Post-Hurricane Cancer Care: Patient Needs after Hurricane Maria

项目总结 评估自然灾害对癌症结局和差异的影响的研究很少，而对于 研究团队的知识；没有人研究过暴露在多重灾难中的影响，特别是在种族 少数群体。目前，该团队正在扩大评估范围，将新冠肺炎和 地震的次生危害(社会隔离、失业、医疗服务中断、结构性 应激生物标记物和多层次健康决定因素的变化。拟议的补编将 通过以下方式补充母公司R21(1R21MD013674)的范围：1)扩大招聘范围，以包括其他 接触过玛丽亚、2020年地震和新冠肺炎的癌症患者(+75)和对照组(+75) 大流行；2)确定患者因疫情的后果而未得到满足的心理和医疗需求 2020年地震和新冠肺炎大流行；以及3)检查玛丽亚、地震和 新冠肺炎大流行对与健康结果相关的多层面因素的影响。拟议的补充项目 将通过探索生理学方法来改变目前自然灾害后健康后果的研究范式 极端应激源对已知影响癌症进展和共病的生物过程的影响 条件，包括炎症和应激激素。通过扩大父赠款的范围以包括 2020年地震和新冠肺炎大流行，研究小组将增加对影响的了解 多重灾难应激源。

PROJECT SUMMARY Studies evaluating the effects of natural disasters on cancer outcomes and disparities are scarce, and to the study team’s knowledge; none have examined the impact of exposure to multiple disasters, particularly in ethnic minority groups. Currently, the team is expanding assessments to include the impact of COVID-19 and the earthquakes’ secondary hazards (social isolation, unemployment, healthcare services disruption, structural damage) on stress biomarkers and changes in multilevel determinants of health. The proposed supplement will complement the scope of the parent R21 (1R21MD013674) by: 1) expanding recruitment to include additional cancer patients (+75) and controls (+75) who were exposed to Maria, the 2020 earthquakes, and the COVID-19 pandemic; 2) identifying patients’ unmet psychological and medical needs resulting from the aftermath of the 2020 earthquakes and the COVID-19 pandemic, and; 3) examining the impact of Maria, the earthquakes, and the COVID-19 pandemic on multilevel factors relevant to health outcomes. The proposed supplement project will shift current research paradigms in health outcomes after natural disasters by exploring the physiological effects of extreme stressors on biological processes known to affect cancer progression and comorbid conditions, including inflammation and stress hormones. By expanding the parent grant’s scope to include the 2020 earthquakes and COVID-19 pandemic, the study team will increase the understanding of the effects of multiple disaster stressors.