Disparities in Chronic Stress, QOL, and Physical Activity among Black and White Breast Cancer Survivors

黑人和白人乳腺癌幸存者在慢性压力、生活质量和体力活动方面的差异

• 批准号: 10013185
• 负责人: Teletia Renee Taylor
• 金额: $ 6.85万
• 依托单位: HOWARD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-09 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10013185
• 关键词: Accelerometer; Accounting; Aerobic Exercise; Affect; African American; Age; Behavioral; Blood; Breast Cancer Risk Factor; Breast Cancer survivor; Cancer Survivor; Chronic; Chronic stress; Crime; Data; Environment; Event; Exercise; Family; Fatigue; Female Breast Carcinoma; Frequencies; Fright; Goals; Guidelines; Health; High Prevalence; Housing; Immunologic Markers; Lead; Life; Life Stress; Longitudinal Studies; Malignant Neoplasms; Measurement; Measures; Mediating; Mediator of activation protein; Metabolic Marker; Methods; Neighborhoods; Not Hispanic or Latino; Observational Study; Occupations; Patient Self-Report; Personal Satisfaction; Physical Function; Physical activity; Physiological; Psychosocial Stress; Quality of life; Race; Recurrence; Reporting; Role; Services; Severities; Social Functioning; Stage at Diagnosis; Stress; Stressful Event; Summary Reports; Survivors; System; Time; Violence; Woman; Work; active method; allostatic load; anticancer research; behavioral response; breast cancer diagnosis; cancer subtypes; exercise intensity; health related quality of life; hormone therapy; improved; indexing; inflammatory marker; lifestyle factors; light weight; malignant breast neoplasm; physical conditioning; physical inactivity; racial health disparity; recruit; repaired; sedentary; sedentary lifestyle; stem; survivorship; systematic review; total energy expenditure; vigorous intensity

Project Summary: Reports indicate Black breast cancer survivors have poorer health-related quality of life (HRQOL) than Whites, although some studies suggest that Blacks have higher spiritual well-being. Several factors contribute to these racial disparities in HRQOL. Data show that chronic life stress negatively impacts HRQOL. Chronic life stress is defined as chronic psychosocial stress stemming from concerns about money, housing, job condition, neighborhood environment, family situation, public services, crime and violence. Studies indicate a higher prevalence of major life events for Blacks than Whites. In addition to chronic life stress, cancer-specific stress (e.g. fear of recurrence) also affects HRQOL in breast cancer survivors. However, studies on HRQOL have primarily focused on one measurement and longitudinal studies in Black breast cancer survivors measuring stress and HRQOL at multiple time points have not been conducted. Physical activity is a key lifestyle factor in healthy survivorship and better HRQOL after breast cancer. Despite data supporting physical activity's beneficial effect on chronic stress and quality of life, a lower percentage of African-American women meet recommended guidelines for aerobic activity compared to Non-Hispanic Whites. The cumulative burden of chronic stress and adverse behavioral responses (e.g. physical inactivity), may lead to increased “wear and tear” on the body's regulatory system, and exceed the body's ability to repair its physiological systems. This pathophysiological mechanism, known as allostatic load, is a marker of chronic stress and is influenced by the frequency and severity of stressful events. Allostatic load is quantified through measurement of multiple physiological indicators, including metabolic, immune and inflammatory markers. Understanding how allostatic load mediates the relationship between perceived chronic stress (life stress and cancer-specific stress), physical activity and HRQOL differentially among Black and White breast cancer survivors has not been determined. Our primary goal is to investigate if chronic stress and physical activity are associated with HRQOL and racial disparities in HRQOL among breast cancer survivors; and whether these associations are mediated by allostatic load. Among Black and White female breast cancer survivors, our aims are to: AIM 1: Investigate the longitudinal relationship between perceived chronic stress (life stress and cancer-specific stress) and HRQOL. AIM 2: Investigate the longitudinal relationship between objectively-measured physical activity and HRQOL. AIM 3: Investigate whether allostatic load is a mediator of the effects of chronic stress and physical activity (total energy expenditure, duration, and sedentary behavior) on HRQOL. !

报告显示，黑人乳腺癌幸存者的健康相关生活质量较差 （HRQOL）比白人，虽然一些研究表明，黑人有更高的精神福祉。几 这些因素导致HRQOL的种族差异。数据显示，慢性生活压力对 HRQOL。慢性生活压力被定义为源于对金钱的担忧的慢性心理社会压力， 住房、工作条件、邻里环境、家庭状况、公共服务、犯罪和暴力。 研究表明，黑人的主要生活事件发生率高于白人。除了慢性生活 压力、癌症特异性压力（例如对复发的恐惧）也会影响乳腺癌幸存者的HRQOL。 然而，对HRQOL的研究主要集中在一个测量和黑人的纵向研究， 乳腺癌幸存者在多个时间点测量压力和HRQOL尚未进行。 身体活动是乳腺癌后健康生存和更好HRQOL的关键生活方式因素。尽管 数据支持体育活动对慢性压力和生活质量的有益影响， 与非西班牙裔相比，非洲裔美国妇女符合推荐的有氧活动指南 白人慢性压力和不良行为反应的累积负担（如缺乏体力活动）， 可能导致身体调节系统的“磨损”增加，并超过身体的修复能力 它的生理系统这种病理生理机制，称为非稳态负荷，是一个标志， 慢性压力，并受到压力事件的频率和严重程度的影响。非稳态负荷被量化 通过测量多个生理指标，包括代谢、免疫和炎症 标记。了解非稳态负荷如何调节感知慢性压力（生活） 应激和癌症特异性应激）、体力活动和HRQOL在黑人和白色乳腺之间差异 癌症幸存者尚未确定。我们的主要目标是调查慢性压力和身体 活动与乳腺癌幸存者的HRQOL和HRQOL的种族差异相关;以及 这些关联是否由非稳态负荷介导。黑人和白色女性乳腺癌 目的1：探讨慢性应激与慢性应激反应的纵向关系 (life应激和癌症特异性应激）和HRQOL。目的2：研究 客观测量的身体活动和HRQOL。目的3：研究非稳态负荷是否是一种介导剂， 慢性压力和体力活动的影响（总能量消耗、持续时间和久坐行为） 关于HRQOL !