Longitudinal investigation of sociocultural and behavioral influences on symptom management, biological response, and functioning between Chinese and White breast cancer survivors.

社会文化和行为对中国和白人乳腺癌幸存者症状管理、生物反应和功能影响的纵向调查。

• 批准号: 10360588
• 负责人: Judy Huei-yu Wang
• 金额: $ 62.92万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10360588
• 关键词: Acculturation; Adherence; Affect; Age; Anxiety; Asian; Behavior; Behavioral; Belief; Biological; Biology; Blood specimen; Breast Cancer survivor; Buffers; Cancer Etiology; Cancer Survivor; Cancer Survivorship; Chinese; Chinese American; Chronic; Chronic stress; Cohort Studies; Communication; Coping Behavior; Cross-Sectional Studies; Data; Development; Diagnosis; Diet; Dietary Practices; Distress; Eating; Emotional; Emotional Stress; Equilibrium; Exercise; Fatigue; Feedback; Fright; Growth; Guidelines; Health; Health Sciences; Hydrocortisone; Immigrant; Immigration; Incidence; Individual; Inflammation; Inflammatory; Intake; Intervention; Interview; Investigation; Lead; Longitudinal prospective study; Malignant Neoplasms; Mediating; Medical; Menopausal Symptom; Mental Depression; Not Hispanic or Latino; Outcome; Outcome Study; Pain; Participant; Pathway interactions; Patient Self-Report; Physical Function; Physical activity; Population; Population Growth; Prevention; Psychological Factors; Psychological Stress; Psychosocial Stress; Public Health; Quality of life; Race; Recurrence; Reporting; Research; Resources; Risk; Sampling; Severities; Social support; Societies; Soy Foods; Stress; Surveys; Symptoms; Telephone; Time; Translating; Unhealthy Diet; Vegetables; Work; authority; base; behavior influence; biracial; clinical care; coping; cruciferous vegetable; cultural values; cytokine; diet and exercise; dietary; functional decline; functional outcomes; good diet; grasp; health care availability; improved; malignant breast neoplasm; preference; psychologic; psychological stressor; psychosocial; racial difference; resilience; response; social; social culture; socioeconomic disadvantage; socioeconomics; soy; symptom management

PROJECT SUMMARY The number of US cancer survivors is growing rapidly, including a significant number of Chinese Americans (CA), a group with an annual breast cancer growth rate of 1.1% and fast population growth due to immigration. Over 63% of CAs are immigrants. Our preliminary study showed that more CA immigrant breast cancer survivors (BCS) had fatigue, pain, and poor physical functioning relative to non-Hispanic White (NHW) BCS. Low-acculturated CAs reported greater psychosocial stress (e.g. greater perceived threat and fear of losing socioeconomic resources); however, they paradoxically reported less depression than NHWs. We do not know why CA BCS appear emotionally resilient when they are physically vulnerable and often lack social resources for coping (i.e., social support, socioeconomic resources and healthcare access). It is unclear whether such resilience is actually a cultural response when many CAs believe that emotional stress causes cancer, and thus they may underreport their distress. Unexpressed chronic stress is related to higher cortisol and inflammation levels detrimental to health. It is also unknown whether CA BCS’ symptom burden persists over time and how culture and social resources influence their ways of managing symptoms and further improving quality of life. Prior data showed CA BCS eating more soy food and cruciferous vegetables than NHWs. Higher soy intake reduces menopausal symptoms and fatigue. Yet, CA BCS had lower adherence to physical activity guidelines than NHWs. Psychosocial stress, poor diet, insufficient exercise, fatigue, and pain are all related to chronic inflammation. Yet, Chinese practices in healthy diet and emotional balance may decrease inflammation. Our preliminary findings were based on self-reports, so we cannot explain how those multifaceted sociocultural and individual factors are intertwined to affect inflammation in the body and outcome differences between the two racial groups. To comprehensively understand sociocultural influence on individual coping behaviors and how they in turn affect racial differences in biological responses (i.e., inflammation and cortisol stress markers), symptom severity, and quality of life, we propose a bi-racial, cohort study among 260 CA BCS (1-5 years post diagnosis) who will be age- and stage-matched to 260 NHW BCS. Utilizing a society-behavior-biology multilevel framework, we will investigate the dynamics of sociocultural, psychological, and behavioral (diet and exercise) influences on symptom severity, biological responses, and functional outcomes. Participants will complete telephone survey interviews and provide blood samples at baseline and 6- and 12-month post- baseline follow-ups. Next, in-depth individual interviews with a subset of samples will be conducted to investigate in depth the causative factors in the pathways in order to develop individually and culturally appropriate interventions conducive to improving clinical care for targeted cancer survivor populations. This is well aligned with the Cancer Moonshot Initiative aimed at increasing symptom control and improving survival.

项目总结