African American Resilience in Surviving Cancer

非裔美国人在癌症生存中的恢复力

• 批准号: 10017169
• 负责人: MALCOLM P CUTCHIN
• 金额: $ 62.37万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-12 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10017169
• 关键词: Address; Adherence; Affect; African American; Attitude; Behavior; Cancer Science; Cancer Survivor; Cancer Survivorship; Characteristics; Collaborations; Communities; Development; Documentation; Environment; Etiology; Evaluation; Funding; Future; Grant; Health; Health Status; Healthcare; Individual; Infrastructure; Intervention; Lead; Life Experience; Link; Longitudinal Studies; Malignant Neoplasms; Mediating; Medical; Modeling; National Cancer Institute; Neighborhoods; Not Hispanic or Latino; Outcome; Participant; Pathway interactions; Perception; Plant Roots; Race; Research; Research Personnel; Risk; Self Management; Social support; Specific qualifier value; Structure; Survivors; Techniques; Testing; Theoretical model; Time; Translating; Variant; advanced analytics; effective intervention; experience; health disparity; health related quality of life; improved; innovation; knowledge translation; longitudinal design; malignant breast neoplasm; metropolitan; mortality; negative affect; prostate cancer survivors; racial disparity; racial health disparity; racism; recruit; resilience; segregation; skills; social; sociodemographics; socioeconomics; stressor; success; survivorship; theories; therapy development

Project Summary/Abstract Substantial racial disparities exist in the health-related quality of life (HRQOL) and mortality of African American (AfAm) relative to Non-Hispanic White (NHW) cancer survivors. The premise of this study is that community, interpersonal, and individual influences combine to negatively affect the HRQOL of AfAm cancer survivors and are, thus, responsible for health disparities between AfAms and NHWs. We propose that the best way to understand these disparities is to move beyond simple documentation of them to an examination of domains that cause variation in HRQOL among AfAm survivors. This effort, however, should be implemented with a collaboration between academic researchers and community stakeholders. To understand the root causes of variability in HRQOL among AfAm breast and prostate cancer survivors, this study proposes to (1) identify significant domains of causal influence on HRQOL among AfAm survivors; (2) specify the paths from these domains to survivors’ HRQOL; (3) identify modifiable factors affecting the strength of these paths; and (4) specify targets of change for future interventions. Our theoretical model draws heavily on a social-ecological model of health and assumes that the domains of influence include significant stressors linked to racial group membership that result from interpersonal, institutionalized, and structural racism and socioeconomic adversity in the U.S. We will test this model in a four-wave longitudinal study, recruiting 600 participants from a National Cancer Institute-funded infrastructure grant of 5500 AfAm cancer survivors living in metropolitan Detroit. The study will address the following Specific Aims: Aim 1. 1a. To use an academic-community collaboration to create a theoretically and community-grounded model of variability in HRQOL among AfAm cancer survivors. 1b. To evaluate the success of the collaboration with a systematic evaluation of community stakeholders’ perceptions of, and attitudes toward, the collaboration experience. Aim 2. To conduct a four-wave longitudinal study of 600 AfAm cancer survivors that empirically tests the relationships proposed in our social-ecological model. Aim 3. To collaborate with the community stakeholders in the dissemination of study findings to scientific and lay audiences and to translate study findings and inform future interventions. The paths through which race-related community, interpersonal, and individual domains of influence may affect the HRQOL of AfAm cancer survivors have not been comprehensively investigated with a longitudinal design. Nor has academic research on AfAm cancer survivors combined a theoretically-driven approach with strong community engagement to develop and test a social-ecological model and disseminate study findings. We expect findings from this study will help to identify modifiable targets of change and risk profiles and inform the development of interventions to address causes of poor HRQOL experienced by AfAm survivors.

项目摘要/摘要 非洲人的健康质量（HRQOL）和死亡率存在实质性的种族差异 美国（AFAM）相对于非西班牙裔白人（NHW）癌症存活。这项研究的前提是 社区，人际关系和个人影响力相结合，对AFAM的HRQOL产生负面影响 癌症存活，因此是AFAMS和NHW之间的健康差异的原因。我们 建议理解这些分布的最佳方法是超越简单的文档， 检查导致AFAM存活中HRQOL变化的域的检查。但是，这项努力应该 通过学术研究人员和社区利益相关者之间的合作来实施。 要了解AFAM乳房和前列腺癌存活中HRQOL变异性的根本原因， 这项研究提案（1）确定了AFAM表面中HRQOL的因果关系的重要领域； （2）指定从这些领域到生存的HRQOL的路径； （3）确定影响影响的可修改因素 这些路径的强度； （4）为将来的干预措施指定变更目标。我们的理论模型绘制 严重的是健康的健康模型，并假设影响领域包括重要的领域 与人际关系，制度化和结构性产生的种族群体成员相关的压力源 种族主义和社会经济逆境在美国，我们将在四波纵向研究中测试该模型， 从国家癌症研究所资助的基础设施授予5500 AFAM癌症的600名参与者 居住在底特律大都会的幸存者。该研究将解决以下具体目标： 目标1。1a。使用学术社区合作来创建理论和社区的基础 AFAM癌症存活中HRQOL变异性的模型。 1B。评估合作的成功 通过系统地评估社区利益相关者对合作的看法并参加 经验。 目的2。对600个AFAM癌症存活的四波纵向研究，该研究紧急测试 在我们的社会生态模型中提出的关系。 目的3。与社区利益相关者合作将研究结果传播给科学 并为观众介绍并翻译研究结果并为将来的干预提供信息。 与种族相关的社区，人际关系和个人影响力领域的途径可能 影响AFAM癌的HRQOL尚未通过纵向进行全面研究 设计。关于AFAM癌症生存的学术研究也没有将理论驱动的方法与 强大的社区参与，以发展和测试社会生态模型并传播研究结果。 我们希望这项研究的发现将有助于确定变化和风险概况的可修改目标，并告知 开发干预措施，以解决AFAM表面表面遇到的不良HRQOL的原因。