Mental Health CPR: Transforming Cancer Survivors' Mental Health with Community Participatory Reach for Equity

心理健康心肺复苏：通过社区参与实现公平，改变癌症幸存者的心理健康

• 批准号: 10627065
• 负责人: GUILLERMO N ARMAIZ-PENA
• 金额: $ 100.63万
• 依托单位: PONCE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627065
• 关键词: Academia; Address; Adverse event; Anxiety; Bankruptcy; Behavior; Biological; Biological Markers; COVID-19 pandemic; Cancer Patient; Cancer Survivor; Caregiver support; Caring; Case Management; Catecholamines; Chemoresistance; Chronic; Chronic stress; Clinical; Clinical Research; Clinical Trials; Communication; Communities; Community Health; Community Health Aides; Community Services; Data Collection; Diagnosis; Disease Progression; Distress; Earthquakes; Economics; Equity; Event; Exposure to; Face; Family; Family Caregiver; Financial Hardship; Government; Health; Health Personnel; Health Sciences; Health system; Healthcare Systems; High Prevalence; Hispanic; Hispanic Populations; Hurricane; Hydrocortisone; Individual; Inequality; Inequity; Inflammation; Institute of Medicine (U.S.); Institution; Intervention; Job loss; Location; Malignant Neoplasms; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mental health promotion; Natural Disasters; Not Hispanic or Latino; Oncology; Outcome; Personal Satisfaction; Phase; Physiological; Politics; Population; Poverty; Prevention; Psychological Stress; Publishing; Puerto Rican; Puerto Rico; Recommendation; Reporting; Research; Research Personnel; Resources; Role; Rural; Services; Social Justice; Specialist; Stress; Survivors; Training; United States; Universities; anxiety symptoms; biobehavior; chemokine; community intervention; cytokine; depressive symptoms; empowerment; experience; geographic disparity; health care quality; health care service; health disparity; health inequalities; hypothalamic-pituitary-adrenal axis; implementation intervention; inflammatory marker; innovation; insight; intervention effect; member; migration; prevent; psychologic; psychological distress; psychosocial; screening; skills; social; social disparities; social factors; social stigma; socioenvironmental factor; structural determinants; systematic review; systemic inflammatory response; underserved community

PROJECT SUMMARY Hispanic cancer patients and survivors face social and structural inequalities perpetuating mental health disparities. Despite these challenges, the study team and community partners are convinced that psychosocial and mental health inequities perpetrated by socio-environmental factors can be overcome through community- based multilevel interventions; yet none currently exist. This project is highly transformative and innovative because it disrupts traditional psycho-oncology mental health care to address upstream structural (limited access to psychosocial and mental health inequities and psychological distress screening), social (mental health stigma), and biological (stress and inflammation biomarkers) determinants of mental health among Hispanic cancer patients and survivors. This transformation will be achieved by simultaneously integrating grassroots (community leaders) and top-down (institutional) resources to increase access to specialized psycho-oncology mental health care services and psychological distress screening while eradicating mental health stigma. First, the team will train lay community leaders to become community health workers addressing psycho-oncology mental health prevention efforts. Second, the investigators, along with community stakeholders, will package the proposed multilevel community-based intervention by integrating and adapting a suite of individual/community interventions and service initiatives previously developed and implemented by members of the research team and proven to positively impact Puerto Rican Hispanic cancer patients and survivors’ psychosocial and mental health wellbeing. At the community level, the team will first train lay community leaders to become community mental health workers through the PHSU-RCMI Community Training Institute for Health Disparities. At the interpersonal level, the community-based intervention will integrate family-communications skills to impact Hispanic cancer patients' and survivor family caregivers’ support quality. At the individual level, the intervention will impact all phases of the mental health prevention continuum to prevent and address psychological distress resulting from cancer and its treatment. At the biological level, investigators will assess the effect of the community intervention on psychological stress biomarkers (cortisol and catecholamine metabolites) and inflammation markers (cytokines and chemokines) related to chronic stress and cancer health outcomes. The team anticipates this project will push a transformative population-level impact through a multilevel approach that empowers communities to understand and address mental health among individuals.

项目总结 拉美裔癌症患者和幸存者面临着持久的心理健康的社会和结构性不平等 差距。尽管有这些挑战，研究团队和社区合作伙伴相信，心理社会 而社会环境因素造成的精神健康不平等，可以通过社区- 以多层次干预为基础的；但目前还不存在。该项目具有很强的变革性和创新性 因为它扰乱了传统的心理肿瘤学心理健康护理，以解决上游结构性问题(机会有限 到心理社会和心理健康不平等和心理痛苦筛查)、社会(心理健康 西班牙裔心理健康的决定因素(污名)和生物学(应激和炎症生物标记物) 癌症患者和幸存者。这一转变将通过同时整合基层实现 (社区领导人)和自上而下的(机构)资源，以增加获得专门的心理肿瘤学的机会 精神卫生保健服务和心理疾病筛查，同时消除心理健康污名。第一, 该小组将培训非专业社区领导人成为社区卫生工作者，解决精神肿瘤学问题 心理健康预防工作。其次，调查人员将与社区利益攸关方一起打包 通过整合和调整一套个人/社区建议的基于社区的多层次干预 以前由研究小组成员制定和实施的干预措施和服务倡议 并被证明对波多黎各拉美裔癌症患者和幸存者的心理社会和心理产生积极影响 健康幸福。在社区层面，团队将首先培训非专业社区领袖成为社区领袖。 精神卫生工作者通过PHSU-RCMI健康差距社区培训研究所。在 在人际层面，以社区为基础的干预将整合家庭沟通技能以影响 拉美裔癌症患者和幸存者家庭照顾者的支持质量。在个人层面上，干预 将影响预防心理健康的所有阶段，以预防和解决心理困扰 由癌症及其治疗引起的。在生物层面上，研究人员将评估 心理应激生物标志物(皮质醇和儿茶酚胺代谢物)的社区干预 炎症标记物(细胞因子和趋化因子)与慢性应激和癌症健康结局有关。这个 团队预计该项目将通过多层次的方法推动人口层面的变革性影响 这使社区能够了解和解决个人的心理健康问题。