Science of Behavior Change in African American Breast Cancer Survivors

非裔美国乳腺癌幸存者行为改变的科学

• 批准号: 9608280
• 负责人: Chanita A. Hughes-Halbert
• 金额: $ 14.95万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-14 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9608280
• 关键词: Acute; Address; Adherence; Adverse effects; Affect; African American; Behavior; Behavior Control; Behavior Therapy; Behavioral; Behavioral Mechanisms; Biological; Biological Factors; Biological Process; Breast Cancer survivor; Cancer Control; Characteristics; Chronic; Clinical; Cognitive; Data; Development; Diagnosis; Diet; Disease; Disease Outcome; Disease Progression; Early Diagnosis; Economics; Education; Etiology; Event; Exposure to; Glucocorticoids; Guidelines; Health behavior; Histologic; Human; Intervention; Laboratories; Life; Low income; Malignant Neoplasms; Mammary Neoplasms; Modeling; Morbidity - disease rate; Nature; Outcome; Pathway interactions; Physical activity; Physiological; Play; Population; Psychosocial Factor; Rattus; Reaction; Recommendation; Reporting; Research; Risk; Role; Sampling; Science; Self Efficacy; Social Conditions; Social isolation; Stress; Stress Tests; Testing; Treatment Efficacy; Variant; Woman; advanced breast cancer; allostatic load; animal data; base; behavior change; biobehavior; biological adaptation to stress; cancer health disparity; compliance behavior; discount; discounting; executive function; experience; human disease; improved; malignant breast neoplasm; mortality; novel; prospective; psychologic; psychosocial; racial disparity; response; social; social stress; socioeconomics; stress reactivity; stressor; tumor growth

PROJECT SUMMARY Despite increased access to early detection and the availability of more effective therapeutic strategies, African American women continue to experience excess rates of morbidity and mortality from breast cancer. One hypothesis about breast cancer disparities is that social conditions and physiological responses to social stressors influence biological processes that are important to the initiation and progression of disease. This hypothesis is based on data from animal studies which have shown that rats that are exposed to social stressors are likely to develop mammary tumors that are histologically and etiologically similar to those that develop among African American women. The HPA axis plays a central role in regulating the physiological stress response; dysregulation of the HPA has been suggested as a mechanism through which social and biological factors contribute to racial disparities in breast cancer outcomes. Many African Americans experience stressful life events and circumstances, including economic, discriminatory, and other stressors. These social factors may contribute to an increased risk of advanced stage disease, but not all African American women who are exposed to adverse social factors develop advanced stage disease and those who have a limited number of stressors can develop advanced stage breast cancer. This may be because stress reactivity is highly individualized. But, stress reactivity and the association between these responses and cognitive mechanisms and adherence to recommendations for cancer control behaviors and treatment compliance have not been examined among women at increased risk for disparities. Therefore, in response to RFA-RM-17-028, Science of Behavior Change: Use-inspired Research to Optimize Adherence, Behavior Change Interventions, and Outcomes (R21), we propose to examine stress reactivity among African American breast cancer survivors. The specific aims of this exploratory study are to: (1) characterize the nature and distribution of stress reactivity among African American breast cancer survivors based on socioeconomic, clinical, and social stressors; (2) examine the relationship between stress reactivity and cognitive mechanisms (e.g., self-efficacy, temporal discounting, and executive control); and (3) determine the extent to which stress reactivity is associated with adherence to recommendations for cancer control behaviors and treatment compliance. The proposed exploratory study will examine key mechanisms that are central to the Science of Behavior Change Network in a novel population and will identify intervention targets that can be used to improve behavioral compliance in a population that is at risk for poor outcomes after being diagnosed with breast cancer.

项目摘要 尽管提前检测有所增加和更有效的治疗策略的可用性，但非洲 美国妇女继续经历乳腺癌的发病率和死亡率过高。一 关于乳腺癌差异的假设是社会状况和对社会的生理反应 压力源会影响对疾病开始和进展至关重要的生物学过程。这 假设基于动物研究的数据，这些数据表明暴露于社会压力源的大鼠 在组织学和病因上可能会发展与与中间发展的乳腺肿瘤 非洲裔美国妇女。 HPA轴在调节生理压力反应中起着核心作用。 HPA的失调被认为是社会和生物学因素的一种机制 在乳腺癌结局中造成种族差异。许多非裔美国人经历压力很大的生活 事件和情况，包括经济，歧视性和其他压力源。这些社会因素可能 导致高级舞台疾病的风险增加，但并非所有暴露的非洲裔美国妇女 不利的社会因素发展了高级舞台疾病，而压力源数量有限的人 可以发展晚期乳腺癌。这可能是因为压力反应性高度个性化。但， 压力反应性以及这些反应与认知机制之间的关联以及遵守 尚未对癌症控制行为和治疗依从性的建议进行检查 妇女面临差异风险增加。因此，为了回应RFA-RM-17-028，行为科学 更改：使用启发的研究以优化依从性，行为改变干预措施和结果 （R21），我们建议检查非裔美国乳腺癌幸存者的压力反应性。具体 这项探索性研究的目的是：（1）表征非洲压力反应性的性质和分布 美国乳腺癌幸存者基于社会经济，临床和社会压力源； （2）检查 压力反应性与认知机制之间的关系（例如，自我效能感，时间折扣和 执行控制）； （3）确定应力反应性与遵守的程度 癌症控制行为和治疗依从性的建议。拟议的探索性研究将 检查在新的人群中行为改变网络的关键机制， 将确定可用于改善处于危险中的行为依从性的干预目标 被诊断出患有乳腺癌后的不良预后。