Disparities in Chronic Stress, QOL, and Physical Activity among Black and White Breast Cancer Survivors

黑人和白人乳腺癌幸存者在慢性压力、生活质量和体力活动方面的差异

基本信息

批准号：
10468979
负责人：
Teletia Renee Taylor
金额：
$ 8.31万
依托单位：
HOWARD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-09 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10468979
关键词：
Accelerometer Accounting Aerobic Exercise Affect African American Age Behavioral Black Populations Black race Blood Breast Cancer Risk Factor Breast Cancer survivor Cancer Survivor Chronic Chronic stress Crime Data Environment Event Exercise Family Fatigue Female Breast Carcinoma Frequencies Fright Goals Guidelines Health High Prevalence Housing Immunologic Markers Lead Life Life Stress Longitudinal Studies Malignant Neoplasms Measurement Measures Mediating Mediator of activation protein Metabolic Marker Methods Neighborhoods Not Hispanic or Latino Observational Study Occupations Patient Self-Report Personal Satisfaction Physical Function Physical activity Physiological Psychosocial Stress Quality of life Race Recurrence Reporting Role Services Severities Social Functioning Stage at Diagnosis Stress Stressful Event Summary Reports Survivors System Time Violence Woman Work active method allostatic load anticancer research behavioral response black women breast cancer diagnosis cancer subtypes exercise intensity health related quality of life hormone therapy improved indexing inflammatory marker lifestyle factors light weight malignant breast neoplasm physical conditioning physical inactivity racial health disparity recruit repaired sedentary sedentary lifestyle stem survivorship systematic review total energy expenditure vigorous intensity

项目摘要

Project Summary: Reports indicate Black breast cancer survivors have poorer health-related quality of life (HRQOL) than Whites, although some studies suggest that Blacks have higher spiritual well-being. Several factors contribute to these racial disparities in HRQOL. Data show that chronic life stress negatively impacts HRQOL. Chronic life stress is defined as chronic psychosocial stress stemming from concerns about money, housing, job condition, neighborhood environment, family situation, public services, crime and violence. Studies indicate a higher prevalence of major life events for Blacks than Whites. In addition to chronic life stress, cancer-specific stress (e.g. fear of recurrence) also affects HRQOL in breast cancer survivors. However, studies on HRQOL have primarily focused on one measurement and longitudinal studies in Black breast cancer survivors measuring stress and HRQOL at multiple time points have not been conducted. Physical activity is a key lifestyle factor in healthy survivorship and better HRQOL after breast cancer. Despite data supporting physical activity's beneficial effect on chronic stress and quality of life, a lower percentage of African-American women meet recommended guidelines for aerobic activity compared to Non-Hispanic Whites. The cumulative burden of chronic stress and adverse behavioral responses (e.g. physical inactivity), may lead to increased “wear and tear” on the body's regulatory system, and exceed the body's ability to repair its physiological systems. This pathophysiological mechanism, known as allostatic load, is a marker of chronic stress and is influenced by the frequency and severity of stressful events. Allostatic load is quantified through measurement of multiple physiological indicators, including metabolic, immune and inflammatory markers. Understanding how allostatic load mediates the relationship between perceived chronic stress (life stress and cancer-specific stress), physical activity and HRQOL differentially among Black and White breast cancer survivors has not been determined. Our primary goal is to investigate if chronic stress and physical activity are associated with HRQOL and racial disparities in HRQOL among breast cancer survivors; and whether these associations are mediated by allostatic load. Among Black and White female breast cancer survivors, our aims are to: AIM 1: Investigate the longitudinal relationship between perceived chronic stress (life stress and cancer-specific stress) and HRQOL. AIM 2: Investigate the longitudinal relationship between objectively-measured physical activity and HRQOL. AIM 3: Investigate whether allostatic load is a mediator of the effects of chronic stress and physical activity (total energy expenditure, duration, and sedentary behavior) on HRQOL. !

项目摘要：报告表明黑人乳腺癌幸存者的健康相关生活质量较差（HRQOL）高于白人，尽管一些研究表明黑人的精神健康状况更高。导致 HRQOL 中这些种族差异的因素数据显示，长期生活压力会产生负面影响。 HRQOL。慢性生活压力被定义为因对金钱的担忧而产生的慢性心理社会压力，住房、工作条件、邻里环境、家庭状况、公共服务、犯罪和暴力。研究表明，除了慢性生活之外，黑人发生重大生活事件的发生率也高于白人。压力、癌症特异性压力（例如担心复发）也会影响乳腺癌幸存者的 HRQOL。然而，HRQOL 的研究主要集中在黑人的一项测量和纵向研究上。尚未对乳腺癌幸存者在多个时间点测量压力和 HRQOL。尽管身体活动是乳腺癌后健康生存和改善 HRQOL 的关键生活方式因素。数据支持体力活动对慢性压力和生活质量有益，但较低的比例与非西班牙裔女性相比，非洲裔美国女性符合建议的有氧运动指南白人长期压力和不良行为反应（例如缺乏身体活动）的累积负担，可能会导致身体调节系统“磨损”增加，并超出身体的修复能力这种病理生理机制，称为稳态负荷，是一个标志。慢性压力，并受压力事件的频率和严重程度的影响，并被量化。通过测量代谢、免疫和炎症等多项生理指标了解非稳态负荷如何调节感知的慢性压力（生活）之间的关系。压力和癌症特异性压力）、体力活动和 HRQOL 在黑人和白人乳房中存在差异我们的主要目标是调查慢性压力是否与身体状况有关。活动与乳腺癌幸存者的 HRQOL 和 HRQOL 的种族差异相关；这些关联是否是由黑人和白人女性乳腺癌中的变稳态负荷介导的。幸存者，我们的目标是：目标 1：调查感知的慢性压力之间的纵向关系（生活压力和癌症特异性压力）和 HRQOL 2：调查之间的纵向关系。客观测量的体力活动和 HRQOL 目标 3：调查非稳态负荷是否是调节因素。慢性压力和体力活动的影响（总能量消耗、持续时间和久坐行为）关于 HRQOL。！