Increasing Breast Cancer Screening in Chinese Immigrants

增加中国移民的乳腺癌筛查

基本信息

批准号：
10316255
负责人：
Lina Jandorf
金额：
$ 23.23万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-12-09 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10316255
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 Chinese American Chinese population 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 Immigrant community Immigration Individual Insurance Intervention Interview Knowledge Language Linguistics Malignant Neoplasms Mammographic screening Mammography Medical Modeling New York City Participant Plague Play Population Poverty Pre-Post Tests Preventive healthcare Province Randomized Clinical Trials Randomized Controlled Trials Reporting Research Residencies Resource-limited setting 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 community barrier cultural health design evidence base experience follow-up health belief health care availability health disparity high school improved innovation malignant breast neoplasm minority communities mortality novel pilot test predictive modeling programs screening screening guidelines social stem success tv watching uptake

项目摘要

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（纽约），中国血统的人的癌症死亡率最高团体。乳腺癌是中国移民妇女中最常见的癌症在美国花费十年或更长时间后，乳腺癌风险的大幅增加。常规乳房X线摄影筛查和及时的随访对于早期发现乳腺癌和生存率增加至关重要。然而，纽约市的中国移民妇女报告说，乳房X线摄影的利用率较低，不太可能与非Latina白人妇女相比，及时完成后续跟进。纽约市的中国移民是更有可能生活在贫困线以下，缺乏保险，并且没有通常的护理来源。超过50％不到高中教育，不能说或理解英语，不会看到西方医生即使有症状，也是第一门课程。这个社区中的研究表明，只有纽约市有23％的中国移民妇女一生都有乳房X光检查。这是一个人口非常需要基本的医疗保健，增加乳腺癌知识并获得乳腺癌筛选。健康差异困扰着医疗保健系统，并源于经济的复杂相互作用，社会和文化因素。健康信念模型（HBM）为解决文化健康提供了一个框架通过假设做出参与的决定，与预防性医疗保健和癌症筛查有关的差异在健康行为中，通过权衡感知的威胁与利益来确定。在HBM的指导下目击者项目使用叙事交流（例如讲故事，个人推荐）来教育，说服，并与目标社区有关预防癌症和筛查。我们在少数民族和移民的工作社区表明，叙事交流可以增加参与乳腺癌筛选。但是，这些干预措施的疗效尚未在中国移民。拟议的研究线的长期目标是提高乳腺癌筛查率对于纽约中国移民。我们计划通过追求以下特定目标来实现这一目标：目标 1。在文化和语言上适应了叙事性乳腺癌教育计划的见证项目，对于中国移民妇女。焦点小组和定性访谈将与社区进行网守和利益相关者获得有关干预内容的反馈。目标2。试点测试可行性和 WP对中国移民妇女的可接受性。飞行员干预的可行性和可接受性将进行评估以确定未来大规模试验的效果大小。筛选乳房X线照片收据和将在前设计中比较乳房X线摄影以及其他HBM构建体的意图按语言分层。成功完成研究目标将使新颖而变革对癌症筛查领域的贡献，尤其是对该服务不足的人群的贡献。