Restore: Improving Sexual Outcomes of Gay and Bisexual Prostate Cancer Survivors

恢复：改善同性恋和双性恋前列腺癌幸存者的性结果

• 批准号: 9528534
• 负责人: B R Simon Rosser
• 金额: $ 72.07万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9528534
• 关键词: Address; Aftercare; Anal Sex; Area; Bisexual; Bladder Control; Cancer Survivor; Caregivers; Clinic; Communities; Depressed mood; Exercise; Funding; Gays; Gold; HIV Infections; HIV Seropositivity; Health; Health Status; Heterosexuals; Intervention; Intervention Trial; Interview; Knowledge; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Mental Health; Methods; Monitor; Needs Assessment; Operative Surgical Procedures; Oral Sex; Outcome; Participant; Patients; Pelvic floor structure; Pharmaceutical Preparations; Physiological; Population; Prostate Cancer therapy; Publications; Quality of life; Radical Prostatectomy; Randomized Controlled Trials; Rehabilitation Outcome; Rehabilitation therapy; Reporting; Research; Research Methodology; Science; Sex Functioning; Sexual Dysfunction; Sexual and Gender Minorities; Social support; Source; Structure; Survivors; Testing; Time; Urinary Incontinence; Vacuum Pumps; Vagina; Work; arm; base; biopsychosocial; clinical practice; community center; comparative; condoms; demographics; design; evidence base; experience; health disparity; improved; interest; man; men; men who have sex with men; primary outcome; programs; recruit; rehabilitative care; response; routine care; same-sex partnership; sex; standard of care; treatment center; treatment effect; treatment program; urinary; web site

Abstract: This application, in response to PA-15-261, “Research leading to interventions to ameliorate health disparities of sexual and gender minorities”, advances research in three areas. First, prostate cancer (PCa) is the second most common cancer among gay, bisexual, and other men who have sex with men (GBM), with documented disparities, yet it is severely under-researched. Because gay sex differs from vaginal sex, physiologically; the results from 614 studies focused on heterosexual men likely do not generalize to GBM with PCa. There have been no rehabilitation studies specific to GBM survivors of PCa, so clinicians have no relevant studies to inform best practice with their GBM patients. Second, most PCa studies have tested one or rehabilitation components. We will conduct the first treatment study of a state of clinical practice comprehensive rehabilitation program on GBM's quality of life, including on both urinary and sexual function and bother measures. Third, almost all PCa studies have focused on men recently treated for PCa. We will study both GBM recently treated (last 2 years) and GBM post-treatment (2+ years), using a stratified design. This study builds on our findings in Restore, an R21 which was only the second study of GBM with PCa to be funded by NCI, and the first to reach publication. We conducted N=41 in-depth qualitative interviews with good saturation, and the largest quantitative study of GBM with PCa to date (N=193), the first needs assessment of GBM with PCa, and the first study of same sex partners and care-givers of GBM. Participants described radical prostatectomy as leaving them “humiliated,” “maimed”, “less than other gay men,” and “severely depressed.” Most (88%) reported ongoing sexual challenges contributing to decreased quality of life, poorer mental health, identity challenges and deteriorated primary relationships. Only three of the eight (38%) outcomes commonly experienced by most GBM were discussed as part of treatment. There was no evidence of any standard of professional rehabilitation; indeed, most GBM just treated themselves. The long-term objective of this research is to improve the health of GBM survivors of PCa and to provide an evidence base for rehabilitation. In Aim I, we will develop an online rehabilitation program tailored for GBM that addresses both the sexual and urinary effects of PCa treatment. In Aim II, we will conduct a comparative recruitment study to identify best methods to recruit 450 GBM with PCa. In Aim III, we will evaluate the effects of the tailored rehabilitation program on sexual and urinary outcomes. We will conduct a 24 month, randomized controlled trial of structured rehabilitation versus routine care. This RCT will identify whether a structured rehabilitation program is effective in addressing the major sexual and urinary problems caused by PCa treatment. As the first treatment study to focus on GBM with PCa (and also on oral and anal sex), it addresses a long-standing health disparity. The study has high potential to transform rehabilitation for GBM with PCa, provide a critical evidence base for clinicians, and inform rehabilitation outcomes for all PCa survivors.

摘要：此应用程序，响应PA-15-261，“研究导致改善健康的干预措施 性别和性别少数群体的差异”，在三个领域进行研究。首先，前列腺癌（PCA）是 同性恋，双性恋和其他与男性发生性关系（GBM）的男女同性恋中第二常见的癌症 记录的分布，但严重研究了。因为同性恋与阴道性别不同，所以 身体上来自异性恋男性的614项研究的结果可能不会概括为GBM 没有针对PCA的GBM表面的康复研究，因此临床医生没有 相关的研究以告知与GBM患者的最佳实践。其次，大多数PCA研究都测试了一个或 康复组件。我们将对临床实践状态进行首次治疗研究 GBM生活质量的全面康复计划，包括尿和性功能 以及这两个措施。第三，几乎所有PCA研究都集中在最近接受过PCA治疗的男性上。我们将 使用分层设计的GBM最近接受了GBM治疗（最近两年）和GBM治疗后（2年以上）。 这项研究基于我们在Restore的发现，这是R21，这只是对PCA的GBM的第二项研究 由NCI资助，也是第一个出版的人。我们进行了n = 41个深入的定性访谈 良好的满意度，以及迄今为止PCA的GBM最大的定量研究（n = 193），第一个需求 使用PCA评估GBM，以及对GBM的同性性伴侣和护理人员的首次研究。参与者 描述的根治性前列腺切除术使它们“受羞辱”，“残疾”，“比其他同性恋者少”，并且 “严重沮丧。”大多数（88％）报告持续的性挑战导致生活质量下降， 精神健康，身份挑战和确定的主要关系较差。八个（38％）中只有三个 作为治疗的一部分，讨论了大多数GBM通常经历的结果。没有证据 任何专业康复标准的标准；确实，大多数GBM只是对待自己。 这项研究的长期目的是改善PCA的GBM表面状况，并提供 康复的证据基础。在AIM I中，我们将制定一项针对GBM量身定制的在线康复计划 解决PCA治疗的性和尿液影响。在AIM II中，我们将进行比较 招聘研究以确定使用PCA招募450 GBM的最佳方法。在AIM III中，我们将评估效果 量身定制的有关性和尿液结果的康复计划。我们将进行24个月的随机 结构化康复与常规护理的对照试验。此RCT将确定是否结构化 康复计划可有效解决PCA引起的重大性和尿液问题 治疗。作为第一个专注于使用PCA（以及口服和肛交）GBM的治疗研究，它解决了 长期存在的健康差异。该研究具有通过PCA转化GBM康复的很高潜力 为临床医生提供关键的证据基础，并为所有PCA存活率提供康复结果。