Family Cancer Experience and Colorectal Cancer Prevention

这份R03申请将作为PI建立一系列研究的基础，致力于以家庭为基础的结直肠癌（CRC）预防和控制领域。癌症是一种共同的经历，影响着病人和家庭成员。虽然研究人员已经研究了癌症对家庭系统的影响，但很少有研究调查了癌症经历对家庭成员预防癌症行为的影响。几乎所有癌症的家族史都是一个重要的风险因素，有癌症家族史的人可能会受到刺激，采取预防癌症的行为，以降低个人患癌症的风险，或者出于其他尚不清楚的原因。因此，癌症的诊断可能成为家庭的一个教育时刻，激励他们单独或集体地参与与癌症相关的健康行为改变。需要更好地了解癌症预防行为的家庭/社会决定因素，以进一步推进该领域，并可以打开“教育时刻”概念的“黑匣子”，以更好地了解癌症，直接或间接地经历，可能会刺激采取癌症预防行为。本次R03申请的目的是通过探索家庭癌症经历的意义及其与癌症预防行为的关系，将家庭带到前台。这项研究将填补我们对癌症预防行为的家族决定因素的理解的重要空白，并可能影响超过1100万的癌症幸存者及其家人。我们将重点关注符合家族风险标准但没有已知遗传综合征的结直肠癌（CRC）家庭。梅奥诊所胃肠健康研究生物库（BGHR）将用于确定和招募24个家庭（72-102个人），使用一种主要符合扎根理论的方法对癌症患者及其家庭成员进行个人深度访谈。我们的目标是：1)描述癌症经历以及它如何影响家庭及其个人成员的行为，特别是在癌症预防的背景下；2)评估以家庭为基础的癌症预防干预的接受程度和偏好；3)探讨以家庭为基础的癌症预防干预的招募、设计和评估的潜在伦理/隐私问题。

DESCRIPTION (provided by applicant): ABSTRACT This R03 application will serve as the foundation by which the PI will build a line of research dedicated to the area of family based approaches to colorectal cancer (CRC) prevention and control. Cancer is a shared experience, affecting both the patient and the family members. While researchers have examined the effects of cancer on the family system, very few studies have examined the effects of the cancer experience on family members' cancer prevention behaviors. Family history is a significant risk factor for almost all cancers and individuals with a family history of cancer may be spurred to engage in cancer prevention behaviors to decrease their personal risk of cancer or for other reasons not yet understood. A diagnosis of cancer may therefore serve as a teachable moment for families, motivating them to engage in cancer-related health behavior change, either individually or collectively. A better understanding of the familial/social determinants of cancer prevention behavior is needed to further advance the field and could open the "black box" of the teachable moment concept to better understand how cancer, experienced directly or indirectly, might stimulate adoption of cancer prevention behaviors. The objective of this R03 application is to bring the family to the foreground by exploring the meaning of the family cancer experience and its relationship to cancer prevention behavior. This study will fill important gaps in our understanding of familial determinants of cancer prevention behavior and potentially affect the more than 11 million estimated cancer survivors and their families. We will focus on families with colorectal cancer (CRC) meeting the familial risk criteria, but with no known genetic syndromes. The Mayo Clinic Biobank for Gastrointestinal Health Research (BGHR) will be used to identify and recruit 24 families (72-102 individuals) for individual in-depth interviews with cancer patients and their family members using an approach primarily consistent with grounded theory. Our aims are to: 1) describe the cancer experience and how it has affected the behaviors of the family and its individual members, especially in the context of cancer prevention; 2) assess receptivity to and preferences for family-based cancer prevention interventions; and 3) explore potential ethical/privacy concerns with regard to the recruitment, design, and evaluation of a family-based cancer prevention intervention. PUBLIC HEALTH RELEVANCE: This study will explore the meaning of the family cancer experience and its relationship to cancer prevention behavior by conducting individual in-depth interviews with 24 cancer patients and their family members. Findings from this study will be used to develop family-based approaches to cancer prevention and control.