Positive Activities for Asian American Cancer Patients and Caregivers

项目总结/摘要 亚裔美国人（AAs）是美国增长最快的少数民族，癌症是导致 死亡在这个群体中。虽然AA谁被诊断为癌症通常报告恐惧，痛苦， 抑郁症，他们被发现利用心理健康服务的比率低于其他群体， 这可能是由于缺乏有文化能力的服务。之前对这些癌症患者生活的研究 关注与健康素养和语言能力相关的障碍，但忽视了独特的文化- 导致他们情绪不佳的相关挑战。AA是集体主义文化的成员 他们认为自己是有联系的，有关系的，属于一个更大的社会群体。如下变动 身体功能和社会角色和责任（例如，在癌症诊断后，个人可能 自我感觉是家庭成员/照顾者的负担。因此， 目前的建议是减少AA患者可能会觉得他们对他们的照顾者的负担， 测试两种积极活动干预的可行性。我们希望为家庭做出贡献， 在一个人的家外将增加AA癌症患者的健康相关的生活质量（HRQOL）， 关联感、自主性和能力（调解人）。在K99阶段，30名年龄在25-70岁之间的AA， 在任何癌症诊断的1年内，将参与：1）家庭贡献; 2）外部贡献; （3）控制活动。定量和定性（例如，半结构化面试、项目人员工作日志） 将收集有关干预措施成功要素的数据。与导师制合作， 团队，AA社区成员和临床医生，一个或两个积极活动干预的原型 （家庭或外部贡献）将为AA癌症患者开发。在R 00阶段，118名患者 (same入选标准为K99期）将随机分配至贡献组或对照组。他们将 每周进行一次阳性或对照活动，持续3个月，结果和介质将 在基线、1.5个月（中点）、3个月（测试后）和6个月（随访）时进行评估。试验将：1） 评估家庭和外部贡献积极活动的可行性和可接受性，2）制定 AA癌症患者积极活动干预（家庭或外部贡献）的原型，3） 评估干预与对照患者HRQOL的变化，以及4）评估 干预效果。该提案介绍了一种新颖的、低成本的、不污名化的、易于实施的、高度可接受的、可移植的 以前未在AA癌症患者中测试的可扩展方法：参与积极活动。如果发现 成功的，这个框架，了解病人照顾者的关系，在AA可用于发展 其他积极的活动，将改善和延长癌症患者的生命，从其他集体主义文化。 拟议的培训计划对于加快候选人向独立工作人员的过渡至关重要。 研究人员专注于开发积极的活动，以消除AA中的癌症护理差异。

PROJECT SUMMARY/ABSTRACT Asian Americans (AAs) are the fastest growing minority group in the U.S., and cancer is the leading cause of death among this group. Although AA who are diagnosed with cancer commonly report fear, distress, and depression, they have been found to utilize mental health services at lower rates than other groups and this may be due to a dearth of culturally-competent services. Prior research on these cancer patients’ lives has focused on barriers associated with health literacy and language proficiency but has ignored unique culture- related challenges that contribute to their poor emotional outcomes. AAs are members of collectivist cultures who view themselves as connected, relational, and belonging to a larger social group. Following changes in physical function and social roles and responsibilities (e.g., job loss) after a cancer diagnosis, individuals may self-perceive that they are a burden on their family members/caregivers. Therefore, the overarching goal of the current proposal is to reduce the burden AA patients may feel they are on their caregivers by designing and testing the feasibility of two positive activity interventions. We expect that contributing to one’s household and outside one’s home will increase health-related quality of life (HRQOL) in AA cancer patients by increasing a sense of relatedness, autonomy, and competence (mediators). In the K99 phase, 30 AAs ages 25-70 and within 1 year of any cancer diagnosis will engage in either: 1) household contribution; 2) outside contribution; or 3) control activities. Quantitative and qualitative (e.g., semi-structured interview, project personnel work logs) data about the successful elements of the interventions will be collected. In collaboration with the mentorship team, AA community members, and clinicians, a prototype of one or both positive activity interventions (household or outside contribution) will be developed for AA cancer patients. In the R00 phase, 118 patients (same inclusion criteria as K99 phase) will be randomized to either the contribution or control group. They will engage in the positive or control activity once per week for 3 months, and outcomes and mediators will be assessed at baseline, 1.5 months (midpoint), 3 months (post-test), and 6 months (follow-up). The trial will: 1) assess the feasibility and acceptability of the household and outside contribution positive activities, 2) develop a prototype of a positive activity intervention (household or outside contribution) for AA cancer patients, 3) assess changes in HRQOL comparing intervention to control patients, and 4) assess mediators of the intervention effects. This proposal introduces a novel, low cost, not stigmatizing, easy to implement, and highly scalable approach not previously tested in AA cancer patients: engaging in positive activities. If found to be successful, this framework for understanding patient-caregiver relationships in AAs can be used to develop other positive activities that will improve and extend the lives of cancer patients from other collectivist cultures. The proposed training plan will be critical in expediting the candidate’s transition into an independent investigator with focused expertise in developing positive activities to eliminate cancer care disparities in AAs.