tara Albrecht, assistant professor, and her entire team for the submission of her Rita and Alex Hillman Foundation application entitled: “Build Stamina: A novel supportive intervention for vulnerable adults with acute leukemia and their caregivers.” This proposal requests funding for a one-year period with a start date of January 1, 2021.

Acute myeloid leukemia (AML) is an aggressive and often debilitating cancer of the blood and bone marrow that negatively effects patients and their primary informal care partner (ICP). For many of these older adults, the initial induction chemotherapy treatment requires a lengthy hospitalization and includes many subsequent weeks over the course of the disease. These older adults are often so sick they are commonly encouraged to rest. Unfortunately, the long period of rest results in diminished physical function during and after treatment. In fact, they become so debilitated that they are unable to function at pre-cancer levels. Diminished physical function in older adults with AML is associated with poor survival and can delay/prevent future life-saving treatments. Other factors that negatively affect health outcomes for older adults with AML include low household income, living in rural and low socioeconomic communities, and those solely insured through Medicaid. ICP’s are the primary source of support for adults with AML. Unfortunately, providing informal care is associated with physical, emotional, social, quality of life (QoL) and health implications. Further, ICPs living in lower socioeconomic and rural communities a particularly vulnerable population as they are at increased risk for isolation and elevated stress. Currently there are no supportive interventions routinely applied in the clinical setting to assist vulnerable adults with AML nor their ICP to improve physical function nor reduce the severity of symptoms. Importantly, the ICPs and the patient’s psychological health and well-being are interrelated. Interventions that target both the patient and ICP as a dyad have shown higher participation rates and improvements in well-being and social support yet they are rare. Given this evidence, the team proposes Build Stamina, a partnered exercise intervention targeting improvements in physical function, common symptoms and QoL. Build Stamina provides an exercise prescription with wearable activity tracking devices and is enhanced with short message service (SMS) text message coaching to support the delivery and uptake of our structured, tailored and progressive exercise intervention.

The team will partner with the Duke Cancer Institute Oncology Patient and Community Advisory Council to: 1) develop and deliver a scalable, home-based partnered exercise intervention that improves physical function, fatigue, disturbed sleep, anxiety, depression, and quality of life for vulnerable seriously ill patients with acute myeloid leukemia and their informal care partners; 2) evaluate the intervention and procedures of delivery; and 3) identify key components necessary to guide the scalability of our intervention into routine clinical practice. At the end of this project, the intervention will be ready for additional testing.