Addressing Psychosocial Disparities in Rural Hispanic Cancer Survivors

解决农村西班牙裔癌症幸存者的心理社会差异

• 批准号: 8521167
• 负责人: Rachel M. Ceballos
• 金额: $ 14万
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-12 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8521167
• 关键词: Address; Affect; Aftercare; Applications Grants; Behavioral; Biological; Biological Factors; Biological Markers; Biomedical Research; Breast; C-reactive protein; Cancer Control; Cancer Survivor; Cancer Survivorship; Cardiovascular Diseases; Cervical; Chronic; Clinical; Communities; Comorbidity; Control Groups; Coupled; Development; Development Plans; Diabetes Mellitus; Distress; Education; Educational workshop; Elements; Emotional; Environment; Ethical Issues; Evaluation; Family; Fatigue; Female; Focus Groups; Fred Hutchinson Cancer Research Center; Fright; Future; Goals; Health; Hispanics; Hormones; Hydrocortisone; Income; Inflammatory; Institute of Medicine (U.S.); Interdisciplinary Study; Intervention; Interview; Investigation; Language; Life; Life Experience; Linguistics; Link; Literature; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Malignant neoplasm of ovary; Manuscripts; Measures; Medical; Mentors; Mentorship; National Research Council; Not Hispanic or Latino; Occupations; Outcome; Ovarian; Pain; Pancreas; Participant; Pathway interactions; Perception; Personal Satisfaction; Phase; Physiological; Population; Prognostic Marker; Program Development; Program Evaluation; Program Sustainability; Proteins; Protocols documentation; Psychoneuroendocrinology; Public Health; Qualitative Methods; Qualitative Research; Quality of life; Randomized; Randomized Controlled Trials; Readability; Recurrence; Research; Research Methodology; Research Personnel; Research Technics; Resources; Risk; Rural; Rural Community; Salivary; Sampling; Scientist; Senior Scientist; Series; Serum; Social status; Social support; Staging; Strategic Planning; Survival Rate; Survivors; Testing; Training; Training Programs; United States National Institutes of Health; Universities; Uterine Cancer; Washington; Woman; anticancer research; authority; base; biobehavior; biopsychosocial; cancer health disparity; cancer prevention; cancer recurrence; cancer risk; career; career development; community based participatory research; design; direct application; empowered; experience; health disparity; health related quality of life; improved; interest; malignant breast neoplasm; member; phase 1 study; phase 2 study; programs; psychosocial; reproductive; responsible research conduct; social; social cognitive theory; survivorship; symposium; tool; uptake

