Fostering Post-Treatment Transitions in African-American Breast Cancer Survivors

描述(由申请人提供)：尽管认知-行为干预[CBI]以前已经被研究过，但很少有研究检查各种策略在早期治疗后阶段的有效性[EOT]。非裔美国人[AA]乳腺癌[BCA]人群一直得不到足够的服务，通常比其他种族人群的预后更差。此外，大多数CBI使用面对面的形式，将其使用限制为那些能够“到达”干预地点的人。我们的社区合作伙伴发现，我们社区针对AA BCA幸存者的计划存在重大差距，特别是在EOT阶段。我们建议与我们的社区合作伙伴合作；使用基于社区的参与性研究方法[CBPR]来调整现有的CBI，以便在完成治疗后的前6个月用于AA BCA幸存者。建议研究的具体目的是：(1)确定现有的CBI应该如何修改，以便在AA患者完成BCA治疗后的头6个月内使用，并特别关注文化内容、治疗次数和提供方式；(2)评估修改后的CBI的可行性、可接受性和满意度；(3)确定修改后的CBI对个人应对资源、感知社会支持和生活质量的影响。在第一阶段，重点将是在社区内建立研究能力和收集信息。合作研究小组将开展能力建设活动。AaBCA幸存者和支持性其他人将被要求批评现有的CBI或参加焦点小组，以收集信息以确定需求/问题，并为干预建议要素，以确保其可接受性和文化敏感性。在第二阶段，当局会进行一项试验研究，以评估改良CBI的可接受性和可行性，并确定其对生活质素和其他相关结果的影响。这项拟议的研究通过以下方式解决了以前发现的差距和局限性：纳入患者和支持他人的观点；以再生障碍性贫血妇女为目标；在治疗后的头6个月提供干预；使用多模式形式，使干预广泛可用，并为再生障碍性乳腺癌幸存者及其亲人量身定做文化。这项先导性研究将为R01应用提供基础，为AA BCA幸存者和支持性其他人进行大规模干预的随机对照试验。

DESCRIPTION (provided by applicant): Although cognitive-behavioral interventions [CBI] have been previously studied, little research has examined the effectiveness of various strategies during the early post-treatment phase [EOT]. The African American [AA] breast cancer [BCA] population has been underserved and generally experienced poorer outcomes than other ethnic populations. In addition, most CBIs use a face-to-face format, limiting their use to those who are able to 'get to' the intervention site. Our community partners have identified significant gaps in programs for AA BCA survivors in our own community, particularly in the EOT phase. We propose to work with our community partners; using community based participatory research methods [CBPR] to adapt an existing CBI for use with AA BCA survivors during the first 6 months after completing treatment. The specific aims for the proposed study are to: (1) Determine how an existing CBI should be modified for use during the first 6 months following treatment with AA patients completing treatment for BCA and their supportive other, with specific attention to cultural content, number of sessions, and mode of delivery; (2) Evaluate the modified CBI in terms of feasibility, acceptability and satisfaction; (3) Determine the impact of the modified CBI on personal coping resources, perceived social support and quality of life. In the first stage, the focus will be on creating research capacity within the community and information gathering. The collaborative research team will engage in capacity-building activities. AA BCA survivors and supportive others will be asked to critique the existing CBI or to participate in focus groups to gather information to identify needs/issues and suggest elements for the intervention in order to ensure its acceptability and cultural sensitivity. In Stage 2, a pilot study of the modified CBI will be conducted to evaluate its acceptability, feasibility and determine the effects on quality of life and other related outcomes. The proposed study addresses the previously identified gaps and limitations by: incorporating both the patient's and supportive other's perspectives; targeting AA women; delivering the intervention during the first 6 months post-treatment; and using a multi-modal format that makes the intervention widely accessible and culturally tailored for AA breast cancer survivors and their loved ones. This pilot study will provide the foundation for an R01 application to conduct a large scale RCT of the intervention for AA BCA survivors and supportive others.