Increasing Breast Cancer Screening in Chinese Immigrants

增加中国移民的乳腺癌筛查

• 批准号: 10156409
• 负责人: Lina Jandorf
• 金额: $ 19.81万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-09 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10156409
• 关键词: Address; Adherence; Adoption; Behavior; Belief; Breast Cancer Detection; Breast Cancer Early Detection; Breast Cancer Education; Breast Cancer Risk Factor; Caring; China; Chinese American; Chinese People; Communication; Communities; Complex; Country; Dissemination and Implementation; Economics; Education; English Language; Ethnic group; Familiarity; Feedback; Focus Groups; Funding; Future; Gatekeeping; Goals; Guidelines; Health behavior; Health education; Healthcare Systems; Healthy People 2020; Human; Immigrant; Immigration; Individual; Insurance; Intervention; Interview; Knowledge; Language; Linguistics; Malignant Neoplasms; Mammographic screening; Mammography; Medical; Minority; Modeling; New York City; Participant; Persons; Plague; Play; Population; Poverty; Pre-Post Tests; Preventive healthcare; Province; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Residencies; Resources; Review Literature; Risk; Role; Screening for cancer; Source; Symptoms; Testing; Time; Treatment Efficacy; Underserved Population; Woman; Work; acceptability and feasibility; base; cancer diagnosis; cancer prevention; cultural health; design; evidence base; experience; feasibility testing; follow-up; health belief; health care availability; health disparity; high school; improved; innovation; malignant breast neoplasm; mortality; novel; predictive modeling; programs; screening; screening guidelines; social; stem; success; tv watching; uptake

In New York City (NYC), persons of Chinese descent experience the highest cancer mortality rate of any ethnic group. Breast cancer is the most commonly diagnosed cancer in Chinese immigrant women, who experience substantial increases in breast cancer risk after spending a decade or more in the US. Regular mammography screening and timely follow up are crucial for early detection of breast cancer and increased survival. However, Chinese immigrant women in NYC report low utilization of screening mammography and are less likely to complete follow up in a timely manner compared to non-Latina white women. Chinese immigrants in NYC are more likely to live below the poverty line, to lack insurance, and to be without a usual source of care. Over 50% have less than a high school education, cannot speak or understand English, and would not see a western doctor as a first course even if they had symptoms. Research within this community has revealed that only 23% of Chinese immigrant women in NYC had ever had a mammogram in their lifetime. This is a population with great need for basic medical care, increased breast cancer knowledge, and access to breast cancer screening. Health disparities plague the health care system and arise from a complex interplay of economic, social, and cultural factors. The Health Belief Model (HBM) provides a framework for addressing cultural health disparities related to preventive health care and cancer screening by positing that making a decision to engage in a health behavior is determined by weighing perceived threats versus benefits. Guided by the HBM, the Witness Project uses narrative communication (e.g., storytelling, personal testimonials) to educate, persuade, and engage target communities about cancer prevention and screening. Our work in minority and immigrant communities has demonstrated that narrative communication can increase participation in breast cancer screening. However, the efficacy of these interventions has not been empirically tested among Chinese immigrants. The long-term goal of the proposed line of research is to increase breast cancer screening rates for NYC Chinese immigrants. We plan to accomplish this objective by pursuing the following specific aims: AIM 1. Culturally and linguistically adapt the Witness Project, a narrative breast cancer education program, for Chinese immigrant women. Focus groups and qualitative interviews will be conducted with community gatekeepers and stakeholders to obtain feedback on intervention content. AIM 2. Pilot test feasibility and acceptability of WP for Chinese immigrant women. Feasibility and acceptability of the pilot intervention will be assessed to determine effect sizes for a future large scale trial. Screening mammogram receipt and intentions to undergo mammography, as well as other HBM constructs will be compared in a pre-post design stratified by language. Successful completion of the study aims will make a novel and transformative contribution to the field of cancer screening, especially for this underserved population.

在纽约市（NYC），华裔癌症死亡率是所有族裔中最高的 组乳腺癌是中国移民妇女中最常见的癌症， 在美国生活十年或更长时间后，乳腺癌风险大幅增加。常规乳房X线摄影 筛查和及时随访对于早期发现乳腺癌和提高存活率至关重要。然而，在这方面， 纽约市的中国移民妇女报告说，筛查性乳房X光检查的利用率较低， 与非拉丁裔白色女性相比，及时完成随访。在纽约的中国移民 更有可能生活在贫困线以下，缺乏保险，没有通常的护理来源。超过50% 我的教育程度低于高中，不会说或理解英语，也不会看西方电影。 医生作为第一个疗程，即使他们有症状。研究表明，只有 纽约市23%的中国移民女性一生中曾做过乳房X光检查。这是一个人口 对基本医疗保健、增加乳腺癌知识和获得乳腺癌治疗的需求很大 筛选健康差距困扰着医疗保健系统， 社会和文化因素。健康信念模型（HBM）为解决文化健康问题提供了一个框架 与预防性保健和癌症筛查有关的差异， 健康行为是通过权衡感知到的威胁与利益来确定的。在HBM的指导下， 见证项目使用叙事沟通（例如，讲故事，个人推荐）教育，说服， 并让目标社区参与癌症预防和筛查。我们在少数民族和移民方面的工作 社区已经证明，叙事沟通可以增加参与乳腺癌 筛选然而，这些干预措施的有效性尚未在中国人中进行实证检验 移民.这项研究的长期目标是提高乳腺癌筛查率 纽约华人移民我们计划通过实现以下具体目标来实现这一目标： 1.在文化和语言上适应见证项目，一个叙事乳腺癌教育计划， 中国移民女性。将与社区进行焦点小组和定性访谈 把关人和利益攸关方就干预措施的内容获得反馈。AIM 2.可行性试验和 中国移民妇女对WP的接受程度。试点干预的可行性和可接受性将 以确定未来大规模试验的效应量。筛查乳房X线检查收据和 将在前后设计中比较接受乳腺X射线摄影的意图以及其他HBM结构 按语言分层。成功完成研究目标将使一个新颖和变革 这是对癌症筛查领域的贡献，特别是对这一服务不足的人群。