Culturally Adapted Cognitive Behavioral Stress and Self-Management (CCBSM)

文化适应认知行为压力和自我管理（CCBSM）

• 批准号: 10204908
• 负责人: MICHAEL Howard ANTONI
• 金额: $ 32.91万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10204908
• 关键词: Accounting; Acculturation; Address; Aftercare; Atlas of Cancer Mortality in the United States; Attention; Attitude; Behavioral; Breast Cancer survivor; Cancer Survivor; Cause of Death; Chicago; Chronic; Cognitive; Diagnosis; Disadvantaged; Discrimination; Disease; Emotional; Evidence based treatment; Family; Fatigue; Functional disorder; Gender Role; Gene Expression; Glucocorticoid Receptor; Glucocorticoids; Health; Hispanics; Impairment; Inflammation; Inflammatory; Intervention; Intestines; Knowledge; Lead; Linguistics; Lipids; Longterm Follow-up; Malignant neoplasm of prostate; Mediating; Mediator of activation protein; Methodology; Minority Groups; Modeling; Molecular; Neuroimmune; Neuroimmunomodulation; Nonmetastatic; Not Hispanic or Latino; Operative Surgical Procedures; Outcome; Pain; Pathway interactions; Patients; Physical Function; Physiological; Physiological Adaptation; Pilot Projects; Population; Process; Radiation; Radiation therapy; Randomized; Recovery; Regulation; Reporting; Research Design; Resistance; Sample Size; Self Management; Severity of illness; Social Functioning; Specificity; Stress; Survival Rate; Survivors; Symptoms; Testing; Time; Translating; Translations; Treatment Side Effects; Well in self; Work; active method; affective disturbance; base; behavioral clinical trial; bilingualism; cancer diagnosis; cardiometabolism; cytokine; design; effectiveness evaluation; efficacy testing; ethnic minority population; fasting glucose; health related quality of life; improved; intimate behavior; leukocyte activation; male; men; post intervention; primary outcome; prostate cancer survivors; psychological distress; psychosocial; receptor sensitivity; reduce symptoms; side effect; social culture; stress management; symptomatic improvement; treatment comparison; urinary

Project Summary:This 5-year study evaluates the effects of a 10-week group-based linguistically translated and culturally adapted cognitive-behavioral stress and self management (C-CBSM) intervention on symptom burden and health related quality of life (HRQOL) in Hispanic men treated for localized prostate cancer (PC). About 80% PC cases are diagnosed as early disease and have a 5- and 10-year survival rate of almost 100% and 99%, respectively. Most patients receive active treatment (~70%) leading to prolonged treatment-related side effects and dysfunction persisting well beyond primary treatment. Survival is offset by chronic side effects such as sexual and urinary dysfunction, pain and fatigue that can lead to poor psychosocial functioning, impaired intimacy and social functioning, and masculinity concerns. Hispanic PC survivors report lower physical and social functioning, poorer emotional well-being and greater sexual and urinary dysfunction, even after accounting for SES and disease severity. This sequela can lead to elevated glucocorticoid release and inflammatory cytokines that have a direct effect on these symptoms and can interfere with physiological pathways necessary for recovery of sexual and urinary functioning. We have shown that CBSM reduces symptom burden and improves HRQOL in bilingual Hispanic PC survivors. In a pilot we showed that a linguistic translation of CBSM with attention to sociocultural processes improved symptom burden and HRQOL in Spanish monolingual PC survivors. We have also shown that CBSM is associated with reduced glucocorticoid resistance and inflammatory gene expression pathways in breast cancer survivors. We propose to (a) deliver a culturally adapted C-CBSM intervention in Spanish that places greater emphasis on salient sociocultural determinants of symptom burden and HRQOL in Hispanics (e.g., fatalistic attitudes, family interdependence, perceived discrimination, machismo), (b) incorporate a neuroimmune model of symptom regulation and management, and (c) test the efficacy of C-CBSM, relative to standard non-culturally adapted CBSM, in two diverse Hispanic communities (Chicago & Miami). We will test our aims in 260 Hispanic men post-treatment for localized PC with elevated symptom burden in a 2 x 4 randomized design with condition (C- CSBM vs. CBSM) as the between groups factors, and time (baseline, post-intervention & 6- and 12-months post baseline) as the within groups factor. Our Primary Aim is to determine whether randomization to C- CBSM, relative to standard CBSM, is associated with reduced symptom burden and improved HRQOL. Our Secondary Aims evaluate whether C-CBSM leads to greater improvements in the intervention targets (e.g., stress management, psychological distress & interpersonal disruption), and physiologic adaptation (i.e., glucocorticoid receptor sensitivity & inflammatory gene expression). We will also evaluate psychosocial and physiological mechanisms as mediators of C-CBSM's effects on our primary outcomes. We will explore moderators (e.g., SES, Hispanic origin) of C-CBSM's effect and C-CBSM's effects on cardiometabolic health.

项目概述：这项为期5年的研究评估了为期10周的以小组为基础的语言翻译的效果

项目成果

Stress Management Interventions to Facilitate Psychological and Physiological Adaptation and Optimal Health Outcomes in Cancer Patients and Survivors.

• DOI: 10.1146/annurev-psych-030122-124119
• 发表时间: 2023-01-18
• 期刊: ANNUAL REVIEW OF PSYCHOLOGY
• 影响因子: 24.8
• 作者: Antoni, Michael H.;Moreno, Patricia I.;Penedo, Frank J.
• 通讯作者: Penedo, Frank J.

Association between real-world experiential diversity and positive affect relates to hippocampal-striatal functional connectivity.

• DOI: 10.1038/s41593-020-0636-4
• 发表时间: 2020-07
• 期刊: NATURE NEUROSCIENCE
• 影响因子: 25
• 作者: Heller, Aaron S.;Shi, Tracey C.;Ezie, C. E. Chiemeka;Reneau, Travis R.;Baez, Lara M.;Gibbons, Conor J.;Hartley, Catherine A.
• 通讯作者: Hartley, Catherine A.