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Ethnicity and Lung Cancer Survival: A Test of the Hispanic Sociocultural Hypothesis

种族与肺癌生存：对西班牙裔社会文化假说的检验

基本信息

批准号：
10440521
负责人：
Heidi Ann Hamann
金额：
$ 64.74万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10440521
关键词：
Acculturation Adopted Affective Age Area Behavioral Black race Cancer Etiology Cancer Patient Cancer Survivorship Car Phone Cessation of life Clinical Treatment Computerized Medical Record Data Death Rate Diagnosis Early Diagnosis Ecological momentary assessment Ethnic Origin Ethnic group Family Fostering Frequencies Gold Health Health Sciences Hispanic Hispanic Populations Incidence Individual Intervention Interview Investigation Life Longitudinal observational study Malignant Neoplasms Malignant neoplasm of lung Measurement Measures Mediating Mediator of activation protein Medical Methodology Methods Morality Neighborhoods Non-Small-Cell Lung Carcinoma Not Hispanic or Latino Outcome Patient Self-Report Patients Persons Process Public Health Publishing Reporting Research Research Personnel Risk Risk Factors Role Sampling Science Site Social Environment Social Interaction Social Processes Social support Surveys Survival Rate Testing Time Underserved Population United States Variant Work base burden of illness cancer survival cultural values demographics ethnic difference ethnic minority experience follow-up health care disparity health related quality of life in vivo innovation low dose computed tomography mortality novel primary outcome psychosocial racial and ethnic recruit resilience screening secondary outcome social social culture social integration socioeconomic disparity socioeconomics survival disparity survival outcome treatment adherence

项目摘要

PROJECT SUMMARY/ABSTRACT As the leading cause of cancer death, lung cancer represents the most significant cancer-related public health challenge in the United States. Although low-dose CT-based screening holds promise for earlier detection, currently, most lung cancer cases are not diagnosed until advanced stages (III, IV) and have 5-year survival rates of 21% or less. In contrast to Black-White survival disparities, Hispanic patients have markedly lower age-adjusted death rates than their non-Hispanic White (NHW) counterparts despite later stage diagnoses and broader SES and healthcare disparities; these findings are well established and consistent with the “Hispanic Health Paradox”, a phenomenon characterized by Hispanic advantages in objective health outcomes (e.g., mortality) despite significant health and socioeconomic risk factors. The leading explanatory hypothesis concerns the role of cultural factors facilitating social integration. Social integration is among the most robust psychosocial predictors of a range of objective health outcomes, including cancer survival. However, no published work has directly tested this sociocultural hypothesis in relation to Hispanic resilience. Consistent with the emerging science of resilience, we propose a multisite, two-study, mixed-methods investigation to evaluate this sociocultural hypothesis. Study 1 is a multisite, longitudinal observational study of 672 Hispanic and NHW individuals with advanced stage lung cancer sampled from three regions across the U.S. Interviews using gold-standard and culturally-informed survey measures (demographics, social integration, cultural values, acculturation) will be conducted in English and Spanish from a centralized coordinating center with a 6- week follow-up to examine change in perceived support provision/needs. The primary outcome of survival and secondary outcomes (e.g., treatment adherence), will be gathered from electronic medical records over mean follow-up time of 33-months. Study 2 is a single-site, 7-day, intensive measurement investigation into the daily units of social integration that mediate outcomes. Study 2 integrates two novel in vivo sampling methods (Electronically Activated Recorder [EAR] and ecological momentary assessments [EMA]) using a mobile phone platform. The current aims are to (1) investigate whether the observed Hispanic survival advantage is mediated by ethnic differences in social integration among recently diagnosed late-stage lung cancer patients and (2) to examine the processes/mechanisms that underlie these relationships in daily life including the role of individual, family, network, and neighborhood-level factors. The highly experienced investigator team includes leaders in all relevant content areas, including the Hispanic health paradox, lung cancer survivorship, social integration, and ecological sampling methodologies. The results will contribute to better understanding of social processes among cancer patients, inform psychosocial interventions based on social integration, and contribute to the emerging science of health resilience as well as racial/ethnic and cultural variations in health outcomes.

项目总结/文摘