DESCRIPTION (provided by applicant): Candidate. Dr. Ceballos is a motivated young investigator with the goal of becoming an independent investigator in the field of cancer health disparities. As a biobehavioral health scientist, she is interested in applying her training in psychoneuroendocrinology (PNE) to the development and evaluation of culturally- appropriate behavioral and psychosocial cancer survivorship interventions. While Dr. Ceballos has substantial training and experience in biobehavioral cancer research, the primary objective of this career development plan is to build on Dr. Ceballos's experience with mentored training in qualitative methods, cultural competency, and program development, providing to provide her with the tools needed to achieve her goal of becoming an independent investigator conducting research to address cancer health disparities. To help her achieve the above stated goals her career development plan will consist of didactic training (coursework, seminars, and workshops), participation in scientific conferences, manuscript development, submission of NIH grant applications, and direct mentorship by senior scientists. Dr. Ceballos will receive guidance from her primary mentor, Dr. Beti Thompson, and co-mentors, Dr. Karen Syrjala and Dr. Anne McTiernan. All 3 mentors are accomplished scientists at the Fred Hutchinson Cancer Research Center (FHCRC) and have distinguished themselves as leaders in their fields and successful mentors of junior investigators. Dr. Ceballos's training program will include participation in the FHCRC and University of Washington Biomedical Research Integrity (BRI) Series, online training in the responsible conduct of research, and formal coursework in Social and Ethical Issues in Public Health. Environment. The FHCRC is ideally suited for the development of Dr. Ceballos's research career and the conduct of the proposed research plan. The FHCRC has a long-standing commitment to the development of productive, independent cancer prevention and control scientists through a variety of training programs. In fact, the goals of the current Strategic Plan for the FHCRC include developing effective strategies for mentoring, recruitment, promotion, and retention of excellent scientists, and promoting opportunities for successful interdisciplinary research. Other aspects of the FHCRC environment that make it a particularly attractive choice for the development of Dr. Ceballos's career and the conduct of the proposed research include demonstrated excellence in cancer prevention and control sciences. This is a rich environment in which Dr. Ceballos will have regular contact with scientists who are leaders in a wide range of relevant fields. Research Plan. Among Hispanics, the 5-year cause-specific survival rate across all stages of female reproductive cancers (breast, uterine, cervical, ovarian) has been steadily improving. As the population of U.S. Hispanics grows from 15% in 2009 to a projected 25% of the U.S. population by 2050, there will be a need to develop resources that support the growing number of Hispanic cancer survivors. This is particularly true as the psychosocial well-being of Hispanic survivors tends to be significantly lower than that of non-Hispanic Whites (NHW). Cancer survivors can experience distress from long-term medical (i.e., fatigue), financial (i.e., job loss), and socio-emotional (i.e., fear of recurrence) burdens of survivorship well beyond completion of primary treatment. However, the addition of linguistic and socio-cultural barriers can increase the distress experienced by Hispanic survivors. The importance of addressing psychosocial well-being of Hispanic survivors is further heightened by the well-established link between chronic distress and dysregulation of physiological biomarkers (e.g., cortisol, c-reactive protein) associated with cancer comorbidities and survivorship. While informational and social support resources have emerged as potent attenuators of the psychosocial and potential physiological burdens of cancer survivorship, the availability and uptake of such programs among Hispanic survivors is greatly limited. To address this disparity and potentially ameliorate the physiological implications of prolonged psychosocial distress, the goals of the proposed investigation are to conduct a two-phased investigation in which a culturally-appropriate Spanish-language support program, based on Social-Cognitive Theory, will be developed. Qualitative research techniques will be used to develop the program (Phase 1) and the program will be evaluated using a randomized control trial and biopsychosocial approach (Phase 2). The specific aims of the proposed investigation are to (1) develop and deliver a culturally appropriate Spanish-language support program for Hispanic female survivors of reproductive cancers living in a rural community, (2) evaluate the effect of the Spanish-language support resource on validated measures of quality of life and psychosocial well-being and, (3) evaluate the effect of the support resource on measures of serum c-reactive protein and salivary cortisol. Specific aim 1 will be accomplished during Phase 1 of the study while specific aims 2 and 3 will be accomplished during Phase 2. Phase 1 of the study will utilize 20 one-on- one interviews and 4 focus groups to assess the applicability of psychosocial needs (identified in the survivorship and health disparities literature) to rural Hispanic female survivors, probe for factors unique to the sample demographic (e.g., low education/income, rural), and assess program materials. Phase 2 of the study will include 80 women who underwent treatment for a reproductive cancer within the past 5 years. Participants will be randomized to the support intervention or delayed-intervention control group. A community based participatory research (CBPR) approach will be integrated into the program development and delivery to address the cultural issue of respecto (deference to authority or social status, in an effort to enhance the cultural-appropriateness and sustainability of the program, empower community members, and encourage their participation in research.

描述（由申请人提供）：候选人。Ceballos博士是一位积极进取的年轻研究者，目标是成为癌症健康差异领域的独立研究者。作为一名生物行为健康科学家，她感兴趣的是将她在精神神经内分泌学（PNE）方面的培训应用于文化上合适的癌症幸存者行为和社会心理干预措施的开发和评估。虽然塞巴洛斯博士在生物行为癌症研究方面有大量的培训和经验，但这个职业发展计划的主要目标是建立在塞巴洛斯博士在定性方法、文化能力和项目开发方面的指导培训经验之上，为她提供实现成为一名独立研究者进行研究以解决癌症健康差异所需的工具。为了帮助她实现上述目标，她的职业发展计划将包括教学培训（课程，研讨会和讲习班），参加科学会议，手稿开发，提交NIH拨款申请，并由资深科学家直接指导。Ceballos博士将接受她的主要导师Beti Thompson博士以及共同导师Karen Syrjala博士和Anne McTiernan博士的指导。这三位导师都是Fred Hutchinson癌症研究中心（FHCRC）的有成就的科学家，他们在各自的领域中都是杰出的领导者，也是年轻研究者的成功导师。Ceballos博士的培训计划将包括参加FHCRC和华盛顿大学生物医学研究诚信（BRI）系列，负责任研究行为的在线培训，以及公共卫生中的社会和伦理问题的正式课程。