The Development and Psychometric Evaluation of the SIRS: A Social Isolation Risk Scale for Survivors of Head and Neck Cancer

头颈癌（HNC）幸存者面临独特的生存挑战（例如，面部毁容）， 往往导致社会孤立。为了解决社会孤立问题并防止相关的负面健康结果， 这对于识别面临社会孤立风险的HNC幸存者至关重要。目前，这些努力因缺乏 筛查工具既足够简单，可以在快节奏的诊所中常规使用， HNC特有的因素，加剧了社会孤立。因此，本建议的总体目的是 制定并进行社会孤立风险量表（SIRS）的初步心理测量评估， 一个简单的筛查工具，用于识别有可能被社会孤立的高危儿童幸存者。目标1：开发SIRS：项目库 generation（1a）：我们的团队将使用归纳和演绎方法来生成一个潜在规模池 项目（即，HNC幸存者社会隔离的原因，一般社会隔离风险因素）， 我们咨询委员会的HNC幸存者成员之间的讨论，以及HNC，社会隔离和 测量，以及文献综述。项目池细化（1b）：我们将通过以下方式细化项目池： 与N = 30名社会孤立的HNC幸存者进行1对1访谈。我们将征求对项目相关性的反馈 （量化等级1至5，数值越高表示相关性越大）、增加/删除项目（项目将 如果70%的被问者赞成增加/删除，则增加/删除），并通过 质量反馈。在1b的结论中，我们将有~16项SIRS（~8项与非物理性相关 社会隔离危险因素和与身体社会隔离危险因素相关的8个项目），进行初步的 目标2b期间的心理测量评估。目标2：管理（2a）并进行初步心理测量 SIRS的评估（2b）。2a.我们将进行为期3个月的纵向研究， SIRS，一项人口统计调查，以及一系列经过验证的社会孤立评估，一般痛苦， 孤独，社会联系，社会期望，和HNC相关的生活质量，N=130 HNC幸存者， 治疗后6个月（T1）和9个月（T2）完成访视。2b.我们将进行初步的 SIRS的心理测量分析，评估项目的属性和SIRS的属性，以及执行 因素分析。根据事先制定的指导方针，我们将选择最后一组项目， SIRS，目标共约10项（约5项与身体危险因素相关，约5项与非身体危险因素相关）。 物理风险因素）。这个项目是（a）重要的，因为它将改善大量（在 至少36%）的HNC幸存者子集，并将作为识别和预防社会孤立的模式 （B）创新，因为它从不同的角度处理问题-侧重于 根本原因（即，社会孤立）的负面结果，而不是负面结果本身。

Head and neck cancer (HNC) survivors have unique survivorship challenges (e.g., facial disfigurement), which often lead to social isolation. To address social isolation and prevent associated negative health outcomes, it is critical to identify HNC survivors at risk for social isolation. Currently, these efforts are hampered by a lack of screening tools that are both sufficiently brief to be used routinely in a fast-paced clinic and capture the risk factors unique to HNC that potentiate social isolation. Hence, the overall purpose of this proposal is to develop and conduct a preliminary psychometric evaluation of the Social Isolation Risk Scale (SIRS), a brief screening tool to identify HNC survivors at risk for social isolation. Aim 1: Develop the SIRS: Item pool generation (1a): Our team will use inductive and deductive methods to generate a pool of potential scale items (i.e., reasons why HNC survivors socially isolate, general social isolation risk factors) through discussions among HNC survivor members of our advisory board, and experts in HNC, social isolation, and measurement, as well as a literature review. Item pool refinement (1b): We will refine the item pool through 1-on-1 interviews with N = 30 socially isolated HNC survivors. We will solicit feedback on item relevance (quantitative scale 1 to 5, higher values indicate more relevance), addition/deletion of items (items will be added/deleted if 70% of those asked endorse addition/deletion), and suggestions for alternative wording via qualitative feedback. At the conclusion of 1b, we will have a ~16-item SIRS (~8 items related to non-physical social isolation risk factors and ~8 items related to physical social isolation risk factors), to undergo preliminary psychometric evaluation during Aim 2b. Aim 2: Administer (2a) and conduct preliminary psychometric evaluation (2b) of the SIRS. 2a. We will conduct a 3-month longitudinal study, in which we will administer the SIRS, a demographic survey, and a battery of validated assessments of social isolation, general distress, loneliness, social connectedness, social desirability, and HNC-related quality of life, to N=130 HNC survivors at their 6-month (T1) and 9-month (T2) post-treatment completion visits. 2b. We will perform preliminary psychometric analyses of the SIRS, evaluating both items’ properties and SIRS’ properties, as well as perform a factor analysis. Based on a priori established guidelines, we will select a final set of items to retain for the SIRS, with the goal of ~10 items in total (~5 items related to physical risk factors and ~5 items related to non- physical risk factors). This project is (a) significant, as it will improve the long-term health of a substantial (at least 36%) subset of HNC survivors and will serve as a model for identifying and preventing social isolation in other at-risk groups; and (b) innovative, as it approaches the problem from a different perspective- focusing on the root cause (i.e., social isolation) of negative outcomes, rather than the negative outcomes themselves.