African American Families Fighting Parental Cancer Together

非裔美国家庭共同抗击父母癌症

• 批准号: 10238130
• 负责人: ADAM DAVEY
• 金额: $ 63.15万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10238130
• 关键词: Address; Adolescent; Adult; African American; Aftercare; Age; Anxiety; Attitude; Behavior; Breast; Cancer Center; Cancer Etiology; Cancer Patient; Caucasians; Child; Child Rearing; Clinical; Cognition; Colon; Colorectal; Communication; Cultural Sensitivity; Depressed mood; Development; Diagnosis; Diagnostic Neoplasm Staging; Distress; Emotional; Ethnic group; Family; Gender; Home; Illness impact; Income; Intention; Intervention; Life; Low income; Lung; Malignant Neoplasms; Marital Status; Mediating; Mission; Nature; Newly Diagnosed; Not Hispanic or Latino; Outcome; Parent-Child Relations; Parental Ages; Parents; Participant; Patients; Population; Population Intervention; Prevention program; Prostate; Race; Randomized; Research; Sampling; School-Age Population; Socioeconomic Status; Solid Neoplasm; Stress; Support Groups; Time; United States; Vulnerable Populations; Youth; base; cancer health disparity; child depression; comparative efficacy; control trial; coping; daily functioning; depressive symptoms; design; efficacy evaluation; emotional distress; experience; fighting; follow-up; high risk; improved; improved outcome; inner city; intervention program; psychoeducation; psychoeducational intervention; public health relevance; recruit; stressor; treatment as usual; treatment effect

 DESCRIPTION (provided by applicant): In 2015, an estimated 340,000 parents of school age children will be newly diagnosed with cancer in the U.S. Parental cancer causes significant emotional distress in both diagnosed parents and children. African American (AA) adults experience a disproportionate burden of solid tumor cancers (e.g., breast, prostate, lung, and colon) which puts AA adolescents, a vulnerable population to begin with, at high risk for parental cancer related distress. Treatments have been somewhat successful for younger school age children (ages 7-12) of cancer patients but most treatment studies have included white middle class samples. Differences in attitudes, daily functioning and levels of distress among different ethnic and racial groups are well-documented, yet few culturally sensitive family intervention programs have been developed for AA families coping with cancer. Building on the PI's previous studies with AA families coping with parental cancer, we propose to conduct a randomized control trial to address this gap. We will of a culturally sensitive family-based intervention that targets the parent child relationship in AA families coping with the impact of solid tumor parental cancer. We will randomize 172 AA families coping with parental cancer to either Families Fighting Cancer Together (FFCT) or to parent psycho-education (TAU). Both manualized treatments include 5 bi-monthly sessions over 10 weeks. Subjects will be African American parents diagnosed for the first time in the past 12 months with Stage I, II, or III solid tumor cancers with at least one child between the ages of 12 and 18 living at home. Patients will be recruited from 3 large inner city cancer centers where there is an estimated 500 eligible low to middle income AA cancer patients a year. Family assessments will be done at baseline, post-treatment (10 weeks), 6-month, and 12-month follow-up. The proposed R01 research has the following aims: Aim 1: Compare the efficacy of FFCT to TAU in reducing depressive symptoms (CDI) and anxiety (RCMAS) in AA adolescents at post-treatment and long term outcome (6 and 12-month follow-up). Aim 2: Compare the efficacy of FFCT to TAU in reducing parental stress (PCQ: impact of illness on child/concerns about parenting) in AA parents at post-treatment and long term outcome (6 and 12-month follow-up). Exploratory Aims: 1. Explore whether moderators identified in Caucasian samples have a similar impact on treatment in AA samples. Specifically, we will examine: a) perceived level of group support, b) gender and age of adolescent, c) parent's marital status, d) SES, and e) stage of parent's cancer on the impact of treatment. 2. Explore whether changes in parent-child attachment and communication mediate the association between treatment and depressive symptoms (CDI) and anxiety (RCMAS) at 6 and12-month follow-up. Treatments to help adolescents cope with the impact of parental cancer are urgently needed, particularly those designed to reach low-income AA populations. Developing effective and transportable family-based interventions for this population could improve developmental adjustment to this significant life stressor at a critical point in the livesof adolescents.

 描述（由申请人提供）：在2015年，估计有340，000名学龄儿童的父母将在美国新诊断出患有癌症。非裔美国人（AA）成年人经历不成比例的实体瘤癌症负担（例如，乳腺、前列腺、肺和结肠），这使得AA青少年，一个开始就很脆弱的人群，处于与父母癌症相关的痛苦的高风险中。对于癌症患者的学龄儿童（7-12岁），治疗已经取得了一定的成功，但大多数治疗研究包括白色中产阶级样本。不同民族和种族群体之间的态度，日常功能和痛苦程度的差异是有据可查的，但很少有文化敏感的家庭干预计划已开发的AA家庭应对癌症。基于PI先前对AA家庭应对父母癌症的研究，我们建议进行一项随机对照试验来解决这一差距。我们将采取具有文化敏感性的以家庭为基础的干预措施， 目的探讨实体瘤对再障家庭亲子关系的影响 癌我们将172个AA家庭应对父母癌症随机选择家庭一起抗癌（FFCT）或父母心理教育（TAU）。这两种手动治疗包括5个双月的会议超过10周。受试者将是在过去12个月内首次被诊断患有I、II或III期实体瘤癌症的非裔美国人父母，至少有一名12至18岁的儿童住在家中。患者将从3个大型内城癌症中心招募，估计每年有500名符合条件的中低收入AA癌症患者。将在基线、治疗后（10周）、6个月和12个月随访时进行家庭评估。拟议的R 01研究有以下目的：目的1：比较FFCT与TAU在治疗后和长期结局（6个月和12个月随访）时减少AA青少年抑郁症状（CDI）和焦虑（RCMAS）的疗效。目标二：在治疗后和长期结局（6个月和12个月随访）时，比较FFCT与TAU在减轻AA父母压力（PCQ：疾病对儿童的影响/对养育的担忧）方面的疗效。探索目标：1.探索在高加索人样本中确定的调节因子是否对AA样本中的治疗有类似的影响。具体而言，我们将研究：（a）团体支持知觉水平、（B）青少年性别及年龄、（c）父母婚姻状况、（d）社会经济地位、（e）父母癌症分期对治疗的影响。2.探讨在6个月和12个月的随访中，亲子依恋和沟通的变化是否介导了治疗与抑郁症状（CDI）和焦虑（RCMAS）之间的关联。迫切需要帮助青少年科普父母癌症影响的治疗，特别是那些旨在帮助低收入AA人群的治疗。为这一人群制定有效和可移动的家庭干预措施，可以在青少年生活的关键时刻改善对这一重大生活压力源的发展调整。