Examining Gender as a Sociocultural Variable Shaping Health Outcomes of Cancer Caregiving

项目摘要/摘要 随着早期发现和新的靶向癌症治疗方法的进步，越来越多的人 为已完成治疗性意向治疗的癌症幸存者(“Curvivors”)以及 那些带着转移性疾病生活多年的人(“后生动物”)。癌症护理关系 Curvivors和Metavivors同样与高压力有关，特别是当个体过渡到后 初步治疗存活率和经验减少了与医疗提供者的接触，继续需要 医疗症状监测，以及照顾者和受照者之间关系动态的演变。AS 这样的照顾者(合作伙伴、家庭成员、亲密朋友)可能会为自己的福祉而挣扎于未得到满足的需求- 和医疗保健利用(例如，参加后续访问、例行医疗保健筛查) 支持他们所关心的幸存者。尽管照看角色由女性担任的比例不成比例，但几乎没有 已知过渡期癌症护理压力对健康影响的性别差异 到初步治疗后的存活率。没有现有的干预措施同时但单独地支持 处于这一关键转折点的癌症幸存者和照顾者；因此，父母R21(建立弹性 在Curvivors和Metavivors的照顾者中：试点随机试验，R21 CA273785-01)是非常新颖的 其目的是评估压力管理的可行性、可接受性和初步效果 弹性培训-松弛弹性响应计划(SMART-3RP)，同时提供给 癌症护理人员和幸存者分别组成不同的小组。在母公司赠款目标的基础上，这 行政补编(针对NOT-OD-22-030)将详细说明可行性和 按参与者性别划分的可接受性。利用量化自我报告和生物行为(如头发皮质醇) 来自48名癌症照顾者-幸存者二人组(N=96)的数据，我们还将分析基线中的性别差异 将性别映射为社会文化变量的特征(即性别规范、与性别有关的特征和 性别关系)，以及SMART-3RP对照顾者的初步疗效的性别差异 幸存者的复原力(主要)和医疗保健利用率(次要)。要丰富对数量的解读 分析，我们将在计划的定性离职面试中增加3个问题，涉及社会文化方面 在癌症护理中的性别。本行政副刊将为研究提供及时的支持 团队将有意义地生成关于干预中性别差异的经验混合方法数据 可行性、可接受性和初步有效性，并促进妇女健康公平的增长 癌症护理研究的现状。此外，这项工作将为MPIS Park和 El-Jwahri支持Lucy Finkelstein-Fox博士，一位有前途的初级调查员，由Park博士和El-Jwahri博士指导- 贾瓦赫里的研究项目致力于女性在癌症生存中的健康和亲密关系。

PROJECT SUMMARY/ABSTRACT With advances in early detection and novel, targeted cancer treatments, a growing number of individuals provide support for cancer survivors who have completed curative intent therapy (“curvivors”) as well as for those who live for many years with metastatic disease (“metavivors”). Cancer caregiving relationships for curvivors and metavivors alike are associated with high stress, particularly as individuals transition to post- initial treatment survivorship and experience decreased contact with medical providers, continued need for medical symptom monitoring, and evolution in relationship dynamics between caregiver and care recipient. As such, caregivers (partners, family members, close friends) may struggle with unmet needs for their own well- being and healthcare utilization (e.g., attendance at follow-up visits, routine healthcare screenings) while supporting the survivor they care for. Though caregiving roles are disproportionately held by women, little is known about possible gender differences in the health impact of cancer caregiving stress during the transition to post-initial treatment survivorship. No existing interventions provide concurrent but separate support for cancer survivors and caregivers at this critical transition point; as such, the parent R21 (“Building Resiliency Among Caregivers of Curvivors and Metavivors: A Pilot Randomized Trial,” R21 CA273785-01) is highly novel in its aim to evaluate the feasibility, acceptability, and preliminary efficacy of the Stress Management and Resiliency Training-Relaxation Resiliency Response Program (SMART-3RP) as delivered concurrently to separate groups of cancer caregivers and survivors. Building upon the aims of the parent grant, this Administrative Supplement (in response to NOT-OD-22-030) will explicate key indices of feasibility and acceptability by participant gender. Leveraging quantitative self-report and biobehavioral (i.e., hair cortisol) data from 48 cancer caregiver-survivor dyads (N = 96), we will also analyze gender differences in baseline characteristics mapping onto gender as a sociocultural variable (i.e., gender norms, gender-related traits, and gender relations), as well as gender differences in preliminary efficacy of the SMART-3RP for caregivers’ and survivors’ resiliency (primary) and healthcare utilization (secondary). To enrich interpretation of quantitative analyses, we will add 3 questions to the planned qualitative exit interviews, regarding of sociocultural aspects of gender in cancer caregiving. This Administrative Supplement will provide timely support for the research team to meaningfully generate empirical mixed-methods data regarding gender differences in intervention feasibility, acceptability, and preliminary efficacy and promote health equity for women in the growing landscape of cancer caregiving research. Further, this work will provide a critical opportunity for MPIs Park and El-Jawahri to support Dr. Lucy Finkelstein-Fox, a promising junior investigator mentored by Drs. Park and El- Jawahri whose research program is dedicated to women’s health and intimacy in cancer survivorship.