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.

项目概要/摘要 非洲人的健康相关生活质量 (HRQOL) 和死亡率存在巨大的种族差异 美国人 (AfAm) 与非西班牙裔白人 (NHW) 癌症幸存者的关系 这项研究的前提是： 社区、人际和个人影响共同对 AfAm 的 HRQOL 产生负面影响 癌症幸存者，因此对 AfAm 和 NHW 之间的健康差异负有责任。 提出理解这些差异的最佳方法是超越对它们的简单记录 然而，应该对导致 AfAm 幸存者 HRQOL 差异的领域进行检查。 通过学术研究人员和社区利益相关者之间的合作来实施。 为了了解 AfAm 乳腺癌和前列腺癌幸存者 HRQOL 变异的根本原因， 本研究建议 (1) 确定对 AfAm 幸存者 HRQOL 具有因果影响的重要领域； (2) 明确从这些领域到幸存者 HRQOL 的路径； (3) 确定影响幸存者 HRQOL 的可修改因素； 这些路径的强度；（4）指定我们的理论模型绘制的变革目标。 很大程度上依赖于健康的社会生态模型，并假设影响范围包括重要的 与种族群体成员身份有关的压力源，这些压力源来自人际、制度化和结构性 美国的种族主义和社会经济逆境。我们将在四波纵向研究中测试这个模型， 从国家癌症研究所资助的 5500 AfAm 癌症基础设施拨款中招募 600 名参与者 该研究将解决以下具体目标： 目标 1. 1a. 通过学术界合作创建一个以理论和社区为基础的 AfAm 癌症幸存者的 HRQOL 变异模型 1b。 对社区利益相关者对合作的看法和态度进行系统评估 经验。 目标 2. 对 600 名 AfAm 癌症幸存者进行四波纵向研究，以实证检验 我们的社会生态模型中提出的关系。 目标 3. 与社区利益相关者合作，将研究结果传播给科学界 并向非专业观众传达研究结果并为未来的干预措施提供信息。 与种族相关的社区、人际和个人影响领域可能通过的路径 尚未对 AfAm 癌症幸存者的 HRQOL 进行全面纵向调查 对 AfAm 癌症幸存者的学术研究也没有将理论驱动的方法与设计结合起来。 社区的大力参与，开发和测试社会生态模型并传播研究结果。 我们期望这项研究的结果将有助于确定可修改的变革目标和风险状况，并提供信息 制定干预措施，解决 AfAm 幸存者 HRQOL 较差的原因。