Endometrial Cancer Survival and Survivorship among Latinas in California: A Mixed Methods Study

加利福尼亚州子宫内膜癌生存率和拉丁裔生存率：一项混合方法研究

• 批准号: 10461655
• 负责人: Victoria Elizabeth Rodriguez
• 金额: $ 4.19万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-02 至 2025-01-01
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10461655
• 关键词: Address; Age; California; Cancer Survivor; Cancer Survivorship; Caring; Clinical; Complement; Comprehensive Cancer Center; Data; Diagnosis; Disease; Education; Educational workshop; Endometrial Carcinoma; Environment; Epidemiologic Methods; Ethnic Origin; Ethnic group; Fellowship; Female; Gender; Goals; Grant; Gynecologic Oncology; Health; Health Insurance; Healthcare Systems; Immigrant community; Incidence; Income; Intervention; Interview; Journals; Knowledge; Latina; Latina Population; Latino; Length; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Malignant neoplasm of ovary; Masks; Mentors; Mentorship; Methodology; Methods; Neighborhoods; Outcome; Public Health; Race; Reading; Research; Research Methodology; Research Personnel; Research Training; Sampling; Shapes; Site; Socioeconomic Status; Survival Analysis; Survival Rate; Training; United States; Universities; Woman; Writing; cancer diagnosis; cancer epidemiology; cancer health disparity; cancer site; cancer survival; cancer therapy; experience; follow-up; health inequalities; improved; insight; low socioeconomic status; multilevel analysis; neoplasm registry; programs; public health research; racial and ethnic; recruit; skills; survival outcome; survivorship; symposium

PROJECT SUMMARY/ABSTRACT The goal of this F31 fellowship is to prepare me to become an independent researcher who can effectively contribute to addressing cancer disparities for Latina women with endometrial cancer (EC). EC is the third most prevalent cancer among Latina women, representing 8% of all new cancer diagnoses among Latinas in the United States. Higher than any other racial/ethnic group, Latinas have had a 30.2% increase in EC incidence between 2010 and 2017. EC is the second most common cancer survivor site among women of all race/ethnicities. While Latinas with EC have relatively high 5-year survival rates, they also are more likely to be diagnosed with later stage and more aggressive disease, have lower quality of and barriers to equitable cancer treatment and follow-up care, and have lower levels of income, education, and health insurance compared to white women. Further, their interactions with the healthcare system and socio-ecological contexts in which they live can directly shape opportunities for and barriers to optimal health impacting their survival and survivorship. Under the guidance of my mentorship team and enhanced by the training from this fellowship, I will conduct an explanatory sequential mixed methods study to examine how macro/systemic level contexts shape the EC survival outcomes and survivorship experiences of Latinas. The Specific Aims of this study are to: 1) Examine the association between treatment facility and endometrial cancer survival and to explore whether race/ethnicity moderates this association; 2) Investigate the association between neighborhood socioeconomic status and EC survival and to examine whether race/ethnicity moderates this association; and 3) Qualitatively explore and characterize Latina EC survivors’ lived experiences and the impact of healthcare system and socio-ecological contexts on survivorship. To accomplish the proposed research, I will implement a comprehensive training and mentorship plan that will build upon my prior cancer health disparities knowledge, research experience, and doctoral training. Specifically, my Training Goals will focus on expanding my knowledge and skills in: 1) cancer epidemiology for gynecologic cancers and gynecologic oncology treatment and survivorship practices; 2) cancer disparities across the cancer continuum; 3) intersections of race/ethnicity, socioeconomic position, and gender with inequities in health, with a focus on Latino and immigrant communities; 4) mixed-methods research approaches and interpretation; 4a) quantitative methodology including epidemiologic methods, survival analysis, and multilevel modeling; 4b) qualitative methodology; and 5) grant writing. These goals will be accomplished through a range of coursework, seminars/workshops, clinical exposure, conferences, journal readings, and tailored mentoring from a committed team of interdisciplinary researchers. Complemented by support from a dedicated research and training environment at the University of California, Irvine Program in Public Health, this fellowship will accelerate my trajectory in becoming an independent researcher focused on reducing cancer disparities in gynecologic cancer.

项目总结/摘要 这个F31奖学金的目标是准备我成为一个独立的研究人员谁可以有效地 有助于解决患有子宫内膜癌（EC）的拉丁妇女的癌症差异。EC是第三个 拉丁美洲妇女中最流行的癌症，占拉丁美洲所有新癌症诊断的8%， 美国的高于任何其他种族/族裔群体，拉丁裔的EC增加了30.2% 2010年至2017年的发病率。EC是所有女性中第二常见的癌症幸存者部位 种族/民族。虽然患有EC的拉丁裔人的5年生存率相对较高，但他们也更有可能 被诊断为晚期和更具侵袭性的疾病，对公平癌症的质量和障碍较低 治疗和后续护理，收入，教育和健康保险水平较低， 白色女人。此外，他们与医疗保健系统和社会生态环境的相互作用， live可以直接塑造获得最佳健康的机会和障碍，影响他们的生存和存活。 在我的导师团队的指导下，并通过这次奖学金的培训，我将进行一次 解释性顺序混合方法研究，以研究宏观/系统层面的背景如何塑造EC 拉丁裔的生存结果和生存经历。本研究的主要目的是：（1）研究 治疗设施与子宫内膜癌生存率之间的关系，并探讨是否 种族/民族缓和这种关联; 2）调查邻里社会经济之间的关联 状态和EC存活率，并检查种族/民族是否调节这种关联;以及3）资格 探索和描述拉丁美洲EC幸存者的生活经历和医疗保健系统的影响， 生存的社会生态环境。为了完成所提出的研究，我将实施一个 全面的培训和指导计划，将建立在我以前的癌症健康差异的知识， 研究经验和博士培训。具体来说，我的培训目标将侧重于扩大我的 知识和技能：1）妇科癌症流行病学和妇科肿瘤治疗 和生存实践; 2）癌症连续体中的癌症差异; 3）种族/民族的交叉， 社会经济地位和性别与健康不平等，重点是拉丁美洲人和移民 社区; 4）混合方法的研究方法和解释; 4a）定量方法 包括流行病学方法、生存分析和多水平建模; 4 b）定性方法; 5)授予写作。这些目标将通过一系列的课程，研讨会/讲习班， 临床接触，会议，期刊阅读，以及来自一个忠诚的 跨学科研究人员。得到专门研究和培训环境的支持， 加州大学欧文分校的公共卫生项目，这项奖学金将加速我在 成为一名独立的研究人员，专注于减少妇科癌症的癌症差异。