This application proposes a rigorous training program that will enable the applicant to become an independent nurse scientist with a sustainable trajectory of research. The program will provide a solid foundation of research experience under the mentorship of established scientists in research-intensive academic and clinical environments. The broader long-term objective of this program is to enable the applicant to advance the science of biobehavioral factors that contribute to cognitive function following breast cancer chemotherapy in a direction of theoretically based translational research. The purpose of this cross-sectional study is to identify modifiable psychosocial (stress, social isolation) and behavioral (physical inactivity, sleep disturbance) factors that may contribute to cognitive function (memory, attention, processing speed, executive function performance) both directly and indirectly, by examining biological (inflammatory markers [IL-6, TNF-?]) factors in breast cancer survivors (BCS) ages 21 to 65 one to five years after chemotherapy. The specific aims are (1) to assess the impact of the aforementioned psychosocial and behavioral factors on inflammatory markers after controlling for individual factors; (2) to assess the impact of inflammatory markers on cognitive function after controlling for individual factors; and (3) to explore direct and indirect (through inflammatory mediators IL-6 and TNF-?) effects of psychosocial and behavioral factors on cognitive function after controlling for selected individual factors. This study will be a nonexperimental, cross-sectional analysis of a sample of 80 women ages 21 to 65 who have a history of non-inflammatory, non-metastatic breast cancer (stages I-III) who have received chemotherapy, and who have been in remission for one to five years. The study will take place in a community setting (the greater Austin metropolitan area). Participants will be recruited through the applicant's relationships with Texas Oncology, the Breast Cancer Resource Center, and the Central Texas Oncology Nursing Society. Data collection will include both unmodifiable and modifiable factors: demographic and treatment-related factors; self-report measures of stress, social isolation, physical inactivity, and sleep disturbance; an objective measure of BMI; neuropsychological assessment of memory, attention, processing speed, and executive function; and biological measures of IL-6 and TNF-?. Each participant will complete questionnaires (containing self-report measures and demographic and treatment-related factors), undergo anthropometric and neuropsychological assessments, and provide blood samples, once. Data analysis will consist of hierarchical regression methods to assess psychosocial and behavioral contributions to cognitive function, as well as mediation analyses to explore the indirect effects of modifiable factors on cognitive function by examining inflammatory mediators. The proposed study is aligned with the mission and research priorities of the National Institute of Nursing Research-specifically, to delineate causative mechanisms underlying symptoms and to advance science through the integration of the biological and behavioral sciences.
NIH ExPorter
NIH ExPorter