Fostering Post-Treatment Transitions in African-American Breast Cancer Survivors

描述（由申请人提供）：尽管先前已研究了认知行为干预[CBI]，但很少有研究检查了治疗后早期[EOT]期间各种策略的有效性。非裔美国人[AA]乳腺癌[BCA]人群一直服务不足，并且通常比其他种族人群的结局更差。此外，大多数CBI使用面对面的形式，限制了他们对那些能够“到达”干预现场的人的使用。我们的社区合作伙伴已经确定了我们自己社区中AA BCA幸存者计划的重大差距，特别是在EOT阶段。我们建议与我们的社区合作伙伴合作;使用基于社区的参与性研究方法[CBPR]，在完成治疗后的前6个月内调整现有的CBI用于AA BCA幸存者。拟议研究的具体目的是：（1）确定在完成BCA治疗的AA患者及其支持性其他人治疗后的前6个月内，应如何修改现有CBI，特别注意文化内容、会话数量和交付模式;（2）评估修改后的CBI的可行性、可接受性和满意度;（3）探讨改良CBI对个体应对资源、领悟社会支持和生活质量的影响。在第一阶段，重点将是在社区内建立研究能力和收集信息。合作研究小组将参与能力建设活动。AA BCA幸存者和其他支持者将被要求批评现有的CBI或参加焦点小组，以收集信息，以确定需求/问题，并建议干预措施的要素，以确保其可接受性和文化敏感性。在第二阶段，我们会就经修订的CBI进行先导研究，以评估其可接受性和可行性，以及对生活质量和其他相关结果的影响。拟议的研究通过以下方式解决了先前确定的差距和局限性：结合患者和支持他人的观点;针对AA女性;在治疗后的前6个月内提供干预;并使用多模式格式，使干预广泛可及，并为AA乳腺癌幸存者及其亲人定制文化。该试点研究将为R 01申请提供基础，以便对AA BCA幸存者和其他支持者的干预措施进行大规模RCT。

DESCRIPTION (provided by applicant): Although cognitive-behavioral interventions [CBI] have been previously studied, little research has examined the effectiveness of various strategies during the early post-treatment phase [EOT]. The African American [AA] breast cancer [BCA] population has been underserved and generally experienced poorer outcomes than other ethnic populations. In addition, most CBIs use a face-to-face format, limiting their use to those who are able to 'get to' the intervention site. Our community partners have identified significant gaps in programs for AA BCA survivors in our own community, particularly in the EOT phase. We propose to work with our community partners; using community based participatory research methods [CBPR] to adapt an existing CBI for use with AA BCA survivors during the first 6 months after completing treatment. The specific aims for the proposed study are to: (1) Determine how an existing CBI should be modified for use during the first 6 months following treatment with AA patients completing treatment for BCA and their supportive other, with specific attention to cultural content, number of sessions, and mode of delivery; (2) Evaluate the modified CBI in terms of feasibility, acceptability and satisfaction; (3) Determine the impact of the modified CBI on personal coping resources, perceived social support and quality of life. In the first stage, the focus will be on creating research capacity within the community and information gathering. The collaborative research team will engage in capacity-building activities. AA BCA survivors and supportive others will be asked to critique the existing CBI or to participate in focus groups to gather information to identify needs/issues and suggest elements for the intervention in order to ensure its acceptability and cultural sensitivity. In Stage 2, a pilot study of the modified CBI will be conducted to evaluate its acceptability, feasibility and determine the effects on quality of life and other related outcomes. The proposed study addresses the previously identified gaps and limitations by: incorporating both the patient's and supportive other's perspectives; targeting AA women; delivering the intervention during the first 6 months post-treatment; and using a multi-modal format that makes the intervention widely accessible and culturally tailored for AA breast cancer survivors and their loved ones. This pilot study will provide the foundation for an R01 application to conduct a large scale RCT of the intervention for AA BCA survivors and supportive others.