Neighborhood effects on Quality of Life in Breast Cancer

社区对乳腺癌生活质量的影响

• 批准号: 7116921
• 负责人: Mario Schootman
• 金额: $ 40.38万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7116921
• 关键词: behavioral /social science research tag; breast neoplasms; clinical research; female; geographic difference; human subject; patient oriented research; psychological aspect of cancer; quality of life; socioenvironment

DESCRIPTION (provided by applicant): With improved survival following breast cancer, there is increasing focus on the health-related quality of life (QoL) of breast cancer survivors. Although neighborhood disadvantage affects adult health behaviors, breast cancer incidence and survival, and QoL of the general population independent of individual-level factors, little attention has been directed toward such neighborhood factors related to QoL following breast cancer diagnosis. The following aims will be addressed in this revised application: 1) Determine the extent of geographic clustering of the change in QoL over time among women with and those without breast cancer at the level of the census tract; 2) Determine the extent to which the change in QoL over time can be explained by neighborhood disadvantage among women with breast cancer and among women without breast cancer; and 3) Identify potential pathways by which neighborhood disadvantage affects changes in QoL over time among women with breast cancer. The proposed prospective, population-based study will extend the current model of individual-level factors and QoL to a multilevel approach by including neighborhood indicators of social and economic disadvantage at the census tract level among women with breast cancer as compared to community-dwelling women without breast cancer. Women with breast cancer will be identified one year following their diagnosis by the Missouri Cancer Registry (MCR). Following consent, they will be interviewed at this time as well as one year later to assess changes over time in QoL. A population-based control group of community-dwelling women without breast cancer will be identified through random-digit dialing and interviewed at similar time points. A composite index of neighborhood disadvantage will be constructed from census data. The multilevel nature of the study makes it possible to identify barriers as part of hypothesized pathways that could be targeted by intervention studies aimed at several levels (e.g., individual and neighborhoods simultaneously) using a multi-pronged approach to improve QoL, as recently recommended by the Institute of Medicine.

描述（由申请人提供）：随着乳腺癌后生存率的提高，人们越来越关注乳腺癌幸存者的健康相关生活质量（QoL）。尽管邻里劣势影响成人健康行为、乳腺癌发病率和生存率以及一般人群的生活质量，而与个人层面的因素无关，但人们很少关注与乳腺癌诊断后生活质量相关的邻里因素。本修订版申请将解决以下目标：1）确定在人口普查区水平上，患有和未患有乳腺癌的妇女随时间推移生活质量变化的地理聚集程度; 2）确定在乳腺癌妇女和未患有乳腺癌的妇女中，生活质量随时间推移的变化在多大程度上可以通过社区劣势来解释;以及3）确定社区劣势影响乳腺癌妇女生活质量随时间变化的潜在途径。拟议的前瞻性，以人群为基础的研究将扩展到一个多层次的方法，包括社区指标的社会和经济劣势在人口普查区水平的乳腺癌妇女相比，社区居住的妇女没有乳腺癌的个人水平的因素和生活质量的当前模型。患有乳腺癌的妇女将在确诊一年后由密苏里州癌症登记处（MCR）进行鉴定。同意后，将在此时以及一年后对他们进行访谈，以评估QoL随时间的变化。将通过随机数字拨号确定一个基于人口的社区居住的无乳腺癌妇女对照组，并在类似的时间点进行访谈。将根据人口普查数据构建一个邻里劣势综合指数。该研究的多层次性质使得有可能将障碍确定为假设途径的一部分，这些途径可以通过针对多个层次的干预研究（例如，个人和社区同时）使用多管齐下的方法来改善生活质量，最近由医学研究所推荐。