Piloting Y-AMBIENT: A Quality of Life Intervention for Young African American Breast Cancer Survivors in Treatment

项目总结/文摘

Project Summary/Abstract Timiya S. Nolan is an Assistant Professor in the College of nursing at The Ohio State University. Dr. Nolan is responding to PAR-18-336 to obtain the skills, knowledge and mentored research experience that are essential for a career as a nurse scientist focusing on cancer survivorship health disparities research. Her long-term goal is to build an independent program of research that identifies contextual factors of quality of life (QOL) among young (18-44) breast cancer survivors from underrepresented minority groups and translates findings to the development, implementation, and dissemination/translation of multi-level QOL interventions and policy changes. The short-term goals for the award period include developing expertise in biobehavioral and environmental contributors to cancer and health outcomes (particularly QOL), scientific processes in the conduct of longitudinal intervention and observational trials, advanced quantitative methods, manuscripts writing and grantsmanship toward building a presence in her respective field among young and African American (AA) breast cancer survivors. Young AA survivors report poorer quality of life (QOL), and face more negative social determinants of health (e.g., low socioeconomic status, limited access to care, discrimination) than young White survivors. Yet, there are no published interventions that comprehensively address QOL (i.e., physical, psychological, social and spiritual well-being) in young AA survivors. This proposal is aimed at evaluating processes and preliminary outcomes of a targeted QOL intervention vs. control in young AA survivors in treatment for early (I-II) & late (III) stage breast cancer. Dr. Nolan adapted this Y-AMBIENT intervention from an existing evidence-based intervention using input from young AA survivors and healthcare providers. We will conduct a two-arm, pilot randomized controlled trial to evaluate feasibility, acceptability, and preliminary health-related outcomes of Y-AMBIENT (themed education, written materials, and videos) vs. an attention control (enhanced usual care). We will recruit 40 young AA survivors who have completed primary breast cancer treatment (n=20 per group and equal representation of those with a history of early and late stage breast cancer within). We will measure feasibility via study recruitment and retention (i.e., study enrollment and study contact completion) and protocol acceptability with satisfaction, usefulness, use of strategies via our Topical Concern and Strategy Sheet. We will triangulate qualitative and quantitative responses from each study contact to (a) identify participants’ perceptions of its acceptability, (b) willingness to participate in aspects of the protocol (participant burden), and (c) use of self-management strategies. At baseline, two-, and five-months, we will examine health-related outcomes (i.e., QOL, spiritual well-being, self- efficacy, and social support) within and between groups using descriptive and multiple-effects modeling techniques. Mentored research accomplished during the award period will lay the foundation for a large efficacy trial of Y-AMBIENT and future identification of other modifiable factors to address with interventions.