OBJECTIVES Physiological stress responses have been suggested as a mechanism through which social and biological factors contribute to racial disparities in breast cancer outcomes. Many African Americans experience stressful life events and circumstances. These social factors may contribute to an increased risk of advanced stage disease at diagnosis and/or faster progression, but not all African American women exposed to adverse social factors develop advanced stage disease. Similarly, women who have a limited number of stressors can develop advanced stage breast cancer. Highly individualized stress reactivity may account for these inconsistent associations. METHOD This report describes the rationale, design, and methods for an exploratory study that uses the experimental medicine approach to: (a) characterize the nature and distribution of stress reactivity among African American breast cancer survivors based on socioeconomic, clinical, and social stressors; (b) examine the impact of stress reactivity on temporal discounting; and (c) determine the extent to which stress reactivity and temporal discounting are associated with adherence to recommendations for cancer control behaviors and treatment compliance as part of the Science of Behavior Change Network. RESULTS This study addresses several empirical gaps about the most effective ways to develop behavior change interventions for a medically underserved population that continues to experience disparities in cancer morbidity and mortality. CONCLUSIONS Results from this research will provide the empirical and conceptual basis for future intervention protocols that target mechanisms that are critical to disparities in African American breast cancer survivors. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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癌症差异中应激反应性的观察性研究和随机试验。

目的已提出生理应激反应作为一种机制，通过该机制社交和生物学因素导致乳腺癌预后方面的种族差异。许多非洲裔美国人经历过压力大的生活事件和环境。这些社会因素可能会导致诊断时罹患晚期疾病的风险增加和/或进展更快，但并非所有暴露于不利社会因素的非洲裔美国妇女都患有晚期疾病。同样，压力源数量有限的女性可以发展晚期乳腺癌。高度个体化的应激反应性可能是造成这些不一致的原因的原因。方法本报告描述了探索性研究的基本原理，设计和方法，该研究使用实验医学方法进行以下工作：（a）根据社会经济，临床和社会压力源，描述非裔美国乳腺癌幸存者之间压力反应的性质和分布；（b）研究压力反应性对时间折现的影响；（c）确定“行为反应网络”的一部分，应激反应性和时间折现与遵守癌症控制行为和治疗依从性建议的相关程度。结果这项研究解决了一些经验上的空白，这些空白针对的是为医疗服务不足的人群制定行为改变干预措施的最有效方法，这些人群继续经历着癌症发病率和死亡率的差异。结论这项研究的结果将为未来的干预方案提供经验和概念基础，这些方案的目标是对非洲裔美国乳腺癌幸存者之间的差异至关重要的机制。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。