Adaptation and Pilot Feasibility of a Psychotherapy Intervention for Latinos with Advanced Cancer

患有晚期癌症的拉丁美洲人心理治疗干预的适应和试点可行性

• 批准号: 10251987
• 负责人: Rosario Costas
• 金额: $ 18.03万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-13 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10251987
• 关键词: Address; Adoption; Advanced Malignant Neoplasm; Anxiety; Area; Behavior Therapy; Behavioral; Cancer Burden; Cancer Center; Cancer Control; Cancer Patient; Cause of Death; Clinic; Clinical; Communities; Cultural Diversity; Data; Diagnosis; Dissemination and Implementation; Distress; Evaluation; Feasibility Studies; Feeling hopeless; Fright; Funding; Future; General Population; Goals; Health; Health Personnel; Home; Incidence; Intention; Intervention; Interview; Language; Latina; Latino; Limited English Proficiency; Linguistics; Malignant Neoplasms; Manuals; Mental Depression; Mental Health; Mental Health Services; Mentors; Meta-Analysis; Methods; Minority; Not Hispanic or Latino; Outcome; Participant; Patient Recruitments; Patients; Personal Satisfaction; Pilot Projects; Population; Positioning Attribute; Probability; Process; Provider; Psychiatric Social Work; Psychotherapy; Public Health; Puerto Rico; Quality of life; Randomized; Randomized Controlled Trials; Reading; Reporting; Research; Research Activity; Research Personnel; Risk; Services; Source; Strategic Planning; Study of Latinos; Testing; Time; Training; Translating; Uncertainty; Underserved Population; United States National Institutes of Health; Ursidae Family; Waiting Lists; acceptability and feasibility; advanced disease; anticancer research; arm; base; cancer health disparity; cancer palliative treatment; cancer therapy; coping; design; disorder prevention; effective intervention; end of life; end of life care; ethnic minority population; experience; hands on research; health disparity; high risk; implementation intervention; implementation science; informant; interest; literacy; malignant breast neoplasm; men; metropolitan; novel; patient oriented; peace; pilot trial; preference; psychologic; psychosocial; public health relevance; research and development; skills; survival disparity; symposium; theories; therapy design; treatment disparity; webinar

PROJECT SUMMARY Latinos are at higher risk of poorer psychological and quality of life outcomes when compared to non-Hispanic white patients and other minority patients and commonly report using spiritual strategies to cope with cancer. Maintaining hope, spiritual well-being and finding meaning in the cancer experience is critical for the adjustment and well-being of advanced cancer patients. However, there are no targeted psychosocial or psychotherapeutic interventions available for Latinos diagnosed with advanced cancer. Meaning-Centered psychotherapy (MCP) is a novel psychotherapeutic intervention designed to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose as they approach the end-of-life. The objective of this study is to culturally adapt and pilot Meaning-Centered Psychotherapy with Spanish-speaking Latinos (MCP-L) diagnosed with advanced cancer. The first aim of this study is to translate and culturally adapt the Meaning Centered Psychotherapy intervention manual guided by the Ecological Validity Framework, based on our previous formative research and with information gathered by interviewing 15 key informants and a pre- pilot of key sections of MCP-L with 10 Spanish-speaking Latinos patients. The second aim is to determine its feasibility and acceptability, and to generate preliminary data on impact (improvement of spiritual well-being, quality of life and reduction of depression, anxiety, and hopelessness) of the culturally adapted version of MCP- L by conducting a randomized controlled pilot trial. My long-term goal is to become an independent clinical researcher and an expert in the cultural adaptation field of psychotherapeutic and psychosocial interventions with minority cancer patients. This application will allow me to acquire the training and mentored research experience and obtain additional training in: (1) Transcreation and cultural adaptation of interventions; (2) Psychotherapy theory research and process research, (3) Mixed methods approaches, (4) Design, implementation and evaluation of randomized controlled trials with Latino patients, and (5) Dissemination and implementation science. I am proposing a mix of guided mentoring, didactic training, coursework, webinars, seminars and tutorials, directed readings, conferences, and hands-on research activities that will facilitate the development of research skills and enable me to gain experience in these areas. This proposal is responsive to the priorities of the NCI Strategic Plan, to study and identify factors contributing to disparities, develop culturally appropriate approaches, and disseminate interventions to overcome health disparities across the cancer control continuum from disease prevention to end-of-life care. The research agenda will allow me to acquire the research skills to become a successful independent investigator in the important field of cultural adaptation of psychosocial interventions for ethnic minority cancer patients. The study findings will be used to submit a competitive NIH R01 application to conduct a large randomized controlled trial of Meaning Centered Psychotherapy with Spanish-speaking patients diagnosed with advanced cancer.

项目总结 与非拉美裔相比，拉丁裔的心理和生活质量更差的风险更高 白人患者和其他少数族裔患者通常报告使用精神策略来应对癌症。 保持希望、精神健康和在癌症经历中找到意义是至关重要的 晚期癌症患者的适应和幸福感。然而，没有有针对性的心理社会或 为被诊断为晚期癌症的拉丁裔人提供心理治疗干预。以意义为中心 心理治疗(MCP)是一种新的心理治疗干预措施，旨在帮助晚期癌症患者 在生命接近尾声时，保持或增强一种意义、和平和使命感。的目标是 这项研究旨在对讲西班牙语的拉美裔人进行文化适应，并引导以意义为中心的心理疗法 L)被诊断为晚期癌症。这项研究的第一个目的是翻译和文化适应 生态效度框架指导下的以意义为中心的心理治疗干预手册 我们之前的形成性研究，以及通过采访15名关键线人和一名预审人员收集的信息 与10名讲西班牙语的拉丁裔患者一起进行MCP-L关键节段的试点。第二个目标是确定其 可行性和可接受性，并生成关于影响的初步数据(改善精神福祉， 生活质量和减少抑郁、焦虑和绝望)的文化适应版本的MCP- L通过进行随机对照的先导试验。我的长期目标是成为一名独立的临床医生 心理治疗和心理社会干预的文化适应领域的研究人员和专家 少数族裔癌症患者。这份申请将使我能够获得培训和指导研究 体验并获得以下方面的额外培训：(1)干预措施的转化和文化适应；(2) 心理治疗理论研究和过程研究，(3)混合方法方法，(4)设计， 拉丁裔患者随机对照试验的实施和评估，以及(5)传播 和实施学。我建议将指导指导、授课培训、课程作业、 网络研讨会、研讨会和教程、定向阅读、会议和实践研究活动 促进研究技能的发展，使我能够在这些领域获得经验。这项建议是 响应NCI战略计划的优先事项，研究和确定造成差异的因素， 制定适合文化的方法，并传播干预措施，以克服各国之间的健康差距 从疾病预防到临终关怀的癌症控制连续不断。研究议程将使我能够 掌握研究技能，在重要的文化领域成为成功的独立调查者 少数民族癌症患者心理社会干预的适应性。这项研究结果将被用于 提交竞争性的NIH R01申请，以进行一项以意向为中心的大型随机对照试验 对被诊断为晚期癌症的西班牙语患者进行心理治疗。