Social Health, Activity Behaviors, and Quality of Life among Young Adult Cancer Survivors: A Longitudinal Study

年轻癌症幸存者的社会健康、活动行为和生活质量：一项纵向研究

• 批准号: 10579920
• 负责人: Kimberly Ann Miller
• 金额: $ 63.14万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10579920
• 关键词: Accelerometer; Adolescent and Young Adult; Aftercare; Age; Behavior; Breast; Cancer Patient; Cancer Survivor; Characteristics; Childhood; Chronic; Clinical; Complex; Comprehensive Cancer Center; Cross-Sectional Studies; Development; Diagnosis; Disease; Disease-Free Survival; Emotional; Employment; Ethnic Origin; Fostering; Gender; General Population; Health; Health Promotion; Health Status; Hospitals; Impairment; Intervention; Latino; Life; Life Experience; Link; Longitudinal Studies; Los Angeles; Malignant Neoplasms; Measures; Medical; Outcome; Patients; Physical Function; Physical activity; Physically Challenged; Population; Process; Prospective Studies; Quality of life; Questionnaires; Race; Recovery; Reporting; Research; Risk; Risk Behaviors; Risk Factors; Social Functioning; Social Network; Social support; Socioeconomic Status; Structure; Symptoms; Testing; Testis; Thyroid Gland; Time; Treatment-related toxicity; Vulnerable Populations; Well in self; Wrist; actigraphy; cancer diagnosis; cancer therapy; cohort; effective intervention; ethnic diversity; experience; follow-up; high risk; improved; longitudinal design; melanoma; mortality; patient oriented; peer; prospective; recruit; safety net; sedentary; sex; social; social contact; social relationships; sociodemographics; survivorship; young adult; young cancer survivor

Abstract Approximately 70,000 adolescents and young adults are diagnosed with cancer between the ages of 15-39 in the U.S. every year. Due to their age and life stage, the experience of a cancer diagnosis as a young adult (YA) can lead to a cascade of emotional and physical challenges. A key obstacle faced by YA cancer patients is impaired social health, a complex construct that includes perceived social belonging, social support, and social network composition. YA patients report social health challenges such as maintaining existing and forming new social relationships after diagnosis, which may contribute to poor quality of life post-cancer. Diminished social health is a major risk factor for poorer health in the general population and has been found to reduce health-promoting behaviors such as physical activity, in part because of the lack of healthy opportunities and support that social contacts can provide. Cancer patients clearly benefit from greater levels of physical activity and lower levels of sedentary time as these are associated with improved quality of life, longer periods of disease-free survival, and lower mortality. Thus, understanding the relationships between social health, physical activity, and quality of life is critically important for YA cancer patients, as the impaired social health experienced by these patients may reduce their activity levels and endanger long-term health outcomes. The overall hypothesis is that social health in YA is negatively impacted following a cancer diagnosis, and that detriments in social health influence subsequent physical activity behaviors and survivorship quality of life (emotional well-being and physical function). In the proposed study, we will comprehensively prospectively assess social health over 12 months and examine its influence on activity behaviors and quality of life. Assessment will begin proximal to diagnosis when changes in social health are likely to initiate for YA cancer patients, with subsequent follow-ups at 3, 6, and 12 months. This longitudinal design will enable the examination of the dynamic changes in social health during and after therapy and its predictive influence on physical activity and quality of life. The Specific Aims are: Aim 1: we will characterize the trajectories of social health in YA cancer patients and assess their influences on quality of life in survivorship; Aim 2: we will investigate the longitudinal associations between social health and activity behaviors in YA cancer patients and test the mediational and reciprocal relationships between social health, activity behaviors, and quality of life; Aim 3: we will explore demographic and clinical moderators of the relationships between social health, activity behaviors, and quality of life. Understanding the mechanistic processes by which social health impacts activity behaviors and quality of life will inform the development of effective intervention strategies to foster social health and improve healthy survivorship for this at-risk and vulnerable population.

摘要 年，约有7万名15-39岁的青少年和年轻人被诊断患有癌症 美国每年都是如此。由于他们的年龄和生活阶段，年轻时被诊断为癌症的经历 (YA)可能会导致一连串的情感和身体挑战。YA癌症患者面临的关键障碍 是否损害了社会健康，这是一个复杂的结构，包括感知的社会归属感、社会支持和 社交网络构成。YA患者报告了社会健康方面的挑战，如维持现有的和 在确诊后形成新的社会关系，这可能会导致癌症后生活质量下降。 社会健康状况下降是普通人群健康状况较差的主要风险因素，已被发现 减少身体活动等促进健康的行为，部分原因是缺乏健康的 社会联系可以提供的机会和支持。癌症患者明显受益于更高的水平 体力活动和较少的久坐时间，因为这些都与生活质量的提高有关， 无病生存期更长，死亡率更低。因此，理解两者之间的关系 社会健康、体力活动和生活质量对于YA癌症患者来说至关重要，因为他们是弱者 这些患者所经历的社会健康可能会降低他们的活动水平，并危及长期健康 结果。总体假设是YA的社会健康在癌症后会受到负面影响 以及社会健康的危害会影响随后的身体活动行为和 生存质量(情感健康和身体机能)。在建议的研究中，我们会 在12个月内全面前瞻性地评估社会健康状况，并考察其对活动的影响 行为和生活质量。当社会健康发生变化时，将在诊断临近时开始评估 可能开始用于YA癌症患者，随后在3、6和12个月进行随访。这是纵向的 设计将能够检查治疗期间和治疗后社会健康的动态变化，以及 对体力活动和生活质量的预测性影响。具体目标是：目标1：我们将 雅癌患者社会健康发展轨迹及其对生活质量的影响 生存；目标2：我们将调查社会健康和活动之间的纵向联系 对YA癌症患者的行为进行研究，并检验社会健康和社会健康之间的中介和互动关系 活动行为和生活质量；目标3：我们将探索人口统计学和临床调节因素 社会健康、活动行为与生活质量之间的关系。理解机械论 社会健康影响活动行为和生活质量的过程将影响 有效的干预策略，促进社会健康，改善高危人群的健康生存 弱势群体。