Developing a Dyadic Survivorship Intervention for Black Women with Breast Cancer and Their Informal Caregivers

1乳腺癌患者和他们的非正式照顾者经常报告说，他们在心理、人际关系和身体上都没有得到满足。 2长期生存的健康需求。尽管二元干预措施在 3改善患者和照顾者的结局，现有的干预措施很少是为黑人患者和 4提供大部分无偿照料和支持的女性家庭成员和朋友。这项研究将 5开发一种通过视频电话会议(VTC)向黑人乳腺癌患者提供的新的二元干预 6和她们的女性非正式照顾者，以提高生活质量和过渡到 7长期生存。这项提议直接回应了NCI关于护理和癌症的优先事项 8存活，并将为首个此类二元干预的随机对照试验奠定基础。 9首先，我们将在以前和现在针对黑人乳腺癌患者及其非正式患者的工作基础上再接再厉 10名照顾者，请DYADS评估潜在的干预内容。接下来，我们将通过以下方式设计传播 11与利益相关者面谈，以确定实施二元生存干预措施的促进者和障碍 12人在临床护理方面。最后，我们将制定一个简短的干预措施，并评估其可接受性和可行性。这个 本提案的13个目标如下：目标1：评估一份简报的潜在领域和特点 14职业训练局非正式干预改善黑人乳腺癌患者和女性的生活质量 在过渡到长期生存期间的15名照顾者。我们将进行定性和定量的征集 16来自双方成员单独和共同的反馈(N=20个双方)，关于主题、领域和 以病人和照顾者为中心的职业训练局生存干预的17个文化特征。目标2. 18确定在临床护理中实施二元生存干预的促进者和障碍。我们 19将通过与癌症中心的利益相关者进行访谈(N=15)来设计传播 20执行研究综合框架。定向主题分析将使我们能够 21了解在临床护理中提供二元干预的障碍和促进者。目标3.评估简报 22职业训练局介入试点可行性研究(N=20个DUADS)。基于AIMS 1和AIMS中的形成性研究 我们将开发一个由癌症中心的心理服务人员远程提供的4个疗程的干预 24岁左右，患者完成积极治疗并过渡到长期生存。我们会收集 来自患者及其女性照顾者的25个定量和定性可行性数据 26干预可接受性。我们还将对评估小组进行试点测试，包括 27双方成员的关系结果、卫生保健利用和生活质量。在完成后 在这个项目中，我们的团队将处于有利地位，可以在更大的试验中测试干预。这样做的最终目的是 29项研究计划旨在通过改善黑人乳腺癌患者的预后来减少健康差距 30名女性照顾者。

1 Breast cancer patients and their informal caregivers often report unmet psychosocial, relational, and physical 2 health needs that persist into long-term survivorship. Although dyadic interventions have shown promise in 3 improving outcomes for patients and caregivers, few existing interventions are designed for Black patients and 4 the female family members and friends who provide the majority of unpaid care and support. This study will 5 develop a novel dyadic intervention delivered via video teleconferencing (VTC) to Black breast cancer patients 6 and their female informal caregivers to improve quality of life and relationship outcomes during the transition to 7 long-term survivorship. This proposal is directly responsive to NCI’s priorities about caregiving and cancer 8 survivorship and will lay the foundation for a randomized controlled trial of a first-of-its-kind dyadic intervention. 9 First, we will build on our previous and current work with Black breast cancer patients and their informal 10 caregivers by asking dyads to evaluate potential intervention content. Next, we will design for dissemination by 11 interviewing stakeholders to identify facilitators and barriers to implementing dyadic survivorship interventions 12 in clinical care. Finally, we will develop a brief intervention and evaluate its acceptability and feasibility. The 13 aims of this proposal are as follows: Aim 1: Evaluate the potential domains and characteristics of a brief 14 VTC intervention to improve quality of life for Black breast cancer patients and female informal 15 caregivers during the transition to long-term survivorship. We will solicit qualitative and quantitative 16 feedback from both members of dyads individually and together (N = 20 dyads) about themes, domains, and 17 characteristics of a culturally appropriate patient- and caregiver-centered VTC survivorship intervention. Aim 2. 18 Identify facilitators and barriers to implementing dyadic survivorship interventions in clinical care. We 19 will design for dissemination by conducting interviews (N = 15) with stakeholders the cancer center based on 20 the Consolidated Framework for Implementation Research. A directed thematic analysis will allow us to 21 understand barriers and facilitators to delivering dyadic interventions in clinical care. Aim 3. Evaluate a brief 22 VTC intervention in a pilot feasibility study (N = 20 dyads). Based on the formative research in Aims 1 and 23 2, we will develop a 4-session intervention delivered remotely by psychology service staff at the cancer center 24 around the time patients complete active treatment and transition to long-term survivorship. We will collect 25 quantitative and qualitative feasibility data from patients and their female caregivers about satisfaction and 26 intervention acceptability. We will also pilot test the assessment battery, including validated measures of 27 relationship outcomes, health care utilization, and quality of life for both dyad members. Upon completion of 28 this project, our team will be well-positioned to test the intervention in a larger trial. The ultimate goal of this 29 research program is to reduce health disparities by improving outcomes for Black breast cancer patients and 30 their female caregivers.