Predicting Surgical Decisions of High-Risk UC Patients

描述（由申请人提供）：这项为期5年的K07奖申请描述了一个培训和研究计划，该计划将为申请人提供指导和“保护时间”，以培养与癌症预防和控制研究事业相关的技能和知识。申请人是一名具有母胎健康心理社会研究背景的社会/健康心理学家。重点是建立癌症知识（例如，生物学，社会心理问题），研究亲密关系过程的方法，以及纵向数据分析的高级统计技能。在培训结束时，申请人将具备足够的专业知识，成为一名在探索医学和社会心理因素如何共同影响癌症预防和控制的研究前沿的完全成熟的独立调查员。拟议的培训包括正式和非正式教学以及创新研究的补充方案。本研究将在培训期间获得的知识和技能应用于一项基于理论和临床相关的研究，研究溃疡性结肠炎（UC）患者在检测到癌前细胞变化后，如何艰难地决定接受医生的建议，手术切除结肠和直肠，这表明结直肠癌的短期风险很高。为了解决对这一高危人群缺乏研究的问题，建议的研究从定性研究到回顾性、横断面研究，再到使用“每日日记”方法的前瞻性、纵向研究，按照逻辑进行。研究了影响手术决定的三个关键因素：1)医学因素，2)健康信念，3)伴侣。UC患者承担风险的性格倾向也将作为其决策的潜在影响进行探讨。研究结果将有助于临床工作，以确保UC患者转介手术能够做出明智的决定，总体目标是帮助降低该人群的CRC发病率和死亡率。理论进步包括决策模型的扩展，以包括不可逆的，改变生活的决定以及人际/家庭影响。该研究将在西奈山（UC的主要转诊地点）进行，并由一位经验丰富的导师（杰出的胃肠病学家）和一组心理和健康研究人员（将作为共同导师）提供支持。该奖项将有助于申请人实现她的短期目标，即成为医学和社会心理对癌症预防和控制结果的影响的独立研究者，并有助于她开展能够帮助降低癌症死亡率和发病率的创新研究的长期目标。

DESCRIPTION (provided by applicant): This 5-year K07 award application describes a program of training and research that will provide the applicant, a social/health psychologist with a background in psychosocial research on maternal-fetal health, with mentoring and "protected time" to build skills and knowledge relevant to a research career in cancer prevention and control. Emphasis is on building knowledge of cancer (e.g., biology, psychosocial issues), methods for the study of close relationship processes, and advanced statistical skills for analysis of longitudinal data. At the conclusion of training, the applicant will have developed sufficient expertise to be a fully-established, independent investigator at the forefront of research exploring how medical and psychosocial factors together influence cancer prevention and control. The proposed training includes formal and informal didactics and a complementary program of innovative research. This research applies knowledge and skills gained during the training period to a theoretically-based, clinically-relevant study of how ulcerative colitis (UC) patients at high risk for colorectal cancer (CRC) make the difficult decision to accept a physician's recommendation for surgical removal of their colon and rectum after detection of pre-cancerous cell change, indicating high short-term risk for CRC. To address the lack of research on this high-risk population, the proposed research progresses logically from a qualitative study, to a retrospective, cross-sectional study, to a prospective, longitudinal study using "daily diary" methods. Three key influences on the surgical decision are investigated: 1) medical factors, 2) health beliefs, and 3) romantic partners. UC patients* dispositional tendency to take risks will also be explored as a potential influence on their decision. Findings will assist clinical efforts to ensure that UC patients referred for surgery are able to make an informed decision, with the overarching goals of helping to reduce CRC morbidity and mortality in this population. Theoretical advances include extension of decision-making models to include irreversible, life-altering decisions as well as interpersonal/family influences. The study will be conducted at Mount Sinai, a primary referral site for UC, and supported by an experienced mentor who is a distinguished gastroenterologist and a team of psychological and health researchers who will serve as co-mentors. The award will be instrumental to the applicant in achieving her short-term goal of becoming an independent investigator of medical and psychosocial influences on cancer prevention and control outcomes, as well as her longer-term objective of conducting innovative research capable of helping to reduce cancer mortality and morbidity.