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.

项目摘要 西班牙癌症患者和冲浪者面临社会和结构性不平等，使心理健康永存 差异。尽管面临这些挑战，研究团队和社区伙伴都确信会心理社会 以及通过社区可以克服社会环境因素所实施的心理健康不平等 - 基于多级干预措施；但是目前没有。该项目具有高度变革性和创新性 因为它破坏了传统的心理肿瘤心理保健来解决上游结构（有限的访问 进行心理和心理健康不平等和心理困扰筛查），社会（心理健康 污名）和生物学（压力和炎症生物标志物）决定了西班牙裔心理健康 癌症患者和存活。通过简单地整合基层，将实现这种转变 （社区领导者）和自上而下的（机构）资源，以增加获得专业心理肿瘤学的机会 精神卫生保健服务和心理困扰筛查，同时消除心理健康污名。第一的， 该团队将培训外行社区领导者，成为社区卫生工作者，解决心理肿瘤学 心理健康预防工作。其次，调查人员以及社区利益相关者将包装 通过整合和改编个人/社区的套件，提出了基于社区的多层次干预 研究团队成员以前开发和实施的干预和服务计划 并证明对波多黎各西班牙裔癌症患者和冲浪者的心理和心理产生积极影响 健康健康。在社区一级，团队将首先训练外行社区领导人成为社区 通过PHSU-RCMI社区培训研究所的精神卫生工作者。在 人际关系水平，基于社区的干预将整合家庭通信技能以影响 西班牙癌症患者和生存家庭护理人员的支持质量。在个人层面，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 由癌症及其治疗产生。在生物学层面，研究人员将评估 社区干预心理压力生物标志物（皮质醇和儿茶酚胺代谢产物）和 与慢性应激和癌症健康结果有关的炎症标记（细胞因子和趋化因子）。这 团队预计该项目将通过多级方法推动人口级的影响 这使社区能够理解和解决个人之间的心理健康。