Adapting and Testing a Novel Self-Compassion Intervention to Reduce Lung Cancer Stigma

项目摘要 考虑到筛查和治疗方面的进步，美国肺癌患者的数量是 预计到2030年将增长25%(从571,340人增加到724,610人)。几乎所有(95%)被诊断为 肺癌报告遭受耻辱(即，对来自 其他人被归因于肺癌)，这可能是这个问题中最突出的心理社会问题 并导致心理和身体健康状况不佳。在……领域的一个关键差距 癌症控制科学是缺乏经验支持的、以患者为中心的干预措施，这些干预措施针对的是 减少对这一不断增长的患者群体的肺癌耻辱。这款K99/R00的目标是适应 现有的正念自我同情(MSC)心理社会干预，以应对预期的分娩挑战 目标是减少肺癌的污名，以及寻找初步证据证明 适应MSC干预减少肺癌污名。K99研究将分两个阶段进行 1)组织利益攸关方焦点小组，指导MSC干预活动的迭代适应，并 材料和2)对肺癌患者进行深入访谈，了解患者对 干预内容以及格式和交付的首选项。R00研究将涉及两个阶段的过程 1)进行一项试验性随机对照试验(n=60)，以测试适应的MSC干预对初级患者的初步疗效 (肺癌耻辱)和次要结果(抑郁症状、生活质量)和2)传导 对来自MSC的有目的抽样的高响应者(n=10)和无响应者(n=10)的访谈 条件(干预后评估)以检查参与者对参与研究的反应。整体而言 K99/R00的目标是为威廉姆森博士提供额外的培训和指导，使其成为 独立的癌症控制研究员将基础行为科学研究的结果转化为 为癌症患者制定量身定制的心理社会干预措施。培训目标包括：1)心理社会 癌症干预的发展和适应；2)先进的定性和混合方法设计和 分析；3)翻译心理学研究(基础健康科学和应用健康科学的协同作用)；4) 在癌症护理中提供以正念和同情为基础的干预；以及5)专业 发展。威廉姆森博士由纪念斯隆·凯特琳癌症中心的杰米·奥斯特罗夫博士指导 以及来自共同导师(丽莎·卡特-哈里斯博士和毛军博士)的专家支持和其他重要的 撰稿人(克里斯托弗·格默博士、凯瑟琳·林奇女士)，他们都致力于威廉姆森博士的职业生涯 发展。拟议的培训计划将有助于威廉姆森博士过渡到独立的 癌症控制研究人员进行一系列有计划的研究，1)表征特定疾病的特征 研究不足的癌症群体的挑战以及2)将基础行为研究的结果转化为 应对这些挑战并最终提高生活质量的量身定做的心理社会干预措施。

Project Summary Given advances in screening and treatment, the number of people in the U.S. living with lung cancer is expected to increase by 25% (from 571,340 to 724,610) by 2030. Nearly all (95%) patients diagnosed with lung cancer report experiencing stigma (i.e., the perception and internalization of negative appraisal from others attributed to one’s lung cancer), which is perhaps the most prominent psychosocial issue in this population and contributes to poor psychological and physical health outcomes. A critical gap in the field of cancer control science is the lack of empirically supported patient-focused interventions that target the reduction of lung cancer stigma for this growing patient population. The goals of this K99/R00 are to adapt the existing Mindful Self-Compassion (MSC) psychosocial intervention to address anticipated delivery challenges and target the reduction of lung cancer stigma as well as to seek preliminary evidence for the efficacy of the adapted MSC intervention in reducing lung cancer stigma. The K99 study will involve a two-phase process of 1) conducting stakeholder focus groups to guide the iterative adaptation of MSC intervention activities and materials and 2) conducting in-depth interviews with lung cancer patients to explore patients’ reactions to intervention content and preferences for format and delivery. The R00 study will involve a two-phase process of 1) conducting a pilot RCT (n=60) to test preliminary efficacy of the adapted MSC intervention on primary (lung cancer stigma) and secondary outcomes (depressive symptoms, quality of life) and 2) conducting interviews with purposively sampled high responders (n=10) and non-responders (n=10) from the MSC condition (assessed post-intervention) to examine participants’ reactions to study participation. The overall objective of this K99/R00 is to provide Dr. Williamson with additional training and mentorship to become an independent cancer control investigator translating findings from basic behavioral scientific research into the development of tailored psychosocial interventions for cancer patients. Training aims include: 1) Psychosocial intervention development and adaptation in cancer; 2) advanced qualitative and mixed-methods design and analysis; 3) translational psychological research (synergy between basic and applied health science); 4) delivery of mindfulness- and compassion-based interventions in cancer care; and 5) professional development. Dr. Williamson is mentored by Dr. Jamie Ostroff at Memorial Sloan Kettering Cancer Center along with expert support from co-mentors (Drs. Lisa Carter-Harris and Jun Mao) and other significant contributors (Dr. Christopher Germer, Ms. Kathleen Lynch), who are all committed to Dr. Williamson’s career development. The proposed training plan will facilitate Dr. Williamson’s transition to independence as a cancer control investigator conducting a programmatic line of research that 1) characterizes disease-specific challenges of understudied cancer groups and 2) translates findings from basic behavioral research into tailored psychosocial interventions that address such challenges and ultimately enhance quality of life.