Exercise Intervention for Lesbian, Gay, Bisexual, and Transgender Cancer Survivors

针对女同性恋、男同性恋、双性恋和变性癌症幸存者的运动干预

• 批准号: 9112953
• 负责人: Charles Stewart Kamen
• 金额: $ 16.61万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-17 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9112953
• 关键词: Address; Adherence; Adult; Aftercare; Anxiety; Area; Award; Behavior; Biological; C-reactive protein; Cancer Control; Cancer Control Research; Cancer Patient; Cancer Survivor; Caring; Clinical; Clinical Trials; Discrimination; Distress; Environment; Exercise; Faculty; Feasibility Studies; Funding; Future; Gays; Goals; Health; Heterosexuals; Home environment; Hydrocortisone; Inflammation; Instruction; Intervention; Intervention Studies; Intervention Trial; K-Series Research Career Programs; Lead; Lesbian; Lesbian Gay Bisexual; Life; Link; Malignant Neoplasms; Medical Oncologist; Mentors; Methods; Moods; Morbidity - disease rate; Patient Self-Report; Personal Satisfaction; Persons; Phase; Population; Positioning Attribute; Prevalence; Psyche structure; Psychologist; Questionnaires; Randomized; Reporting; Research; Risk; Serum amyloid A protein; Social support; Stress; Survivors; Testing; Time; Training; Training Programs; Underserved Population; United States; Universities; Walking; Work; actigraphy; anticancer research; arm; base; biopsychosocial; cancer care; cancer diagnosis; cancer therapy; cancer type; career; career development; community intervention; design; exercise intervention; experience; health disparity; improved; innovation; member; mortality; novel; oncology; phase II trial; post intervention; psychologic; psychological distress; response; strength training; transgender; underserved minority

 DESCRIPTION (provided by applicant): Prevalence of cancer is up to 2.1 times higher among lesbian, gay, bisexual, and transgender (LGBT) persons than heterosexuals, yet LGBT cancer survivors are virtually invisible in cancer research in the United States. This invisibility, as wel as real and expected discrimination, leads LGBT cancer patients and survivors to experience 1.7 times higher rates of psychological distress than heterosexual survivors. Given these rates of distress, the unique sociocultural factors acting on LGBT survivors, and the fact that distress is linked with increased cancer-related morbidity and mortality, tailored interventions to reduce distress among LGBT cancer survivors are needed. Our preliminary research shows that care partners of LGBT survivors want to be included in interventions to support survivors and that social support is strongly linked to psychological distress among LGBT adults. Our novel dyadic framework incorporates support from care partners and a standardized exercise intervention, Exercise for Cancer Patients (EXCAP(c)(r), a 6 week, home-based progressive walking and resistance training program), and may be effective in reducing distress among LGBT survivors. In this K07 Career Development Award application, Dr. Charles Kamen, a clinical psychologist with a background in health disparities and dyadic intervention research, proposes to conduct a Phase II RCT randomizing 70 LGBT cancer survivors (all cancer types, 1-24 months post treatment) plus their 70 care partners (broadly defined) to: Arm 1, a novel, partner-assisted version of EXCAP(c)(r) (called EXCAP-PA), in which both survivors and care partners will receive EXCAP(c)(r) materials and instruction together, or Arm 2, a survivor-only version of EXCAP(c)(r), i which only the LGBT cancer survivor will receive EXCAP(c)(r) materials. The overall hypothesis of this study is that among LGBT survivors, EXCAP-PA, incorporating care partner support, will be more efficacious than survivor-only EXCAP(c)(r) in improving biopsychosocial aspects of distress. Dr. Kamen is well positioned as a junior faculty member in an exceptional environment at the University of Rochester. He needs additional training in three core competency areas in order to launch an independent research career: 1) clinical trials for LGBT health, 2) integration of biological endpoints, and 3) design of exercise interventions. His mentors have over 30 years of experience conducting cancer control intervention trials and include: Dr. Karen Mustian, PEAK Lab Director and exercise oncology expert; Dr. Gary Morrow, Director of Cancer Control research; Dr. Kathi Heffner, psychoneuroimmunologist; Dr. Deborah Bowen, community intervention expert; and advisors Dr. Supriya Mohile, medical oncologist; Dr. James McMahon, dyadic intervention expert; and Dr. Charles Heckler, biostatistician. The career development goals and protected time provided by this training award will prepare Dr. Kamen to become an expert in cancer-related health disparities and dyadic interventions for LGBT cancer survivors and care partners. Further, if successful, this study will address a critical disparity (distress) n the underserved population of LGBT survivors.

 描述（由申请人提供）：男女同性恋、双性恋和变性人（LGBT）的癌症患病率比异性恋高2.1倍，但LGBT癌症幸存者在美国的癌症研究中几乎是不可见的。这种无形性，以及真实的和预期的歧视，导致LGBT癌症患者和幸存者经历比异性恋幸存者高1.7倍的心理困扰。鉴于这些痛苦率，作用于LGBT幸存者的独特社会文化因素，以及痛苦与癌症相关发病率和死亡率增加有关的事实，需要采取量身定制的干预措施，以减少LGBT癌症幸存者的痛苦。我们的初步研究表明，LGBT幸存者的护理伙伴希望被纳入支持幸存者的干预措施中，社会支持与LGBT成年人的心理困扰密切相关。我们的新型二元框架结合了护理合作伙伴的支持和标准化的运动干预，癌症患者运动（EXCAP（c）（r），为期6周，以家庭为基础的渐进式步行和阻力训练计划），并可能有效地减少LGBT幸存者的痛苦。在K 07职业发展奖申请中，临床心理学家Charles Kamen博士拥有健康差异和二元干预研究的背景，他建议进行一项随机抽取70名LGBT癌症幸存者的II期RCT。（所有癌症类型，治疗后1-24个月）加上他们的70个护理伙伴（广义定义）：臂1，一种新型的合作伙伴辅助版本的EXCAP（c）（r）（称为EXCAP-PA），其中幸存者和护理伙伴将一起接受EXCAP（c）（r）材料和指导，或第2组，EXCAP（c）（r）的幸存者版本，只有LGBT癌症幸存者才能收到EXCAP（c）（r）材料。这项研究的总体假设是，在LGBT幸存者中，EXCAP-PA，结合护理伙伴的支持，将比幸存者更有效地改善生物心理社会方面的困扰。卡门博士在罗切斯特大学的特殊环境中担任初级教员。他需要在三个核心能力领域进行额外的培训，以启动独立的研究生涯：1）LGBT健康的临床试验，2）生物学终点的整合，以及3）运动干预的设计。他的导师拥有超过30年的癌症控制干预试验经验，包括：凯伦·穆斯蒂安博士，PEAK实验室主任和运动肿瘤学专家;加里·莫罗博士，癌症控制研究主任; Kathi Heffner博士，心理神经免疫学家;黛博拉·鲍恩博士，社区干预专家;和顾问Supriya Mohile博士，医学肿瘤学家;詹姆斯·麦克马洪博士，二元干预专家;和生物统计学家查尔斯·赫克勒博士该培训奖提供的职业发展目标和受保护的时间将使Kamen博士成为LGBT癌症幸存者和护理伙伴的癌症相关健康差异和二元干预方面的专家。此外，如果成功的话，这项研究将解决LGBT幸存者中服务不足人群的关键差异（痛苦）。