Grant Details
Grant Number: |
1UG3CA220642-01 Interpret this number |
Primary Investigator: |
Park, Crystal |
Organization: |
University Of Connecticut Storrs |
Project Title: |
Multilevel Resilience Trajectories in the Transition to Cancer Survivorship |
Fiscal Year: |
2017 |
Abstract
For individuals with cancer, the end of active treatment and return to life “as usual” is widely recognized as a
difficult transition (IOM 2005): the physical and emotional intensity of active treatment with attendant support
and structure are suddenly replaced with expectations that survivors will readily resume life just where they
left off. Yet individuals vary greatly in terms of their adjustment during this critical transition point into
survivorship, which can set the course of their long-term well-being. Currently, no comprehensive research
explaining the underlying mechanisms and outcomes of resilience from this point has been conducted.
Resilience trajectories provide a useful way to model individual differences in survivors’ post-treatment
adjustment. In this application, we respond to PAR-16-326, which requests elucidation of “mechanisms and
processes of resilience.” We will examine adjustment to the challenge that end of primary treatment poses to
cancer patients/survivors. Based on the Social Cognitive Restorative Model of Wellbeing (Lent, 2007), we aim
to determine the pre-challenge (pre-transition) biological, personal and social factors that predict trajectories of
survivors’ recovery and resilience in four different life domains (physical and psychological health and well-
being, social functioning, and health behaviors), with multiple self-report and objective indices comprising each
domain. Our prospective study proposes to follow 575 individuals diagnosed with breast, prostate, or colorectal
cancer across the transition to survivorship, assessed during active treatment, within three months of
completing treatment, and six, nine, and twelve months post-treatment. Participants will be recruited through
the SEER Registry at Yale-New Haven Hospital. Per requirements of PAR 16-326, our project has 2 distinct
phases: In the UG3 planning phase, we will establish study infrastructure, pilot-test and finalize our selection of
assays, secure IRB approval, develop recruitment procedures, and train staff. For the UH3 phase, we will
implement a longitudinal prospective study to test hypotheses derived from our dynamic model of resilience.
Our ultimate goal is to identify processes (mechanisms) that mediate the pathways between patients’ final
stages of primary cancer treatment and quality of their subsequent reintegration into “life as usual” that hold
potential as targets of intervention, based on their influence on resilience trajectories. Our specific aims are to
identify the different trajectories of survivors’ adjustment through the transition (e.g., resilience, recovery,
delayed recovery, chronic difficulties) by domain and the extent to which trajectories are related or distinct
across domains, to examine predictors and processes that explain these different trajectories, and to
determine if characteristics such as type of cancer or gender moderate their influences. Characterizing these
trajectories, their determinants, and their underlying processes are essential for promoting resilience in
survivorship and for developing effective and targeted interventions.
Publications
None