Developing a Culturally Targeted mHealth Intervention for Cancer-Related Sleep Disturbance in African American Breast Cancer Survivors

针对非裔美国乳腺癌幸存者癌症相关睡眠障碍制定文化针对性的移动健康干预措施

• 批准号: 9222474
• 负责人: Brian D Gonzalez
• 金额: $ 2.92万
• 依托单位: RBHS -CANCER INSTITUTE OF NEW JERSEY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9222474
• 关键词: Accounting; Address; Adherence; Affect; African American; Anxiety; Behavior; Behavior Therapy; Behavioral; Behavioral Medicine; Biological; Biological Process; Breast Cancer survivor; Cancer Etiology; Cancer Institute of New Jersey; Cancer Intervention; Cancer Patient; Cancer Survivor; Cancer Survivorship; Circadian Rhythms; Clinical; Clinical Trials; Cognitive Therapy; Cohort Studies; Collaborations; Continuance of life; Data; Data Set; Development; Development Plans; Devices; Distress; Educational workshop; Elderly; Ensure; Environment; Epidemiology; Etiology; Fatigue; Feasibility Studies; Foundations; Fright; Funding; General Population; Goals; Grant; Health; Immune; Impaired cognition; Inflammation; Intervention; Interview; K-Series Research Career Programs; Learning; Malignant Neoplasms; Medicine; Mentored Research Scientist Development Award; Mentors; Mentorship; Meta-Analysis; Metabolic; Methodology; Methods; Minority; Motivation; Napping; Obesity; Online Systems; Ownership; Pain; Participant; Patients; Pattern; Personal Satisfaction; Population; Population Sciences; Positioning Attribute; Primary Insomnia; Public Health; Publications; Publishing; Qualitative Methods; Quality of life; Recommendation; Records; Recurrence; Reporting; Research; Resort; Resources; Risk Factors; Sleep; Sleep disturbances; Sleeplessness; Solid; Stress; Structure; Testing; Theoretical model; Training; Treatment-Related Cancer; United States; Vasomotor; Woman; Wrist; Writing; acronyms; base; cancer health disparity; cancer recurrence; cancer risk; cancer subtypes; career; career development; clinically significant; cohort; coping; design; diaries; efficacy testing; falls; follow-up; handheld mobile device; health disparity; holistic approach; improved; individualized medicine; mHealth; malignant breast neoplasm; member; mobile application; professor; programs; psychologic; psychosocial; skills; standard care; survivorship; symposium; tenure track; therapy development; training opportunity; web site

PROJECT ABSTRACT Candidate. My career goal is to reduce cancer health disparities in cancer survivorship by addressing sleep disturbance and other quality of life issues (e.g., distress, cognitive impairment, fear of cancer recurrence) in minority cancer populations. I received a solid foundation in observational cancer quality of life research, but my training has not provided the skills I need to develop mHealth behavioral interventions or the skills needed to reduce cancer health disparities. I look forward to taking the next steps in my career development, and the K01 provides an ideal opportunity to develop the necessary skills to achieve my career goal. This line of research has the potential to significantly improve cancer survivorship because of A) the large impact that sleep disturbance and other quality of life issues have on well-being, B) growing evidence of disparities in cancer survivorship, and C) the large and growing population of minority cancer survivors. Career Development Plan. My career development plan builds on my training in observational cancer quality of life research. I propose to develop the skills necessary to become a leader in the field of developing mHealth behavioral interventions for sleep disturbance and other quality of life issues in minority cancer survivors. Training will be obtained through participation in scientific conferences (mHealth, sleep medicine, behavioral medicine), methods workshops (designing mHealth interventions, health disparities research, clinical trial analyses), coursework (health disparities, qualitative methods, mobile app development), and structured mentorship from experts in intervention development (Dr. Sharon Manne), cancer health disparities (Dr. Elisa Bandera), sleep disturbance (Dr. Martica Hall), qualitative interviewing (Dr. Shawna Hudson), mHealth methodology (Dr. Lee Ritterband), developing culturally targeted interventions (Dr. Cathy Meade), and grant writing. This training will ensure that I achieve my goals, which are to: 1) Learn the health disparities research skills that will help me conceptualize and implement culturally targeted behavioral interventions for sleep disturbance and other quality of life issues, 2) acquire the skills necessary to develop and test behavioral interventions, including qualitative interviewing, mHealth methodology, and clinical trial analyses, and 3) Develop a deeper understanding of sleep disturbance and other quality of life issues in cancer survivors. Research Plan. We propose a sequential mixed methods approach to develop and pilot test a new mHealth behavioral intervention for cancer-related sleep disturbance that is culturally targeted to African American breast cancer survivors. We plan to take a holistic approach to cancer-related sleep disturbance as compared to standard treatment for primary insomnia, which is less effective in cancer survivors than in the general population. We will first identify predictors of cancer-related sleep disturbance in a unique cohort of African American breast cancer survivors as well as collect qualitative data on the barriers to standard treatment and opportunities for cultural targeting (Aim 1). Using data gathered in Aim 1, we will iteratively develop an mHealth intervention to address cancer-related sleep disturbance in African American breast cancer survivors (Aim 2). This intervention will address predictors of cancer- related sleep disturbance, reduce barriers to motivation and usage, and be culturally targeted to this population. It will also be tailored to patients' unique sleep patterns, adjusting recommendations based on automatically gathered objective sleep data via actigraphs (unobtrusive wrist-worn devices). Lastly, we will test this intervention for acceptability, feasibility, and preliminary efficacy (Aim 3). Thus, this project will address a health disparity for a distressing quality of life issue in a large and growing population. Mentorship Team. Each member of the mentorship team has external funding, including eight R01s between the five mentors. The team has excellent publication and mentorship track records. Collaborations with this esteemed mentorship team will result in 3-4 publications per year (2-3 first-authored). Environmental and Institutional Commitment. The research environment, facilities, and resources at the Rutgers Cancer Institute of New Jersey are ideal for career development in cancer survivorship disparities research. Numerous training opportunities are available across campus. I will carry out my K01 activities as a tenure-track Assistant Professor in the Division of Population Science with strong institutional commitment, including from Associate Director for Population Science Dr. Sharon Manne. Conclusions. Cancer-related sleep disturbance is a common and distressing survivorship issue. African American breast cancer survivors are at urgent need for a culturally targeted intervention that addresses the factors that make cancer-related sleep disturbance different from primary insomnia. In the proposed sequential mixed methods study, I will develop a new, tailored, mHealth, and culturally targeted intervention for cancer-related sleep disturbance in African American breast cancer survivors. The use of mHealth methods will ensure wide disseminability. The K01 award period will culminate in a R01 proposal. The K01 mentored career development award will support my transition to independence and position me as an expert in reducing cancer health disparities in cancer survivorship.

