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

检查性别作为影响癌症护理健康结果的社会文化变量

• 批准号: 10770121
• 负责人: Areej El-Jawahri
• 金额: $ 16.56万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-19 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10770121
• 关键词: Address; Administrative Supplement; Appointment; Behavior; Belief; Budgets; Cancer Survivor; Cancer Survivorship; Caregivers; Caring; Characteristics; Clinical; Data; Dedications; Dimensions; Disease; Distress; Early Diagnosis; Eligibility Determination; Enrollment; Evolution; Face; Family; Family member; Fatigue; Feasibility Studies; Friends; Funding; Gender; Gender Relations; Goals; Hair; Health; Health Promotion; Healthcare; Heterogeneity; Hospitalization; Hydrocortisone; Individual; Institutional Review Boards; Intervention; Interview; Knowledge; Link; Malignant Neoplasms; Maps; Medical; Mentors; Methods; Monitor; Morbidity - disease rate; Outcome; Pain; Parents; Participant; Pathway interactions; Patient Self-Report; Patients; Personal Satisfaction; Physical Function; Physically Challenged; Population; Protocols documentation; Provider; Psychologist; Randomized; Relaxation Therapy; Research; Research Personnel; Research Support; Resources; Risk; Role; Science; Self Care; Shapes; Strategic Planning; Stress; Support Groups; Surveys; Survivors; Symptoms; Testing; Training; United States National Institutes of Health; Visit; Woman; Women' s Health; Work; acceptability and feasibility; biobehavior; cancer care; cancer therapy; care giving burden; care recipients; career development; caregiving; caregiving research; disorder prevention; emotional distress; experience; follow-up; gender difference; health care service utilization; health difference; health equity promotion; indexing; intervention effect; intervention program; intimate behavior; man; mortality; next generation; novel; parent grant; pilot trial; poor health outcome; primary outcome; programs; promote resilience; randomized trial; recruit; resilience; response; satisfaction; screening; secondary analysis; sex; social culture; stress management; stress resilience; stressor; survivorship; trait; treatment as usual; treatment effect; treatment group

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.

项目总结/摘要 随着早期检测和新型靶向癌症治疗的进展，越来越多的人 为已经完成治愈性治疗的癌症幸存者（“curvivors”）提供支持， 那些患有转移性疾病多年的人（“转移存活者”）。巨蟹座的人际关系 曲线生存者和后生存者都与高压力有关，特别是当个体过渡到后 初始治疗存活率和经验减少与医疗提供者的接触， 医学症状监测以及护理者和护理接受者之间的关系动态的演变。作为 这样，照顾者（伴侣、家庭成员、亲密朋友）可能会为自己的健康而努力满足未满足的需求， 存在和保健利用（例如，参加随访访视、常规医疗筛查）， 支持他们所关心的幸存者尽管女性在这方面的比例很高， 了解在过渡期间癌症对健康的影响可能存在性别差异 到初始治疗后的存活率。现有的干预措施没有同时提供单独的支持， 癌症幸存者和照顾者在这个关键的过渡点;因此，父母R21（“建设弹性 在Curvivors和Metavivors的护理者中：一项初步随机试验，”R21 CA 273785 -01）是高度新颖的 目的是评估压力管理的可行性、可接受性和初步疗效， 弹性训练-放松弹性反应计划（SMART-3RP），同时提供给 不同的癌症护理人员和幸存者群体。根据父母补助金的目标， 行政补充（响应NOT-OD-22-030）将阐明可行性的关键指标， 参与者性别的可接受性。利用定量自我报告和生物行为（即，毛发皮质醇） 数据来自48个癌症护理者-幸存者二元组（N = 96），我们还将分析基线的性别差异 作为社会文化变量映射到性别上的特征（即，性别规范，性别相关特征， 性别关系），以及SMART-3RP对照顾者的初步疗效的性别差异， 幸存者的弹性（主要）和医疗保健利用（次要）。为了丰富定量解释， 分析，我们将在计划的定性离职面谈中增加3个问题，涉及社会文化方面 癌症护理中的性别问题。本行政补充文件将为研究提供及时的支持 小组就干预措施中的性别差异有意义地生成经验性混合方法数据 可行性、可接受性和初步疗效，促进日益增长的妇女健康公平 癌症研究的前景。此外，这项工作将为MPI公园提供一个关键的机会， El-Jawahri支持Lucy Finkelstein-Fox博士，一位由Park博士和El博士指导的有前途的初级研究员， 她的研究项目致力于妇女的健康和癌症生存的亲密关系。