Exercise Intervention for Lesbian, Gay, Bisexual, and Transgender Cancer Survivors

针对女同性恋、男同性恋、双性恋和变性癌症幸存者的运动干预

• 批准号: 9512855
• 负责人: Charles Stewart Kamen
• 金额: $ 16.61万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-17 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9512855
• 关键词: Address; Adherence; Adult; Aftercare; Anxiety; Area; Award; Behavior; Biological; C-reactive protein; Cancer Control; Cancer Control Research; Cancer Patient; Cancer Survivor; Caring; Clinic; Clinical; Clinical Trials; Competence; Discrimination; Distress; Environment; Exercise; Faculty; Feasibility Studies; Funding; Future; Gays; Goals; Health; Heterosexuals; Home environment; Hydrocortisone; Inflammation; Instruction; Intervention; Intervention Studies; Intervention Trial; K-Series Research Career Programs; Lesbian; Lesbian Gay Bisexual; Link; Malignant Neoplasms; Medical Oncologist; Mentors; Methods; Minority; Moods; Morbidity - disease rate; Patient Self-Report; Personal Satisfaction; Persons; Phase; Population; Positioning Attribute; Prevalence; Psyche structure; Psychologist; Questionnaires; Randomized; Reporting; Research; Risk; Serum amyloid A protein; Social support; Standardization; Stress; Survivors; Testing; Time; Training; Training Programs; Underserved Population; United States; Universities; Walking; Work; actigraphy; anticancer research; arm; base; biopsychosocial; cancer care; cancer diagnosis; cancer therapy; cancer type; career; career development; community intervention; design; exercise intervention; experience; health disparity; improved; innovation; member; mortality; novel; oncology; phase II trial; post intervention; psychologic; psychological distress; public health relevance; response; strength training; transgender; virtual

 DESCRIPTION (provided by applicant): Prevalence of cancer is up to 2.1 times higher among lesbian, gay, bisexual, and transgender (LGBT) persons than heterosexuals, yet LGBT cancer survivors are virtually invisible in cancer research in the United States. This invisibility, as wel as real and expected discrimination, leads LGBT cancer patients and survivors to experience 1.7 times higher rates of psychological distress than heterosexual survivors. Given these rates of distress, the unique sociocultural factors acting on LGBT survivors, and the fact that distress is linked with increased cancer-related morbidity and mortality, tailored interventions to reduce distress among LGBT cancer survivors are needed. Our preliminary research shows that care partners of LGBT survivors want to be included in interventions to support survivors and that social support is strongly linked to psychological distress among LGBT adults. Our novel dyadic framework incorporates support from care partners and a standardized exercise intervention, Exercise for Cancer Patients (EXCAP(c)(r), a 6 week, home-based progressive walking and resistance training program), and may be effective in reducing distress among LGBT survivors. In this K07 Career Development Award application, Dr. Charles Kamen, a clinical psychologist with a background in health disparities and dyadic intervention research, proposes to conduct a Phase II RCT randomizing 70 LGBT cancer survivors (all cancer types, 1-24 months post treatment) plus their 70 care partners (broadly defined) to: Arm 1, a novel, partner-assisted version of EXCAP(c)(r) (called EXCAP-PA), in which both survivors and care partners will receive EXCAP(c)(r) materials and instruction together, or Arm 2, a survivor-only version of EXCAP(c)(r), i which only the LGBT cancer survivor will receive EXCAP(c)(r) materials. The overall hypothesis of this study is that among LGBT survivors, EXCAP-PA, incorporating care partner support, will be more efficacious than survivor-only EXCAP(c)(r) in improving biopsychosocial aspects of distress. Dr. Kamen is well positioned as a junior faculty member in an exceptional environment at the University of Rochester. He needs additional training in three core competency areas in order to launch an independent research career: 1) clinical trials for LGBT health, 2) integration of biological endpoints, and 3) design of exercise interventions. His mentors have over 30 years of experience conducting cancer control intervention trials and include: Dr. Karen Mustian, PEAK Lab Director and exercise oncology expert; Dr. Gary Morrow, Director of Cancer Control research; Dr. Kathi Heffner, psychoneuroimmunologist; Dr. Deborah Bowen, community intervention expert; and advisors Dr. Supriya Mohile, medical oncologist; Dr. James McMahon, dyadic intervention expert; and Dr. Charles Heckler, biostatistician. The career development goals and protected time provided by this training award will prepare Dr. Kamen to become an expert in cancer-related health disparities and dyadic interventions for LGBT cancer survivors and care partners. Further, if successful, this study will address a critical disparity (distress) n the underserved population of LGBT survivors.

 描述（由申请人提供）：女同性恋、男同性恋、双性恋和跨性别者 (LGBT) 的癌症患病率比异性恋者高 2.1 倍，但 LGBT 癌症幸存者在美国的癌症研究中几乎不可见。考虑到这些痛苦发生率、作用于 LGBT 幸存者的独特社会文化因素以及事实上，痛苦与癌症相关发病率和死亡率的增加有关，因此需要采取量身定制的干预措施来减少 LGBT 癌症幸存者的痛苦，我们的初步研究表明，LGBT 幸存者的护理伙伴希望参与支持幸存者的干预措施，并且社会支持是必要的。与 LGBT 成年人的心理困扰密切相关。我们的新型二元框架得到了护理伙伴的支持，并提供了标准化运动干预措施，即癌症患者运动（EXCAP(c)(r)，一项为期 6 周的家庭渐进式步行和阻力训练计划）。 ，并且可能有效在这份 K07 职业发展奖申请中，拥有健康差异和二元干预研究背景的临床心理学家 Charles Kamen 博士建议开展一项 II 期随机对照试验，随机抽取 70 名 LGBT 癌症幸存者（所有癌症类型、治疗后 1-24 个月）加上他们的 70 个护理合作伙伴（广义）： 第 1 组，EXCAP(c)(r) 的新型合作伙伴辅助版本（称为 EXCAP-PA），其中幸存者和护理伙伴将一起收到 EXCAP(c)(r) 材料和指导，或第 2 组，仅幸存者版本的 EXCAP(c)(r)，其中只有 LGBT 癌症幸存者才会收到 EXCAP(本研究的总体假设是，在 LGBT 幸存者中，结合护理伙伴支持的 EXCAP-PA 在改善生物心理社会方面的痛苦方面将比仅针对幸存者的 EXCAP(c)(r) 更有效。卡门博士是作为罗切斯特大学的一名初级教员，他需要在三个核心能力领域接受额外的培训，才能开展独立的研究生涯：1) LGBT 健康的临床试验，2) 生物终点的整合， 3) 运动干预设计。他的导师拥有超过 30 年的癌症控制干预试验经验，其中包括：PEAK 实验室主任、运动肿瘤学专家 Karen Mustian 博士；癌症控制研究主任 Gary Morrow 博士；凯西·赫夫纳 (Kathi Heffner)，心理神经免疫学家；黛博拉·鲍文 (Deborah Bowen) 博士，医学肿瘤学家；詹姆斯·麦克马洪 (James McMahon) 博士，生物统计学家。该培训奖将使 Kamen 博士成为癌症相关健康差异和 LGBT 癌症幸存者和护理合作伙伴双元干预方面的专家。该研究将解决服务不足的 LGBT 幸存者群体中的严重差异（困境）。