项目摘要 候选人。我的职业目标是通过解决癌症生存的癌症健康差异 睡眠障碍和其他生活质量问题（例如，遇险，认知障碍，对癌症的恐惧 少数癌症种群复发）。我在观察性癌症质量方面获得了坚实的基础 生活研究，但我的培训尚未提供我需要开发MHealth行为干预措施的技能 或减少癌症健康差异所需的技能。我期待着我的下一步 职业发展，K01提供了发展必要技能以实现的理想机会 我的职业目标。这一研究有可能显着改善癌症的生存 由于a）睡眠障碍和其他生活质量问题对幸福感的影响很大， b）越来越多的癌症生存差异的证据，c） 少数民族癌幸存者。 职业发展计划。我的职业发展计划以我的观察癌培训为基础 生活质量研究。我建议发展成为该领域领导者所需的技能 为睡眠障碍和其他生活质量问题开发MHealth的行为干预措施 少数民族癌幸存者。将通过参加科学会议来获得培训 （MHealth，睡眠医学，行为医学），方法研讨会（设计MHealth干预措施， 健康差异研究，临床试验分析），课程（健康差异，定性方法， 移动应用程序开发）以及干预开发专家的结构化指导（博士 沙龙·曼恩（Sharon Manne），癌症健康差异（Elisa Bandera博士），睡眠障碍（Martica Hall博士）， 定性访谈（Shawna Hudson博士），MHealth方法论（Lee Ritterband博士），开发 具有文化针对性的干预措施（Cathy Meade博士）和授予写作。这项培训将确保我 实现我的目标，即：1）学习将帮助我的健康差异研究技能 概念化和实施具有文化针对性的行为干预措施，以进行睡眠障碍和其他 生活质量问题，2）获得制定和测试行为干预所需的技能，包括 定性访谈，MHealth方法论和临床试验分析以及3）更深入 了解癌症幸存者的睡眠障碍和其他生活质量问题。 研究计划。我们提出了一种连续的混合方法方法来开发和试点测试一个新的 与癌症相关的睡眠障碍的MHealth行为干预措施在文化上针对 非裔美国人乳腺癌幸存者。我们计划采用与癌症相关睡眠的整体方法 与原发性失眠的标准治疗相比，干扰症在癌症中的效果较差 幸存者比普通人群。我们将首先确定与癌症相关睡眠障碍的预测指标 在一个独特的非裔美国乳腺癌幸存者中，并收集有关有关的定性数据 标准治疗和文化靶向机会的障碍（AIM 1）。使用AIM收集的数据 1，我们将迭代地开发MHealth干预措施，以解决与癌症相关的睡眠障碍 非裔美国人乳腺癌幸存者（AIM 2）。这种干预将解决癌症的预测指标 - 相关的睡眠障碍，减少动力和使用的障碍，并在文化上成为目标 人口。它也将针对患者独特的睡眠方式量身定制，调整基于建议 在自动通过Actigraphs（不引人注目的腕部设备）收集客观睡眠数据上。最后，我们 将测试此干预措施的可接受性，可行性和初步功效（AIM 3）。因此，这个项目 在人口增长的大量和增长的人口中，将解决令人痛苦的生活质量问题的健康差异。 指导团队。指导团队的每个成员都有外部资金，包括八个R01 在五个导师之间。该团队拥有出色的出版和指导记录。 与这个受人尊敬的指导团队的合作将每年产生3-4个出版物（2-3个首次撰写）。 环境和机构承诺。研究环境，设施和资源 新泽西州罗格斯癌症研究所是癌症生存职业发展的理想选择 差异研究。校园各地都有许多培训机会。我将执行我的K01 作为人口科学系的任期助理教授的活动 机构承诺，包括人口科学副总监Sharon Manne博士。 结论。与癌症相关的睡眠障碍是一个普遍且令人痛苦的生存问题。非洲人 美国乳腺癌幸存者迫切需要一种以文化为目标的干预措施来解决 使癌症相关睡眠障碍的因素与原发性失眠不同。在提议中 顺序混合方法研究，我将开发一种新的，量身定制的，MHealth的和具有文化目标的 非裔美国人乳腺癌幸存者中与癌症相关的睡眠障碍的干预。使用 MHealth方法将确保广泛的分配性。 K01奖项期将在R01中达到高潮 提议。 K01指导职业发展奖将支持我向独立的过渡 并将我定位为减少癌症生存中癌症健康差异的专家。