F32 Administrative Supplement for Childcare Costs: Addressing Fertility Information Needs and Fertility-related Distress among Female Adult Survivors of Childhood Cancer

F32 儿童保育费用行政补充：解决儿童癌症成年女性幸存者的生育信息需求和与生育相关的困扰

• 批准号: 10811353
• 负责人: Juliann Stalls
• 金额: $ 0.25万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10811353
• 关键词: Achievement; Address; Administrative Supplement; Adult; Area; Behavior Therapy; Behavioral Model; Biological; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caregivers; Caring; Child; Clinical; Cognitive; Communication; Data; Development; Diagnosis; Distress; Emotional; Evaluation; Feedback; Fellowship; Female; Fertility; Foundations; Future; Gatekeeping; Goals; Grief reaction; Health; Health Benefit; Impairment; Individual; Infertility; Intervention; Interview; Knowledge; Late Effects; Lead; Left; Length; Life; Link; Literature; Malignant Childhood Neoplasm; Malignant Neoplasms; Manuals; Medical; Mental Depression; Modality; Modeling; National Cancer Institute; Ovarian tissue cryopreservation; Patients; Pattern; Phase; Population; Provider; Public Health; Quality of life; Questionnaires; Reporting; Reproductive Health; Research Personnel; Research Priority; Resources; Risk; Risk Estimate; Role; Sampling; Secondary to; Self Efficacy; Sexual Health; Stress; Structure; Survivors; Target Populations; Testing; Time; Training; Universities; Woman; acceptability and feasibility; aged; cancer therapy; career; child bearing; childcare allowance; childhood cancer survivor; combination intervention strategy; cost; design; evidence base; fertility improvement; fertility preservation; flexibility; health knowledge; improved; intervention refinement; motherhood; novel; oocyte cryopreservation; phase 1 study; post intervention; prepuberty; preservation; primary ovarian insufficiency; psychologic; side effect; skills; survivorship; theories; therapy design; therapy development; training opportunity; Achievement; Address; Administrative Supplement; Adult; Area; Behavior Therapy; Behavioral Model; Biological; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caregivers; Caring; Child; Clinical; Cognitive; Communication; Data; Development; Diagnosis; Distress; Emotional; Evaluation; Feedback; Fellowship; Female; Fertility; Foundations; Future; Gatekeeping; Goals; Grief reaction; Health; Health Benefit; Impairment; Individual; Infertility; Intervention; Interview; Knowledge; Late Effects; Lead; Left; Length; Life; Link; Literature; Malignant Childhood Neoplasm; Malignant Neoplasms; Manuals; Medical; Mental Depression; Modality; Modeling; National Cancer Institute; Ovarian tissue cryopreservation; Patients; Pattern; Phase; Population; Provider; Public Health; Quality of life; Questionnaires; Reporting; Reproductive Health; Research Personnel; Research Priority; Resources; Risk; Risk Estimate; Role; Sampling; Secondary to; Self Efficacy; Sexual Health; Stress; Structure; Survivors; Target Populations; Testing; Time; Training; Universities; Woman; acceptability and feasibility; aged; cancer therapy; career; child bearing; childcare allowance; childhood cancer survivor; combination intervention strategy; cost; design; evidence base; fertility improvement; fertility preservation; flexibility; health knowledge; improved; intervention refinement; motherhood; novel; oocyte cryopreservation; phase 1 study; post intervention; prepuberty; preservation; primary ovarian insufficiency; psychologic; side effect; skills; survivorship; theories; therapy design; therapy development; training opportunity

