F32 Administrative Supplement for Childcare Costs: Addressing Fertility Information Needs and Fertility-related Distress among Female Adult Survivors of Childhood Cancer

F32 儿童保育费用行政补充：解决儿童癌症成年女性幸存者的生育信息需求和与生育相关的困扰

• 批准号: 10811353
• 负责人: Juliann Stalls
• 金额: $ 0.25万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10811353
• 关键词: Achievement; Address; Administrative Supplement; Adult; Area; Behavior Therapy; Behavioral Model; Biological; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caregivers; Caring; Child; Clinical; Cognitive; Communication; Data; Development; Diagnosis; Distress; Emotional; Evaluation; Feedback; Fellowship; Female; Fertility; Foundations; Future; Gatekeeping; Goals; Grief reaction; Health; Health Benefit; Impairment; Individual; Infertility; Intervention; Interview; Knowledge; Late Effects; Lead; Left; Length; Life; Link; Literature; Malignant Childhood Neoplasm; Malignant Neoplasms; Manuals; Medical; Mental Depression; Modality; Modeling; National Cancer Institute; Ovarian tissue cryopreservation; Patients; Pattern; Phase; Population; Provider; Public Health; Quality of life; Questionnaires; Reporting; Reproductive Health; Research Personnel; Research Priority; Resources; Risk; Risk Estimate; Role; Sampling; Secondary to; Self Efficacy; Sexual Health; Stress; Structure; Survivors; Target Populations; Testing; Time; Training; Universities; Woman; acceptability and feasibility; aged; cancer therapy; career; child bearing; childcare allowance; childhood cancer survivor; combination intervention strategy; cost; design; evidence base; fertility improvement; fertility preservation; flexibility; health knowledge; improved; intervention refinement; motherhood; novel; oocyte cryopreservation; phase 1 study; post intervention; prepuberty; preservation; primary ovarian insufficiency; psychologic; side effect; skills; survivorship; theories; therapy design; therapy development; training opportunity

Impaired fertility is a highly distressing, under-addressed, late effect of cancer and cancer treatment among female adult survivors of childhood cancer. Many female survivors are uncertain about their fertility status and report unmet fertility information needs and fertility-related distress. For those who desire biological children, overestimation of risk for impaired fertility may cause unnecessary emotional and relational distress. Underestimation may lead to a missed opportunity to pursue having biological children due to factors such as premature ovarian insufficiency. Yet, to date, fertility-related information needs and distress remain largely unaddressed in this population. Following the ORBIT Model for behavioral intervention development, the proposed study seeks to design and refine a behavioral intervention to address unmet fertility-related information needs and fertility-related distress among female adult survivors of childhood cancer (aged 18-44). Phase I of the study will involve conducting individual interviews with female adult survivors of childhood cancer (N=20) and medical providers who care for this population (N=10) to inform the development of a preliminary, manualized, intervention. Based on existing literature and feedback from experts in behavioral interventions for cancer survivors, adult survivors of childhood cancer, and infertility, it is anticipated that an intervention combining strategies from Patient Activation Theory and Acceptance and Commitment Therapy will be developed. Intervention development is flexible and will be tailored based on feedback received from stakeholders. In Phase 2, preliminary intervention content will be delivered to a small sample of the target population (N=30). Feasibility and acceptability, as well as examination of pre- to post-intervention patterns of change in intervention targets (primary: fertility health knowledge, fertility-related distress; secondary: psychological flexibility, patient activation, and self-efficacy), will be assessed and utilized to further refine the intervention (e.g., intervention strategies, intervention length, and delivery modality). In line with the National Cancer Institute’s priority research area focused on cancer survivorship, the overall goal of the fellowship is to support Dr. Stalls to develop expertise that will enable her to become a leading clinical researcher in the development and evaluation of behavioral interventions to address reproductive and sexual health late effects among cancer survivors. To do so requires a unique combination of knowledge and skills in the areas of, 1) Reproductive and Sexual Health, 2) Behavioral Intervention Development and Evaluation, and 3) Professional Development. Training in these areas will be accomplished through guidance from expert sponsors and collaborators as well as the many resources and training opportunities offered at Duke University. Completion of this fellowship would not only advance the survivorship literature in this area and propel Dr. Stalls toward her career goals, but help address the significant gap in well-trained clinical researchers who are equipped to address these highly personal and time-sensitive reproductive and sexual health late effects of cancer and cancer treatment.

生育力受损是癌症和癌症治疗的一种非常令人苦恼的、未得到充分解决的后遗症 成年女性儿童癌症幸存者。许多女性幸存者不确定自己的生育状况， 报告未满足的生育信息需求和与生育有关的痛苦。对于那些想要生孩子的人来说， 过高估计生育力受损的风险可能会导致不必要的情绪和关系痛苦。 低估可能会导致错过生孩子的机会，原因包括 早产卵巢功能不全。然而，迄今为止，与生育有关的信息需求和痛苦在很大程度上仍然存在。 在这群人中没有被解决。遵循行为干预发展的轨道模型， 建议的研究试图设计和改进一种行为干预来解决未满足的生育相关信息 成年女性癌症幸存者(18-44岁)的需求和与生育相关的痛苦。第I阶段： 这项研究将涉及对成年女性儿童癌症幸存者(N=20)进行个别采访，并 照顾这一人群(N=10)的医疗提供者告知开发初步的、手册的、 干预。基于现有文献和癌症行为干预专家的反馈 幸存者，儿童癌症的成年幸存者，以及不孕不育，预计联合干预 将从患者激活理论和接受与承诺疗法中制定策略。 干预措施的制定是灵活的，并将根据从利益攸关方收到的反馈进行调整。同相 2、初步干预内容将提供给目标人群中的一小部分样本(N=30)。可行性 和可接受性，以及对干预前后干预目标变化模式的审查 (主要：生育健康知识，生育相关痛苦；次要：心理灵活性，患者 激活度和自我效能)将被评估并用于进一步细化干预(例如，干预 策略、干预时长和交付方式)。与国家癌症研究所的优先研究一致 在专注于癌症生存的领域，该奖学金的总体目标是支持斯托尔斯博士发展专业知识 这将使她成为行为能力发展和评估方面的领先临床研究人员 解决癌症幸存者生殖和性健康后遗症的干预措施。要做到这一点需要 1)生殖和性健康，2)行为方面的知识和技能的独特结合 干预发展与评估；3)专业发展。这些领域的培训将是 通过专家赞助商和合作者的指导以及许多资源和 杜克大学提供的培训机会。完成这一奖学金不仅将推动 这一领域的生存文学，并推动斯图尔斯博士朝着她的职业目标前进，但有助于解决 训练有素的临床研究人员的差距，他们有能力解决这些高度个人化和时间敏感的问题 生殖和性健康癌症的后遗症和癌症治疗。