Examining Gender as a Sociocultural Variable Shaping Health Outcomes of Cancer Caregiving

检查性别作为影响癌症护理健康结果的社会文化变量

基本信息

批准号：
10770121
负责人：
Areej El-Jawahri
金额：
$ 16.56万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-19 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10770121
关键词：
Address Administrative Supplement Appointment Behavior Belief Budgets Cancer Survivor Cancer Survivorship Caregivers Caring Characteristics Clinical Data Dedications Dimensions Disease Distress Early Diagnosis Eligibility Determination Enrollment Evolution Face Family Family member Fatigue Feasibility Studies Friends Funding Gender Gender Relations Goals Hair Health Health Promotion Healthcare Heterogeneity Hospitalization Hydrocortisone Individual Institutional Review Boards Intervention Interview Knowledge Link Malignant Neoplasms Maps Medical Mentors Methods Monitor Morbidity - disease rate Outcome Pain Parents Participant Pathway interactions Patient Self-Report Patients Personal Satisfaction Physical Function Physically Challenged Population Protocols documentation Provider Psychologist Randomized Relaxation Therapy Research Research Personnel Research Support Resources Risk Role Science Self Care Shapes Strategic Planning Stress Support Groups Surveys Survivors Symptoms Testing Training United States National Institutes of Health Visit Woman Women&apos s Health Work acceptability and feasibility biobehavior cancer care cancer therapy care giving burden care recipients career development caregiving caregiving research disorder prevention emotional distress experience follow-up gender difference health care service utilization health difference health equity promotion indexing intervention effect intervention program intimate behavior man mortality next generation novel parent grant pilot trial poor health outcome primary outcome programs promote resilience randomized trial recruit resilience response satisfaction screening secondary analysis sex social culture stress management stress resilience stressor survivorship trait treatment as usual treatment effect treatment group

项目摘要

PROJECT SUMMARY/ABSTRACT With advances in early detection and novel, targeted cancer treatments, a growing number of individuals provide support for cancer survivors who have completed curative intent therapy (“curvivors”) as well as for those who live for many years with metastatic disease (“metavivors”). Cancer caregiving relationships for curvivors and metavivors alike are associated with high stress, particularly as individuals transition to post- initial treatment survivorship and experience decreased contact with medical providers, continued need for medical symptom monitoring, and evolution in relationship dynamics between caregiver and care recipient. As such, caregivers (partners, family members, close friends) may struggle with unmet needs for their own well- being and healthcare utilization (e.g., attendance at follow-up visits, routine healthcare screenings) while supporting the survivor they care for. Though caregiving roles are disproportionately held by women, little is known about possible gender differences in the health impact of cancer caregiving stress during the transition to post-initial treatment survivorship. No existing interventions provide concurrent but separate support for cancer survivors and caregivers at this critical transition point; as such, the parent R21 (“Building Resiliency Among Caregivers of Curvivors and Metavivors: A Pilot Randomized Trial,” R21 CA273785-01) is highly novel in its aim to evaluate the feasibility, acceptability, and preliminary efficacy of the Stress Management and Resiliency Training-Relaxation Resiliency Response Program (SMART-3RP) as delivered concurrently to separate groups of cancer caregivers and survivors. Building upon the aims of the parent grant, this Administrative Supplement (in response to NOT-OD-22-030) will explicate key indices of feasibility and acceptability by participant gender. Leveraging quantitative self-report and biobehavioral (i.e., hair cortisol) data from 48 cancer caregiver-survivor dyads (N = 96), we will also analyze gender differences in baseline characteristics mapping onto gender as a sociocultural variable (i.e., gender norms, gender-related traits, and gender relations), as well as gender differences in preliminary efficacy of the SMART-3RP for caregivers’ and survivors’ resiliency (primary) and healthcare utilization (secondary). To enrich interpretation of quantitative analyses, we will add 3 questions to the planned qualitative exit interviews, regarding of sociocultural aspects of gender in cancer caregiving. This Administrative Supplement will provide timely support for the research team to meaningfully generate empirical mixed-methods data regarding gender differences in intervention feasibility, acceptability, and preliminary efficacy and promote health equity for women in the growing landscape of cancer caregiving research. Further, this work will provide a critical opportunity for MPIs Park and El-Jawahri to support Dr. Lucy Finkelstein-Fox, a promising junior investigator mentored by Drs. Park and El- Jawahri whose research program is dedicated to women’s health and intimacy in cancer survivorship.

项目概要/摘要随着早期检测和新型靶向癌症治疗的进步，越来越多的人为已完成治疗性意向治疗的癌症幸存者（“幸存者”）以及那些患有转移性疾病多年的人（“metavivors”）的癌症护理关系。幸存者和后幸存者都与高压力有关，特别是当个体过渡到后幸存者时初始治疗存活率和经验减少与医疗提供者的接触，持续需要医疗症状监测以及护理人员和护理接受者之间关系动态的演变。因此，照顾者（伴侣、家庭成员、亲密朋友）可能会因自己的健康需求未得到满足而苦苦挣扎。健康状况和医疗保健利用（例如，参加随访、常规医疗保健筛查）支持她们所照顾的幸存者尽管护理角色大部分由女性承担，但很少有女性承担这一角色。了解过渡期间癌症护理压力对健康影响可能存在的性别差异现有的干预措施没有为初始治疗后的生存提供同时但单独的支持。处于这一关键转变点的癌症幸存者和护理人员；因此，家长 R21（“增强复原力”）在幸存者和元幸存者的照顾者中：一项试点随机试验，”R21 CA273785-01）非常新颖其目的是评估压力管理和压力管理的可行性、可接受性和初步效果弹性训练-放松弹性响应计划 (SMART-3RP) 同时交付给根据家长补助金的目标，将癌症护理人员和幸存者分开。行政补充（针对 NOT-OD-22-030）将阐明可行性的关键指标和利用定量自我报告和生物行为（即头发皮质醇）来确定参与者的可接受性。来自 48 名癌症护理者-幸存者二人组 (N = 96) 的数据，我们还将分析基线中的性别差异将性别映射为社会文化变量的特征（即性别规范、与性别相关的特征和性别关系），以及 SMART-3RP 对护理人员和护理人员初步功效的性别差异幸存者的复原力（主要）和医疗保健利用（次要）丰富定量解释。分析后，我们将在计划的定性离职面谈中添加 3 个关于社会文化方面的问题本行政补充文件将为该研究提供及时的支持。团队有意义地生成有关干预中性别差异的经验混合方法数据可行性、可接受性和初步有效性，促进日益增长的妇女健康公平此外，这项工作将为 MPI Park 和癌症护理研究提供重要机会。 El-Jawahri 支持 Lucy Finkelstein-Fox 博士，她是一位有前途的初级研究员，由 Park 博士和 El-Jawahri 博士指导。 Jawahri 的研究项目致力于女性健康和癌症幸存者的亲密关系。