Impaired fertility is a highly distressing, under-addressed, late effect of cancer and cancer treatment among female adult survivors of childhood cancer. Many female survivors are uncertain about their fertility status and report unmet fertility information needs and fertility-related distress. For those who desire biological children, overestimation of risk for impaired fertility may cause unnecessary emotional and relational distress. Underestimation may lead to a missed opportunity to pursue having biological children due to factors such as premature ovarian insufficiency. Yet, to date, fertility-related information needs and distress remain largely unaddressed in this population. Following the ORBIT Model for behavioral intervention development, the proposed study seeks to design and refine a behavioral intervention to address unmet fertility-related information needs and fertility-related distress among female adult survivors of childhood cancer (aged 18-44). Phase I of the study will involve conducting individual interviews with female adult survivors of childhood cancer (N=20) and medical providers who care for this population (N=10) to inform the development of a preliminary, manualized, intervention. Based on existing literature and feedback from experts in behavioral interventions for cancer survivors, adult survivors of childhood cancer, and infertility, it is anticipated that an intervention combining strategies from Patient Activation Theory and Acceptance and Commitment Therapy will be developed. Intervention development is flexible and will be tailored based on feedback received from stakeholders. In Phase 2, preliminary intervention content will be delivered to a small sample of the target population (N=30). Feasibility and acceptability, as well as examination of pre- to post-intervention patterns of change in intervention targets (primary: fertility health knowledge, fertility-related distress; secondary: psychological flexibility, patient activation, and self-efficacy), will be assessed and utilized to further refine the intervention (e.g., intervention strategies, intervention length, and delivery modality). In line with the National Cancer Institute’s priority research area focused on cancer survivorship, the overall goal of the fellowship is to support Dr. Stalls to develop expertise that will enable her to become a leading clinical researcher in the development and evaluation of behavioral interventions to address reproductive and sexual health late effects among cancer survivors. To do so requires a unique combination of knowledge and skills in the areas of, 1) Reproductive and Sexual Health, 2) Behavioral Intervention Development and Evaluation, and 3) Professional Development. Training in these areas will be accomplished through guidance from expert sponsors and collaborators as well as the many resources and training opportunities offered at Duke University. Completion of this fellowship would not only advance the survivorship literature in this area and propel Dr. Stalls toward her career goals, but help address the significant gap in well-trained clinical researchers who are equipped to address these highly personal and time-sensitive reproductive and sexual health late effects of cancer and cancer treatment.

生育能力受损是一种高度令人痛苦的，未受解固的，癌症治疗的晚期作用 雌性成年儿童癌症生存。许多女性生存不确定其生育状况和 报告未满足的生育信息需求和与生育有关的困扰。对于那些渴望生物孩子的人 高估生育能力受损的风险可能会导致不必要的情绪和关系困扰。 低估可能会导致失踪的机会追求生物孩子，因为 早产卵巢不足。但是，迄今为止，与生育有关的信息需求和困扰仍然很大 在这一人群中未受解决。遵循行为干预发展的轨道模型， 拟议的研究旨在设计和完善行为干预措施，以解决未满足生育有关的信息 儿童癌症的女性成年人生存中的需求和与生育有关的困扰（18-44岁）。第一阶段 该研究将涉及对儿童癌症的女性成人生存（n = 20）和 关心该人群的医疗提供者（n = 10）为开发初步，手动， 干涉。基于现有文献和癌症行为干预专家的反馈 幸存者，儿童癌症的成人生存和不育，预计将进行干预措施 将制定患者激活理论以及接受和承诺疗法的策略。 干预开发是灵活的，将根据利益相关者的反馈来量身定制。在阶段 2，初步干预含量将被输送到目标群体的一小部分样本（n = 30）。可行性 和可接受性以及干预后干预后的干预后模式的检查 （主要：生育健康知识，与生育有关的困扰；次要：心理灵活性，患者 将评估并利用激活和自我效能）进一步完善干预措施（例如，干预措施 策略，干预长度和交付方式）。与国家癌症研究所的优先研究一致 研究金的总体目标是支持Strandship的总体目标，以支持Stalls博士发展专业知识 这将使她能够成为行为发展和评估的领先临床研究人员 解决癌症存活中生殖和性健康后期影响的干预措施。这样做需要 1）生殖和性健康领域中知识和技能的独特组合，2）行为 干预开发和评估，以及3）专业发展。在这些领域的培训将是 通过专家赞助商和合作者的指导以及许多资源和 杜克大学提供的培训机会。该奖学金的完成不仅会推进 该领域的生存文献，并推动Stalls博士的职业目标，但有助于解决重大的 训练有素的临床研究人员的差距等同于解决这些高度个人和时间敏感的差距 癌和癌症治疗的生殖和性健康后期作用。