Pilot Project 1: Mexican immigrants' biological and behavioral cancer risk based on stress

项目摘要/摘要 新冠肺炎大流行带来的前所未有的负担对癌症的传播产生了严重后果 护理：患者对疾病和新实施的治疗路径和 方案可能会因为次优或延迟的护理而影响长期存活率。为种族和少数民族服务 接受乳腺癌治疗的妇女，为规范获得乳腺癌治疗而实施的体制措施 患者对医疗环境和治疗顺序的修改可能会加剧现有的 疾病的不成比例的负担。因此，了解新冠肺炎对癌症护理的影响 由少数群体接收，并确定潜在的可修改因素，以告知未来的护理模式 交付是至关重要的。U-Hand(休斯顿大学/医学安德森分校)减少癌症差异的计划 (P20CA221697；9/22/17-8/31/21)是休斯顿大学和 德克萨斯大学MD安德森癌症中心，支持卓越的教育规划和 影响种族/民族群体健康公平的研究创新 癌症差异。拟议的行政补编申请是以下目标的自然延伸 UHAND伙伴关系，它反映了其执行创新社会/行为的总体使命 旨在减轻黑人和西班牙裔群体癌症不平等的科学。具体地说，建议的 补充将是这一目标的延伸，调查新冠肺炎大流行对 来自种族和民族社区的妇女接受最佳乳腺癌治疗的比例不成比例 受疾病及其心理社会后遗症的影响。这项提议是合乎逻辑的下一步，建立在 行政申请人在癌症相关结果的中间决定因素方面的专业知识。试点数据 收集的数据将评估黑人癌症护理中断和与健康相关的生活质量的不同比率 以及被诊断为早期乳腺癌的西班牙裔女性(与非西班牙裔白人女性相比)， 并研究差异的近端、中端和远端决定因素如何影响这些结果。它 据设想，这项研究将提供有关“高危”患者的信息，以及利用现有社会 资源。最后，这些发现将被用来为未来能够持续有效的多层次干预提供信息 急性后新冠肺炎环境中的护理提供模式。在一年的行政管理期间 补充资助期、研究和辅导培训活动将帮助申请者完成 建议项目的研究目标，并培养支持她对机械原理的理解的技能 这导致不同群体在医疗保健利用和结果方面存在差异，从而促进 在减少和消除癌症差距方面取得成功的职业生涯。

PROJECT SUMMARY/ABSTRACT The unprecedented burden of the COVID-19 pandemic has critical consequences for the delivery of cancer care: patients present greater vulnerability to the disease and newly implemented treatment pathways and protocols may affect long-term survival because of suboptimal or delayed care. For racial and ethnic minority women receiving treatment for breast cancer, institutional measures implemented to regulate access of patients to medical settings and modifications in therapy sequence may exacerbate the existing disproportionate burden of the disease. Therefore, understanding the impact of COVID-19 on the cancer care received by minority groups and identifying potentially modifiable factors to inform future models of care delivery is critical. The U-HAND (University of Houston/MD Anderson) Program to Reduce Cancer Disparities (P20CA221697; 9/22/17-8/31/21) is a collaborative partnership between the University of Houston and The University of Texas MD Anderson Cancer Center that supports excellence in educational programming and innovation in research that affects health equity among racial/ethnic groups disproportionately affected by cancer disparities. The proposed Administrative Supplement application is a natural extension of the aims of the UHAND partnership and it is reflective of its overarching mission to execute innovative social/behavioral science aimed at mitigating cancer inequities for Black and Hispanic groups. Specifically, the proposed Supplement will be an extension of this goal by investigating the impact that the COVID-19 pandemic has on the receipt of optimal breast cancer care among women from racial and ethnic communities disproportionately affected by the illness and its psychosocial sequelae. This proposal is a logical next step building upon the Administrative Applicant’s expertise on the intermediate determinants of cancer-related outcomes. Pilot data collected will assess differential rates of cancer care disruption and health-related quality of life among Black and Hispanic women diagnosed with early-stage breast cancer (as compared with non-Hispanic white women), and examine how proximal, intermediate, and distal determinants of disparities contribute to these outcomes. It is envisioned that the study will yield information about “at-risk” patients and ways to leverage existing social resources. Finally, these findings will be used to inform future multilevel interventions able to sustain effective models of care delivery in a post-acute COVID-19 environment. During the one-year Administrative Supplement grant period, research and mentored training activities will help the applicant complete the research aims of the proposed project, and develop skills that will support her understanding of mechanisms that contribute to disparities in both health care utilization and outcomes among diverse groups to foster a successful career in reducing and eliminating cancer disparities.