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

描述（由申请人提供）：虽然认知行为干预[CBI]已经被研究过，但很少有研究检查在早期治疗后阶段[EOT]中各种策略的有效性。非裔美国人[AA]乳腺癌[BCA]人群一直得不到充分的服务，而且通常比其他种族人群的预后更差。此外，大多数cbi采用面对面的形式，限制了他们对那些能够“到达”干预地点的人的使用。我们的社区合作伙伴已经发现，在我们自己的社区中，针对AA BCA幸存者的项目存在重大差距，特别是在EOT阶段。我们建议与我们的社区伙伴合作；使用基于社区的参与性研究方法[CBPR]对现有的CBI进行调整，使其在完成治疗后的前6个月内适用于AA BCA幸存者。拟议研究的具体目的是：(1)确定如何在完成BCA治疗的AA患者及其支持性治疗后的前6个月内修改现有的CBI，特别注意文化内容，会话次数和交付模式；(2)对修改后的CBI进行可行性、可接受性和满意度评价；(3)确定修改后的CBI对个人应对资源、感知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信息收集。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或参与焦点小组收集信息，以确定需求/问题，并提出干预的要素，以确保其可接受性和文化敏感性。在第二阶段，我们会进行一项试验研究，以评估改良后的综合医疗计划的可接受性和可行性，并确定对生活质素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：结合患者和支持性他人的观点；以AA女性为目标；在治疗后的前6个月进行干预；并采用多模式的形式，使干预措施更容易获得，并为AA乳腺癌幸存者及其亲人量身定制文化。该试点研究将为R01申请提供基础，以对AA BCA幸存者和支持性其他人进行大规模的RCT干预。

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.