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

为患有乳腺癌的黑人女性及其非正式护理人员制定二元生存干预措施

• 批准号: 10512499
• 负责人: Tess Thompson
• 金额: $ 7.88万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-25 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10512499
• 关键词: Address; Adherence; Black race; Breast Cancer Patient; Breast Cancer survivor; Cancer Center; Cancer Patient; Cancer Survivorship; Caregiver support; Caregivers; Caring; Characteristics; Clinical; Consolidated Framework for Implementation Research; Data; Family; Family member; Feasibility Studies; Feedback; Female; Focus Groups; Foundations; Friends; Goals; Health; Individual; Intervention; Interview; Long Term Survivorship; Malignant Neoplasms; Measures; Methods; Outcome; Patient-Focused Outcomes; Patients; Persons; Positioning Attribute; Psychology; Quality of life; Randomized Controlled Trials; Reduce health disparities; Reporting; Research; Sampling; Services; Spouse Caregiver; Spouses; Testing; Time; Work; acceptability and feasibility; active method; base; black patient; black women; brief intervention; caregiving; clinical care; design; experience; health care service utilization; improved; improved outcome; informal caregiver; malignant breast neoplasm; member; novel; physical conditioning; pilot test; programs; psychosocial; recruit; remote delivery; satisfaction; survivorship; therapy design; therapy development

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.

1 乳腺癌患者及其非正式护理人员经常报告心理社会、关系和身体方面未得到满足 2 持续存在于长期生存中的健康需求。尽管二元干预已显示出希望 3 改善患者和护理人员的治疗效果，现有的干预措施很少是针对黑人患者和护理人员设计的 4 提供大部分无偿关怀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型二元干预措施 6 及其女性非正式护理人员在过渡期间改善生活质量和关系结果 7.长期生存。该提案直接响应 NCI 关于护理和癌症的优先事项 8 的存活率，并将为首次双元干预的随机对照试验奠定基础。 9 首先，我们将在之前和当前针对黑人乳腺癌患者及其非正式工作的基础上开展工作。 10 名护理人员通过要求两人评估潜在的干预内容。接下来，我们将通过以下方式进行传播设计： 11 采访利益相关者以确定实施二元生存干预措施的促进因素和障碍 临床护理12人。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 该提案的 13 个目标如下： 目标 1：评估摘要的潜在领域和特征 14 VTC 干预提高黑人乳腺癌患者和非正式女性的生活质量 15 名护理人员正在向长期生存过渡。我们将进行定性和定量的征集 16 条来自二人组成员单独和共同（N = 20 人）关于主题、领域和 以患者和护理人员为中心的文化上适当的 VTC 生存干预的 17 个特征。目标2。 18 确定在临床护理中实施二元生存干预措施的促进因素和障碍。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 实施研究综合框架。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措施的障碍和促进因素。目标 3. 评估摘要 22 VTC 干预试点可行性研究（N = 20 对）。基于目标 1 和 23 2，我们将开发由癌症中心的心理服务人员远程提供的 4 次干预 24 年前后，患者完成积极治疗并过渡到长期生存。我们将收集 来自患者及其女性护理人员的 25 个定量和定性可行性数据，涉及满意度和 26 干预的可接受性。我们还将对评估组进行试点测试，包括经过验证的措施 27 双方成员的关系结果、医疗保健利用率和生活质量。完成后 28 在这个项目中，我们的团队将处于有利地位，可以在更大规模的试验中测试干预措施。此次活动的最终目的 29 研究计划旨在通过改善黑人乳腺癌患者的治疗结果来减少健康差距 30 他们的女性照顾者。