Geographic and Racial Disparities in Mammography Screening and Barriers to Receiving Care

项目摘要 这份K 01提案题为“乳房X线摄影筛查中的地理和种族差异以及 接受照顾”描述了职业发展和研究计划，这将有助于在 Justin Xavier摩尔博士转变为乳腺领域独立研究者的发展 癌症差异和社区参与性研究。摩尔医生有流行病学的背景 癌症预防和控制，包括定量方法，研究设计，地理空间 分析和社会流行病学。然而，这笔赠款将为摩尔博士提供额外的必要培训， 贝叶斯方法和推理，定性和混合方法，健康传播，参与者 招聘，和社区参与的研究，通过课程，独立研究与 专注和指导。摩尔博士的跨学科导师包括在以下方面取得成就的研究人员： 乳腺癌差异研究，通过社区参与式癌症健康传播 研究，定性和混合方法的方法，通过他们的多重资助NIH奖。 此外，他们的专门知识将为研究所的职业发展和研究活动提供必要的支持。 摩尔博士在本申请中提出的研究。 拟议的研究将为乳腺癌差异领域提供有价值的见解，并解决关键问题。 使用创新的方法研究与乳腺癌种族和地理差异相关的公共卫生问题 分析方法它将结合联合收割机摩尔博士在空间和癌症流行病学的专业知识与导师的 在乳腺癌、健康传播和社区基础的大型干预研究方面的专业知识 参与式研究和混合方法分析，以了解个人，人际，社区 少数民族（西班牙裔和黑人）妇女生活在最高风险的乳房X光检查筛查的促进者 美国的社区。该研究包括将通过使用 跨学科的研究方法，包括贝叶斯方法的小面积估计乳房X光检查 筛选，半结构化面试，并在试点研究中招募的调查研究。的 目的包括：（1）确定黑人和西班牙裔妇女中乳房X光检查筛查率低的地区， 新的小区域估计; 2）量化黑人乳腺癌高风险县的新指数 和西班牙裔，3）在黑人和西班牙裔妇女中进行试点研究，在小说中分层 指数，以了解个人，人际关系和社区的障碍，对意向接收 乳房X光检查通过拟议的研究，研究者将了解特定的文化 障碍，并使用基于社区的方法在高风险社区内建立牢固的关系， 为开展更大规模的可持续干预措施纵向研究奠定基础。

PROJECT SUMMARY This K01 proposal entitled “Geographic and Racial Disparities in Mammography Screening and Barriers to Receiving Care” describes the career development and research plan that will be instrumental in the development of Dr. Justin Xavier Moore’s transition into an independent investigator in the field of breast cancer disparity and community-based participatory research. Dr. Moore has a background in epidemiology and cancer prevention and control that includes training in quantitative methods, research design, geospatial analysis, and social epidemiology. However, this grant will provide Dr. Moore with additional needed training in Bayesian methodology and inference, qualitative and mixed-methods, health communication, participant recruitment, and community-participatory research through a combination of courses, independent studies with hands on focus, and mentoring. Dr. Moore’s interdisciplinary mentors include researchers with achievements in breast cancer disparities research, cancer health communication through community-based participatory research, qualitative and mixed methods approaches as indicated through their multiply funded NIH awards. Further, their expertise will provide the necessary support for the career development and research activities of the study proposed in this application by Dr. Moore. The proposed research will provide valuable insight to the field of breast cancer disparities and address key public health questions of relevance to racial and geographic disparities in breast cancer using innovative analytical methods. It will combine Dr. Moore’s expertise in spatial and cancer epidemiology with the mentors’ expertise in large intervention studies on breast cancer, health communication and community-based participatory research, and mixed-methods analysis to understand the individual, interpersonal, community facilitators of mammography screening among minority (Hispanic and Black) women living in the highest risk communities of the United States. The research includes specific aims that be will achieved using interdisciplinary research methods including Bayesian methodology for small-area estimates of mammography screening, semi-structured interviews, and survey research among those recruited within the pilot study. The aims include: (1) identifying areas of low mammography screening among Black and Hispanic women using novel small-area estimation; 2) quantifying a novel index of high-risk counties for breast cancer among Blacks and Hispanics, and 3) performing a pilot study among Black and Hispanic women, stratified among the novel index, to understand the personal, interpersonal, and community barriers on intentions to receiving mammography screening. Through the proposed research the investigator will understand culturally specific barriers and develop a strong rapport within high-risk communities using a community-based approach that will provide a foundation to develop a larger longitudinal study with sustainable interventions.