Building Resiliency Among Survivors of Cancers Diagnosed During Adolescence and Young Adulthood (AYAs): A Relaxation Response Resiliency Program for AYAs (3RP-AYA)

背景：在青春期和青年期（AYA）诊断出的癌症幸存者代表了一个 这是一个独特的幸存者群体，他们容易遭受长期压力和不利的健康后果。 在社会情感和身体发育高峰期接受癌症诊断 变化有可能加剧典型的调整问题，并干扰重要的年龄特异性 里程碑;尽管他们的脆弱性，但缺乏有针对性的计划来帮助AYA管理这些 压力源采用自我报告和客观测量，本研究建议开发和测试的可行性， 可接受性和初步效果的适应，虚拟交付，以证据为基础的计划，放松 反应弹性计划（3RP），9在促进AYA幸存者的压力管理和应对中的作用 癌的具体目标：使用2阶段混合方法，60我们建议：1）调整身心 针对AYA的弹性团体干预（3RP-AYA），旨在减轻压力和促进压力- 治疗后过渡期的管理; 2）进行开放试点（n=8），以测试和完善 3RP-AYA; 3a）在一项初步随机对照试验（n=60）中， 对处于早期阶段的AYA进行虚拟的、基于小组的压力管理计划的初步效果 及3b）探讨收集毛发样本进行检验的可行性及接受程度 通过皮质醇测量的干预相关压力变化。候选人：佩雷斯博士是一名西班牙裔女性， 儿童癌症幸存者是马萨诸塞州总医院/哈佛医学院的讲师。 该提案将为佩雷斯博士提供必要的技能和指导培训，她需要完成她的职业生涯 目标是成为一名独立的调查员，在设计，测试和传播创新， 整合的（即，结合行为和身心技能）干预措施，以改善身心健康 癌症幸存者的结果。辅导：为了支持她的职业目标，佩雷斯博士已经组装了一个 一群成功的受人尊敬的教师，他们在混合方法和身心研究方面拥有专业知识（爱丽舍公园， 博士，公共卫生硕士），行为干预技术，行为科学和研究传播（约瑟夫格里尔， 博士），癌症生存率（克里斯托弗Recklitis，博士，公共卫生硕士，杰弗里胡椒，医学博士，公共卫生硕士），压力和 心理神经免疫学（PNI; John Denninger，MD，PhD）和生物统计学（Yuchiao Chang，PhD）。 培训：通过导师支持，资源丰富的环境，教学培训和研究 佩雷斯博士将实现以下培训目标：1）发展专业知识， 为AYA癌症幸存者设计和测试有针对性的综合干预措施; 2）获得使用技能 行为干预技术（BIT）作为提供和传播行为干预的平台， AYAs; 3）在癌症生存率中发展PNI研究的能力。

BACKGROUND: Survivors of cancers diagnosed during adolescence and young adulthood (AYA) represent a distinct group of survivors who are vulnerable to experiencing chronic stress and adverse health outcomes.1 Receiving a cancer diagnosis during a developmental period marked by peak socioemotional and physical changes has the potential to exacerbate typical adjustment problems and interfere with important age-specific milestones; despite their vulnerability, there are a lack of targeted programs to help AYAs manage these stressors. Using self-report and objective measures, this study proposes to develop and test the feasibility, acceptability and preliminary effects of an adapted, virtually delivered, evidence-based program, the Relaxation Response Resiliency Program (3RP),9 in promoting stress management and coping among survivors of AYA cancers. Specific Aims: Using a 2-phase, mixed methods approach,60 we propose to 1) adapt a mind-body resiliency group intervention for AYAs (3RP-AYA) that is aimed at reducing stress and promoting stress- management during the post-treatment transitional period; 2) conduct an open pilot (n=8) to test and refine the 3RP-AYA; 3a) examine, in a pilot randomized controlled trial (n=60), the feasibility, acceptability, and preliminary effects of a virtual, group-based, stress-management program for AYAs who are in the early stages of survivorship; and 3b) explore the feasibility and acceptability of collecting hair samples to examine intervention-related changes in stress as measured by cortisol. CANDIDATE: Dr. Perez is a Hispanic female childhood cancer survivor who is an instructor at the Massachusetts General Hospital/Harvard Medical School. This proposal will provide Dr. Perez with the requisite skills and mentored training she needs to fulfill her career goals of becoming an independent investigator with expertise in designing, testing, and disseminating innovative, integrative (i.e., combined behavioral and mind-body skills) interventions to improve physical and mental health outcomes among cancer survivors. MENTORING: To support her career goals, Dr. Perez has assembled a successful group of esteemed faculty with expertise in mixed methods and mind-body research (Elyse Park, PhD, MPH), behavioral intervention technology, behavioral science and research dissemination (Joseph Greer, PhD), cancer survivorship (Christopher Recklitis, PhD, MPH, Jeffrey Peppercorn, MD, MPH), stress and psychoneuroimmunology (PNI; John Denninger, MD, PhD), and biostatistics (Yuchiao Chang, PhD). TRAINING: Through the mentorship support, resource-rich environment, didactic training, and research activities afforded by this award, Dr. Perez will achieve the following training aims: 1) To develop expertise in designing and testing targeted integrative interventions for survivors of AYA cancer; 2) To acquire skills in the use of behavioral intervention technologies (BITs) as a platform to deliver and disseminate behavioral interventions for AYAs; and 3) To develop competence in PNI research within cancer survivorship.