Leveraging Implementation Science to Promote Behavior Change and Reduce Cancer Health Disparities among American Indian and Alaska Native Older Adults

利用实施科学促进美洲印第安人和阿拉斯加原住民老年人的行为改变并减少癌症健康差异

• 批准号: 10399686
• 负责人: Maja Pedersen
• 金额: $ 8.59万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-04 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10399686
• 关键词: Leveraging; Implementation; Science; Promote; Behavior

Project Summary American Indian and Alaska Native (AIAN) adults are more likely to develop cancer and die from it than white American adults, reflecting pronounced and persistent cancer health disparities (CHDs). Colorectal cancer (CRC) rates are disproportionately high among AIANs in the Northern Plains and Alaska regions; likewise, risk factors for CRC are also high, including non-modifiable factors such as increasing age and rurality, and proven modifiable risk factors such as physical inactivity, and obesity. A recent consensus report indicates strong evidence that physical activity (PA) lowers risk for colon cancer through systemic (i.e., metabolism, inflammation) and obesity reduction pathways. However, despite availability of efficacious behavioral interventions to increase PA among older adults, a critical gap exists between evidence generated and action taken to implement such interventions among AIAN older adults. This gap represents a missed opportunity to implement current evidence-based interventions (EBIs) in cancer prevention among high-risk populations experiencing pronounced CHDs. Implementation science concentrates on understanding and accelerating integration of such EBIs into public health practice settings to improve health and can be leveraged here to address this critical public health gap, thus addressing persistent CHDs and improving overall health among AIAN communities. This F99/K00 Predoctoral to Postdoctoral Fellow Transition Award application assists a promising trainee - Maja Pedersen, who has 15 years of experience in community-based behavioral interventions among rural AIAN communities in the Northern Plains and Alaska regions - to embark on a rigorous research and training program to confront this critical gap using best practices for intervention research with AIAN communities and current implementation science methods. Pedersen’s long-term goal is to become an independent investigator in designing and implementing PA interventions among underserved populations - including AIANs - to improve cancer-related health outcomes and reduce CHDs. Her short-term goals include gaining expertise in the use of multilevel intervention methods, dissemination and implementation science, cancer prevention and control among geriatric populations, experimental design, and intensive longitudinal methods. In collaboration with her multidisciplinary team of predoctoral mentors, she has developed a training plan to initiate these goals via coursework, workshops, scientific meetings, directed readings, and mentored research (F99 Phase). As she transitions into the postdoctoral phase, she will assemble a team of high-level, cancer-focused mentors to support her through continued mentored training with an explicit focus on cancer prevention and control. Her postdoctoral research (K00 Phase) executes the logical next steps in her research sequence on a trajectory toward a full-scale implementation and effectiveness trial as an independent scientist.

项目摘要 美国印第安人和阿拉斯加原住民(AIAN)成年人患癌症和死于癌症的可能性比白人更大 美国成年人，反映了明显和持续的癌症健康差距(CHD)。结直肠癌 (CRC)比率在北部平原和阿拉斯加地区的AIAN中高得不成比例；同样，风险 CRC的因素也很高，包括不可修改的因素，如年龄和乡村生活的增加，并已得到证实 可改变的风险因素，如缺乏运动和肥胖。最近的一份共识报告显示， 有证据表明，体力活动(PA)通过全身(即新陈代谢， 炎症)和减肥途径。然而，尽管有有效的行为 在老年人中增加PA的干预措施，在所产生的证据和行动之间存在严重差距 为在AIAN老年人中实施此类干预而采取的措施。这一差距意味着错失了 在高危人群中实施当前的循证干预措施(EBI)预防癌症 经历了明显的先心病。实施科学专注于理解和加速 将这种EBI整合到公共卫生实践环境中以改善健康，并可在此利用 解决这一严重的公共卫生差距，从而解决顽固性先天性心脏病，并改善 安安社区。这份F99/K00博士后到博士后过渡奖的申请帮助 有前途的实习生-Maja Pedersen，她在社区行为方面有15年的经验 对北部平原和阿拉斯加地区农村AIAN社区的干预--开始 严格的研究和培训计划，使用干预的最佳实践来应对这一关键差距 与AIAN社区和当前的实施科学方法进行研究。彼得森的长期目标是 成为一名独立的调查员，在服务不足的人群中设计和实施PA干预措施 包括AIAN在内的人群--改善与癌症相关的健康结果，减少CHD。她的短期 目标包括在使用多级干预方法、传播和实施方面获得专门知识 老年人群中的科学、癌症预防和控制、实验设计和强化 纵向研究方法。在与她的多学科博士前导师团队的合作下，她 制定了培训计划，通过课程作业、研讨会、科学会议、指导 阅读资料和辅导性研究(F99阶段)。当她过渡到博士后阶段时，她将 组建一支高水平、专注于癌症的导师团队，通过持续的导师培训为她提供支持 明确以癌症预防和控制为重点。她的博士后研究(K00阶段)执行 在她的研究序列中合乎逻辑的下一步是走向全面实施的轨迹和 作为一名独立科学家进行有效性试验。