MULTIPLE RISKS, DECISIONS & BEHAVIORS IN THE GENOMIC ERA

多重风险、决策

• 批准号: 7883230
• 负责人: KAREN E HURLEY
• 金额: $ 13.45万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-17 至 2010-09-03
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7883230
• 关键词: Accounting; Address; Adherence; Affect; Affective; Alcoholism; Algorithms; Alleles; Area; Behavior; Behavioral; Belief; Biopsy; Breast; Budgets; Cancer Family; Cancer Patient; Case Study; Cervical; Characteristics; Classification; Clinical; Clinical Research; Cluster Analysis; Cognitive; Colon; Colon Carcinoma; Colonoscopy; Colorectal; Complex; Computers; Consultations; Counseling; Country; Data Collection; Detection; Disease; Distress; Education; Exposure to; Factor Analysis; Family; Family history of; Genetic; Genetic Markers; Genetic Services; Genetic screening method; Genomics; Goals; Grouping; Growth; Guidelines; HIV; Heavy Drinking; Hereditary Breast Carcinoma; Hereditary Malignant Neoplasm; Hereditary Neoplastic Syndromes; Hereditary Nonpolyposis Colorectal Neoplasms; Human Resources; Individual; Informed Consent; Inherited; Investigation; Life; Linear Models; Link; Longitudinal Studies; Malignant Neoplasms; Mammography; Market Research; Marketing; Mentors; Methods; Modeling; Molecular Biology; Occupational; Operative Surgical Procedures; Organ; Outcome; Parents; Patients; Pattern; Penetrance; Persons; Pharmaceutical Preparations; Population; Postdoctoral Fellow; Procedures; Process; Psychiatry; Psychosocial Factor; Recommendation; Regression Analysis; Relative (related person); Research; Research Infrastructure; Research Methodology; Research Personnel; Resources; Risk; Risk Management; Risk Reduction; Sampling; Screening procedure; Skin Cancer; Statistical Methods; Subgroup; Syndrome; System; Taxonomy; Techniques; Testing; Time; Training; Training and Infrastructure; Transcend; Translating; Trees; Variant; Woman; Work; base; behavioral health; cancer genetics; cancer prevention; cancer risk; cancer site; cancer type; experience; follow-up; genetic epidemiology; high risk; innovation; interest; intervention effect; protective behavior; psychologic; psychosocial; research study; risk perception; satisfaction; service utilization; statistics; time use; uptake

This proposal is for advanced training and mentored researchfor Dr. Karen Hurley to become an independent behavioral investigator in hereditary cancer risk. It addresses two challenges posed by the genomic revolution: 1) accounting for multiple, interrelated risk-reducing behavior outcomes in the same person, and 2) accounting for individual variation in the relations between predictor variables and behavioral outcomes. Hereditary syndromes often confer risk to several organs at once, yet studies usually assess one screening outcome at a time. Similarly, psychosocial factors are often analyzed as independent predictors; yet within a given person they are interdependent. Developing new assessment and statistical strategies to understand how patients process complex information, and to analyze interrelated behavioral outcomes, will enhance the accuracy and clinical utility of researchfindings. Study 1will assess longitudinal patterns of adherence (full, partial or none) to comprehensive, multi-organ screening guidelines in HNPCC patients. Cluster analysis will yield a taxonomy of perceived/risk worry types (e.g., selective worry about one type of cancer vs. pervasive worry) that will be used to predict trajectories of adherence over time. In Study 2, BRCA1/2 carriers will be offered computer-based genetic education for two low penetrance cancer risk alleles (RAD51 amplifies BRCA-related risk; APCI1307K indicates colon cancer risk). We will assess genetic testing uptake levels, and explore patterns of relations between predictor variables using automatic interaction detection (AID). We aim to identify groups of patients with different counseling needs, and to examine the differential impact of counseling on satisfaction, distress, and adherence to risk reduction in these groups. The training plan supports the proposed research with coursework in cancer genetics, genetic epidemiology, molecular biology and advanced statistics (latent class analysis, growth curve analysis, hierarchical linear models, and automatic interaction detection). The long-term goal is promote cancer prevention and control efforts in hereditary cancer syndromes by increasing adherence to health-protective behaviors in high risk individuals; however, the research methods developed here may be applied to average risk individuals who receive multiple recommendations for screening (e.g., women over 50 undergoing routine breast, colorectal, cervical, and skin cancer surveillance).

这项提案是为凯伦·赫尔利博士提供高级培训和指导研究，使其成为一名

项目成果

A prospective study of quality of life in patients undergoing pelvic exenteration: interim results.

接受盆腔廓清术的患者生活质量的前瞻性研究：中期结果。

• DOI: 10.1016/j.ygyno.2012.09.030
• 发表时间: 2013
• 期刊: Gynecologic oncology
• 影响因子: 4.7
• 作者: Rezk,YoussefA;Hurley,KarenE;Carter,Jeanne;Dao,Fanny;Bochner,BernardH;Aubey,JaniceJ;Caceres,Aileen;Einstein,MHeather;Abu-Rustum,NadeemR;Barakat,RichardR;Makker,Vicky;Chi,DennisS
• 通讯作者: Chi,DennisS

"My funky genetics": BRCA1/2 mutation carriers' understanding of genetic inheritance and reproductive merger in the context of new reprogenetic technologies.

《我的时髦遗传学》：BRCA1/2突变携带者在新的生殖技术背景下对基因遗传和生殖融合的理解。

• DOI: 10.1037/a0028434
• 发表时间: 2012
• 期刊: Families, systems & health : the journal of collaborative family healthcare
• 作者: Werner-Lin,Allison;Rubin,LisaR;Doyle,Maya;Stern,Rikki;Savin,Katie;Hurley,Karen;Sagi,Michal
• 通讯作者: Sagi,Michal

Development and preliminary evaluation of a training workshop for the collection of patient-reported outcome (PRO) interview data by research support staff.

• DOI: 10.1007/s13187-012-0427-z
• 发表时间: 2013-03
• 期刊: JOURNAL OF CANCER EDUCATION
• 影响因子: 1.6
• 作者: Atkinson, Thomas M.;Hurley, Karen;Bylund, Carma L.;Berk, Alexandra;Diminni, Kimberly;Ostroff, Jamie S.
• 通讯作者: Ostroff, Jamie S.

Motivations for breast surgery: a qualitative comparison study of breast reconstruction, augmentation, and reduction patients.

乳房手术的动机：乳房重建、增大和缩小患者的定性比较研究。

• DOI: 10.1111/j.1524-4741.2009.00820.x
• 发表时间: 2009
• 期刊: The breast journal
• 作者: Rubin,LisaR;Klassen,Anne;Cano,StefanJ;Hurley,Karen;Pusic,AndreaL
• 通讯作者: Pusic,AndreaL