Restore: Improving Sexual Outcomes of Gay and Bisexual Prostate Cancer Survivors

恢复：改善同性恋和双性恋前列腺癌幸存者的性结果

基本信息

批准号：
9980806
负责人：
B R Simon Rosser
金额：
$ 60.61万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9980806
关键词：
Address Aftercare Anal Sex Area Bisexual Bladder Control Caregivers Clinic Communities Depressed mood Exercise Funding Gays Gold HIV Infections HIV Seropositivity Health Health Status Heterosexuals Intervention Intervention Trial Interview Knowledge Malignant Neoplasms Malignant neoplasm of prostate Measures Mental Health Methods Monitor Needs Assessment Operative Surgical Procedures Oral Sex Outcome Participant Patients Pelvic floor structure Pharmaceutical Preparations Physiological Population Prostate Cancer therapy Publications Quality of life Radical Prostatectomy Randomized Controlled Trials Rehabilitation Outcome Rehabilitation therapy Reporting Research Research Methodology Science Sex Functioning Sexual Dysfunction Sexual and Gender Minorities Social support Source Structure Survivors Testing Time Urinary Incontinence Vacuum Pumps Vagina Work arm base biopsychosocial clinical practice community center comparative condoms demographics design evidence base experience health disparity improved interest man men men who have sex with men primary outcome programs prostate cancer survivors recruit rehabilitative care response routine care same-sex partnership sex standard of care three-arm study treatment center treatment effect treatment program urinary web site

项目摘要

Abstract: This application, in response to PA-15-261, “Research leading to interventions to ameliorate health disparities of sexual and gender minorities”, advances research in three areas. First, prostate cancer (PCa) is the second most common cancer among gay, bisexual, and other men who have sex with men (GBM), with documented disparities, yet it is severely under-researched. Because gay sex differs from vaginal sex, physiologically; the results from 614 studies focused on heterosexual men likely do not generalize to GBM with PCa. There have been no rehabilitation studies specific to GBM survivors of PCa, so clinicians have no relevant studies to inform best practice with their GBM patients. Second, most PCa studies have tested one or rehabilitation components. We will conduct the first treatment study of a state of clinical practice comprehensive rehabilitation program on GBM's quality of life, including on both urinary and sexual function and bother measures. Third, almost all PCa studies have focused on men recently treated for PCa. We will study both GBM recently treated (last 2 years) and GBM post-treatment (2+ years), using a stratified design. This study builds on our findings in Restore, an R21 which was only the second study of GBM with PCa to be funded by NCI, and the first to reach publication. We conducted N=41 in-depth qualitative interviews with good saturation, and the largest quantitative study of GBM with PCa to date (N=193), the first needs assessment of GBM with PCa, and the first study of same sex partners and care-givers of GBM. Participants described radical prostatectomy as leaving them “humiliated,” “maimed”, “less than other gay men,” and “severely depressed.” Most (88%) reported ongoing sexual challenges contributing to decreased quality of life, poorer mental health, identity challenges and deteriorated primary relationships. Only three of the eight (38%) outcomes commonly experienced by most GBM were discussed as part of treatment. There was no evidence of any standard of professional rehabilitation; indeed, most GBM just treated themselves. The long-term objective of this research is to improve the health of GBM survivors of PCa and to provide an evidence base for rehabilitation. In Aim I, we will develop an online rehabilitation program tailored for GBM that addresses both the sexual and urinary effects of PCa treatment. In Aim II, we will conduct a comparative recruitment study to identify best methods to recruit 450 GBM with PCa. In Aim III, we will evaluate the effects of the tailored rehabilitation program on sexual and urinary outcomes. We will conduct a 24 month, randomized controlled trial of structured rehabilitation versus routine care. This RCT will identify whether a structured rehabilitation program is effective in addressing the major sexual and urinary problems caused by PCa treatment. As the first treatment study to focus on GBM with PCa (and also on oral and anal sex), it addresses a long-standing health disparity. The study has high potential to transform rehabilitation for GBM with PCa, provide a critical evidence base for clinicians, and inform rehabilitation outcomes for all PCa survivors.

摘要：本申请响应 PA-15-261，“改善健康干预措施的研究” 性别少数群体的差异”，推进了三个领域的研究首先，前列腺癌（PCa）。同性恋、双性恋和其他男男性行为者 (GBM) 中第二常见的癌症记录了差异，但研究严重不足，因为同性恋与阴道性行为不同，生理学上；614 项针对异性恋男性的研究结果可能无法推广到 GBM 目前还没有针对 PCa 的 GBM 幸存者的康复研究，因此追随者没有进行过康复研究。其次，大多数 PCa 研究已经测试了一项或多项。我们将进行首次临床实践治疗研究。针对 GBM 生活质量的综合康复计划，包括泌尿和性功能第三，几乎所有 PCa 研究都集中在最近接受 PCa 治疗的男性。使用分层设计研究最近治疗的 GBM（过去 2 年）和治疗后的 GBM（2 年以上）。这项研究建立在我们在 Restore 中的研究结果的基础上，Restore 是一项 R21，这只是 GBM 与 PCa 的第二项研究由 NCI 资助，第一个发表。我们对 41 人进行了深度定性访谈。良好的饱和度，以及迄今为止最大规模的 GBM 与 PCa 定量研究（N=193），首先需要 GBM 与 PCa 的评估，以及对 GBM 参与者的同性伴侣和照顾者的首次研究。描述根治性前列腺切除术让他们“受到羞辱”、“致残”，“比其他男同性恋者少”，并且 “严重抑郁。”大多数人（88%）表示持续的性挑战导致生活质量下降，心理健康状况较差、身份认同受到挑战以及主要关系恶化，这八个中只有三个 (38%)。大多数 GBM 普遍经历的结果作为治疗的一部分进行了讨论。没有证据表明。事实上，大多数 GBM 都只是对待自己。这项研究的长期目标是改善 PCa 的 GBM 幸存者的健康，并提供在目标 I 中，我们将开发一个针对 GBM 量身定制的在线康复计划。在目标 II 中，我们将讨论 PCa 治疗对性和泌尿系统的影响。招募研究以确定用 PCa 招募 450 个 GBM 的最佳方法。在目标 III 中，我们将评估其效果。我们将进行为期 24 个月的随机康复计划。结构化康复与常规护理的对照试验该随机对照试验将确定结构化康复是否有效。康复计划可有效解决 PCa 引起的主要性和泌尿问题作为第一个针对 GBM 合并 PCa（以及口交和肛交）的治疗研究，它涉及了治疗。该研究具有很大的潜力来改变 GBM 合并 PCa 的康复，为忠诚者提供重要的证据基础，并为所有前列腺癌幸存者提供康复结果信息。