Disparities in Chronic Stress, QOL, and Physical Activity among Black and White Breast Cancer Survivors

黑人和白人乳腺癌幸存者在慢性压力、生活质量和体力活动方面的差异

• 批准号: 10004024
• 负责人: Chiranjeev Dash
• 金额: $ 7.55万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10004024
• 关键词: Accelerometer; Accounting; Aerobic Exercise; Affect; African American; Age; Behavioral; Blood; Breast Cancer Risk Factor; Breast Cancer survivor; Cancer Survivor; Chronic; Chronic stress; Crime; Data; Environment; Event; Exercise; Family; Fatigue; Female Breast Carcinoma; Frequencies; Fright; Goals; Guidelines; Health; High Prevalence; Housing; Immunologic Markers; Lead; Life; Life Stress; Longitudinal Studies; Malignant Neoplasms; Measurement; Measures; Mediating; Mediator of activation protein; Metabolic Marker; Methods; Neighborhoods; Not Hispanic or Latino; Observational Study; Occupations; Patient Self-Report; Personal Satisfaction; Physical Function; Physical activity; Physiological; Psychosocial Stress; Quality of life; Race; Recurrence; Reporting; Role; Services; Severities; Social Functioning; Stage at Diagnosis; Stress; Stressful Event; Survivors; System; Time; Violence; Woman; Work; active method; allostatic load; anticancer research; behavioral response; breast cancer diagnosis; cancer subtypes; exercise intensity; health related quality of life; hormone therapy; improved; indexing; inflammatory marker; lifestyle factors; light weight; malignant breast neoplasm; physical conditioning; physical inactivity; racial health disparity; recruit; repaired; sedentary; sedentary lifestyle; stem; survivorship; systematic review; total energy expenditure; vigorous intensity

Project Summary/Abstract – Project 2 Reports indicate Black breast cancer survivors have poorer health-related quality of life (HRQOL) than Whites, although some studies suggest that Blacks have higher spiritual wellbeing. Several factors contribute to these racial disparities in HRQOL. Data show that chronic life stress negatively impacts HRQOL. Chronic life stress is defined as chronic psychosocial stress stemming from concerns about money, housing, job condition, neighborhood environment, family situation, public services, crime and violence. Studies indicate a higher prevalence of major life events for Blacks than Whites. In addition to chronic life stress, cancer-specific stress (e.g. fear of recurrence) also affects HRQOL in breast cancer survivors. However, studies on HRQOL have primarily focused on one measurement and longitudinal studies in Black breast cancer survivors measuring stress and HRQOL at multiple time points have not been conducted. Physical activity is a key lifestyle factor in healthy survivorship and better HRQOL after breast cancer. Despite data supporting physical activity’s beneficial effect on chronic stress and quality of life, a lower percentage of African-American women meet recommended guidelines for aerobic activity compared to Non-Hispanic Whites. The cumulative burden of chronic stress and adverse behavioral responses (e.g. physical inactivity), may lead to increased “wear and tear” on the body’s regulatory system, and exceed the body’s ability to repair its physiological systems. This pathophysiological mechanism, known as allostatic load, is a marker of chronic stress and is influenced by the frequency and severity of stressful events. Allostatic load is quantified through measurement of multiple physiological indicators, including metabolic, immune and inflammatory markers. Understanding how allostatic load mediates the relationship between perceived chronic stress (life stress and cancer-specific stress), physical activity and HRQOL differentially among Black and White breast cancer survivors has not been determined. Our primary goal is to investigate if chronic stress and physical activity are associated with HRQOL and racial disparities in HRQOL among breast cancer survivors; and whether these associations are mediated by allostatic load. Among Black and White female breast cancer survivors, our aims are to: AIM 1: Investigate the longitudinal relationship between perceived chronic stress (life stress and cancer-specific stress) and HRQOL. AIM 2: Investigate the longitudinal relationship between objectively-measured physical activity and HRQOL. AIM 3: Investigate whether allostatic load is a mediator of the effects of chronic stress and physical activity (total energy expenditure, duration, and sedentary behavior) on HRQOL.

项目总结/摘要 – 项目 2 报告表明黑人乳腺癌幸存者的健康相关生活质量（HRQOL）比白人差， 尽管一些研究表明黑人具有更高的精神健康水平，但有几个因素促成了这些。 HRQOL 的种族差异 数据显示，慢性生活压力会对 HRQOL 产生负面影响。 定义为因对金钱、住房、工作条件的担忧而产生的慢性社会心理压力， 邻里环境、家庭状况、公共服务、犯罪和暴力研究表明较高。 黑人重大生活事件的发生率高于白人 除了慢性生活压力外，癌症特异性压力也较白人高。 （例如对复发的恐惧）也会影响乳腺癌幸存者的 HRQOL 然而，关于 HRQOL 的研究已经证实。 主要关注黑人乳腺癌幸存者的一项测量和纵向研究 尚未进行多个时间点的压力和 HRQOL 身体活动是关键的生活方式因素。 尽管有数据支持体力活动有益，但乳腺癌后仍能保持健康的生存和更好的 HRQOL。 对慢性压力和生活质量的影响，符合建议的非洲裔美国女性比例较低 与非西班牙裔白人相比的有氧运动指南 慢性压力和累积负担。 不良行为反应（例如缺乏身体活动）可能会导致身体“磨损”增加 调节系统，并超出身体修复其生理系统的能力。 称为非稳态负荷的机制是慢性压力的标志，受频率和压力的影响。 压力事件的严重程度通过测量多种生理情况来量化。 指标，包括代谢、免疫和炎症标志物了解稳态负荷如何介导。 感知的慢性压力（生活压力和癌症特异性压力）、体力活动和 黑人和白人乳腺癌幸存者之间的 HRQOL 差异尚未确定。 目标是调查慢性压力和体力活动是否与 HRQOL 和种族差异相关 乳腺癌幸存者的 HRQOL；以及这些关联是否由稳态负荷介导。 对于黑人和白人女性乳腺癌幸存者，我们的目标是： 目标 1：调查纵向关系 感知的慢性压力（生活压力和癌症特异性压力）与 HRQOL 之间的关系：调查 客观测量的体力活动与 HRQOL 之间的纵向关系 AIM 3：调查。 稳态负荷是否是慢性压力和体力活动（总能量消耗、 HRQOL 的持续时间和久坐行为）。