Positive Activities for Asian American Cancer Patients and Caregivers

为亚裔美国癌症患者和护理人员开展的积极活动

• 批准号: 10360944
• 负责人: Lilian J Shin-Cho
• 金额: $ 9.87万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-13 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360944
• 关键词: Affect; Age; Asian Americans; Award; Behavior; Behavioral; Cancer Control; Cancer Patient; Capital; Caregiver well-being; Caregivers; Cause of Death; Church; Cognitive; Collaborations; Communities; Competence; Control Groups; Country; Data; Dependence; Development; Diagnosis; Distant; Distress; Elements; Emotional; Enrollment; Environment; Family Caregiver; Family member; Feeling; Friends; Fright; Goals; Home; Household; Human Resources; Individual; Intervention; Interview; Job loss; Language; Learning; Malignant Neoplasms; Mediating; Mediator of activation protein; Mental Depression; Mental Health Services; Mentorship; Methods; Minority Groups; Outcome; Participant; Patients; Personal Satisfaction; Phase; Physical Function; Population; Qualitative Research; Quality of life; Randomized; Reporting; Research; Research Personnel; Research Training; Role; Self Administration; Self Determination; Services; Social Responsibility; Social support; Structure; Testing; Thinking; Training; Work; acceptability and feasibility; cancer care; cancer diagnosis; cancer health disparity; cancer prevention; cancer therapy; community based participatory research; comparison intervention; cooking; cost; cultural competence; design; disparity elimination; experience; family burden; feasibility testing; follow-up; health care disparity; health disparity; health literacy; health related quality of life; improved; inclusion criteria; intervention effect; member; novel; perceived stress; physical symptom; prototype; psychologic; skills; social group; social relationships; social stigma; theories; therapy design; volunteer

PROJECT SUMMARY/ABSTRACT Asian Americans (AAs) are the fastest growing minority group in the U.S., and cancer is the leading cause of death among this group. Although AA who are diagnosed with cancer commonly report fear, distress, and depression, they have been found to utilize mental health services at lower rates than other groups and this may be due to a dearth of culturally-competent services. Prior research on these cancer patients’ lives has focused on barriers associated with health literacy and language proficiency but has ignored unique culture- related challenges that contribute to their poor emotional outcomes. AAs are members of collectivist cultures who view themselves as connected, relational, and belonging to a larger social group. Following changes in physical function and social roles and responsibilities (e.g., job loss) after a cancer diagnosis, individuals may self-perceive that they are a burden on their family members/caregivers. Therefore, the overarching goal of the current proposal is to reduce the burden AA patients may feel they are on their caregivers by designing and testing the feasibility of two positive activity interventions. We expect that contributing to one’s household and outside one’s home will increase health-related quality of life (HRQOL) in AA cancer patients by increasing a sense of relatedness, autonomy, and competence (mediators). In the K99 phase, 30 AAs ages 25-70 and within 1 year of any cancer diagnosis will engage in either: 1) household contribution; 2) outside contribution; or 3) control activities. Quantitative and qualitative (e.g., semi-structured interview, project personnel work logs) data about the successful elements of the interventions will be collected. In collaboration with the mentorship team, AA community members, and clinicians, a prototype of one or both positive activity interventions (household or outside contribution) will be developed for AA cancer patients. In the R00 phase, 118 patients (same inclusion criteria as K99 phase) will be randomized to either the contribution or control group. They will engage in the positive or control activity once per week for 3 months, and outcomes and mediators will be assessed at baseline, 1.5 months (midpoint), 3 months (post-test), and 6 months (follow-up). The trial will: 1) assess the feasibility and acceptability of the household and outside contribution positive activities, 2) develop a prototype of a positive activity intervention (household or outside contribution) for AA cancer patients, 3) assess changes in HRQOL comparing intervention to control patients, and 4) assess mediators of the intervention effects. This proposal introduces a novel, low cost, not stigmatizing, easy to implement, and highly scalable approach not previously tested in AA cancer patients: engaging in positive activities. If found to be successful, this framework for understanding patient-caregiver relationships in AAs can be used to develop other positive activities that will improve and extend the lives of cancer patients from other collectivist cultures. The proposed training plan will be critical in expediting the candidate’s transition into an independent investigator with focused expertise in developing positive activities to eliminate cancer care disparities in AAs.

项目概要/摘要 亚裔美国人 (AA) 是美国增长最快的少数群体，癌症是导致癌症的主要原因 这个群体中的死亡。尽管 AA 被诊断患有癌症的人通常会感到恐惧、痛苦和 研究发现，他们利用心理健康服务的比例低于其他群体，这 可能是由于缺乏具有文化能力的服务。先前对这些癌症患者生活的研究已经 关注与健康素养和语言能力相关的障碍，但忽视了独特的文化- 导致他们不良情绪结果的相关挑战。 AA 是集体主义文化的成员 他们认为自己是有联系的、有关系的并且属于一个更大的社会群体。以下变化 癌症诊断后，个人可能会影响身体机能以及社会角色和责任（例如失业） 自我认为他们是家庭成员/照顾者的负担。因此，该计划的总体目标是 目前的建议是通过设计和 测试两种积极活动干预措施的可行性。我们希望为家庭和 外出活动将通过增加 AA 癌症患者的健康相关生活质量 (HRQOL) 关联感、自主感和能力感（中介）。在K99阶段，30名年龄在25-70岁之间的AA 在诊断出任何癌症后 1 年内，将参与以下任一活动： 1) 家庭捐款； 2）外部贡献； 或 3) 控制活动。定量和定性（例如，半结构化访谈、项目人员工作日志） 将收集有关干预措施成功要素的数据。与导师合作 团队、AA 社区成员和临床医生，一种或两种积极活动干预措施的原型 （家庭或外部捐款）将为 AA 癌症患者开发。在R00阶段，118名患者 （与 K99 阶段相同的纳入标准）将被随机分配到贡献组或对照组。他们会 每周进行一次积极或对照活动，持续 3 个月，结果和中介因素将是 在基线、1.5 个月（中点）、3 个月（测试后）和 6 个月（随访）时进行评估。审判将：1) 评估家庭和外部贡献积极活动的可行性和可接受性，2) 制定 针对 AA 癌症患者的积极活动干预（家庭或外部贡献）的原型，3) 评估干预措施与对照患者的 HRQOL 变化，以及 4) 评估影响因素 干预效果。该提案提出了一种新颖、成本低、不污名化、易于实施、推广性强的方案。 以前未在 AA 癌症患者中测试过的可扩展方法：参与积极的活动。如果发现是 成功后，这个用于理解 AA 中患者与护理人员关系的框架可用于开发 其他将改善和延长来自其他集体主义文化的癌症患者生命的积极活动。 拟议的培训计划对于加快候选人过渡为独立人士至关重要 具有专注于开展积极活动以消除 AA 中癌症护理差异的专业知识的研究者。