Developing a culturally tailored mHealth symptom monitoring intervention to improve adherence to endocrine therapy among Black women with breast cancer

项目摘要 候选目标。我的职业目标是通过解决以下问题来减少乳腺癌的健康差异： 少数癌症人群的癌症护理提供问题。我在观察方面有了坚实的基础， 流行病学的方法，我已经应用到癌症生存研究，但我的训练没有 提供了开发移动健康行为干预或文化定制和测试行为所需的技能 干预措施。K08提供了一个理想的机会来发展必要的技能，以实现我的长期目标。 作为一名独立的临床科学家的职业目标。 候选人职业发展计划。在这个应用程序中，我建议通过培训来培养必要的技能， 成为开发mHealth行为干预药物依从性领域的领导者， 少数癌症幸存者的其他癌症护理提供问题。将通过参加下列活动获得培训： 科学会议，方法研讨会，课程作业，以及专家在开发方面的指导 文化定制的行为干预（克莱门特Gwede博士），坚持内分泌治疗， 乳腺癌患者（Dawn Hershman博士），mHealth方法（Brian Gonzalez博士），随机化 行为干预的临床试验（石楠吉姆博士），招募和保留少数民族参与者， 临床研究（Susan Vadaparamanet博士）和生物样本质量和检测（Shelley Tworoger博士）。这 培训将确保我实现我的短期目标，之后我将处于独特的位置，以弥补差距 跨学科，包括：1）临床乳腺癌护理，2）行为干预发展，文化 定制和测试，以及3）在研究中使用移动的卫生技术和生物标本， 弱势群体。 体制环境。莫菲特癌症中心的研究环境、设施和资源是 理想的职业发展，我有我的系主任，博士Czerniecki和同事的全力支持 人口科学部主任Shelley Tworoger博士。 研究计划。我们提出了一种迭代的方法来开发和试点测试一个新的移动健康行为 针对黑人乳腺癌幸存者文化定制的AET依从性干预。我们将首先使用 由黑人乳腺癌幸存者告知的定性方法，以制定干预蓝图（Aim 1）。然后，我们将反复完善和文化定制的mHealth干预措施，重点是症状监测 管理（目标2）。最后，我们将测试干预措施的可接受性、可行性和初步效果。 功效（目标3）。该项目将解决生活质量（症状负担）和护理提供（药物治疗 健康差异人群中的依从性）问题。

PROJECT SUMMARY Candidate Goals. My career goal is to reduce breast cancer health disparities in outcomes by addressing cancer care delivery issues in minority cancer populations. I received a solid foundation in observational epidemiological methods which I have applied to cancer survivorship research, but my training has not provided the skills I need to develop mHealth behavioral interventions or culturally-tailor and test behavioral interventions. The K08 provides an ideal opportunity to develop the necessary skills to achieve my long-term career goal as an independent clinical scientist. Candidate Career Development Plan. In this application, I propose training to develop the skills necessary to become a leader in the field of developing mHealth behavioral interventions for medication adherence and other cancer care delivery issues in minority cancer survivors. Training will be obtained through participation in scientific conferences, methods workshop, coursework, and structed mentorship from experts in developing culturally tailored behavioral interventions (Dr. Clement Gwede), adherence to endocrine therapy among patients with breast cancer (Dr. Dawn Hershman), mHealth methodology (Dr. Brian Gonzalez), randomized clinical trials of behavioral interventions (Dr. Heather Jim), recruitment and retention of minority participants to clinical studies (Dr. Susan Vadaparampil), and Biospecimen quality and testing (Dr. Shelley Tworoger). This training will ensure that I achieve my short-term goals after which I will be uniquely positioned to bridge gaps across disciplines, including: 1) Clinical breast cancer care, 2) Behavioral intervention development, cultural tailoring, and testing, and 3) Using mobile health technologies and biologic specimens in studies among vulnerable populations. Institutional Environment. The research environment, facilities, and resources at Moffitt Cancer Center are ideal for career development and I have the full support of my Department Chair, Dr. Czerniecki and Associate Center Director of the Division of Population Sciences, Dr. Shelley Tworoger. Research Plan. We propose an iterative approach to develop and pilot test a new mHealth behavioral intervention for AET adherence that is culturally tailored to Black breast cancer survivors. We will first use qualitative methods informed by Black breast cancer survivors to develop a blueprint of the intervention (Aim 1). We will then iteratively refine and culturally tailor the mHealth intervention focusing on symptom monitoring and management (Aim 2). Lastly, we will test the intervention for acceptability, feasibility, and preliminary efficacy (Aim 3). This project will address quality of life (symptom burden) and care delivery (medication adherence) issues in a health disparity population.