Empowering Latinas to Obtain Guideline-Concordant Breast Cancer Screenings

帮助拉丁裔获得符合指南的乳腺癌筛查

• 批准号: 10518742
• 负责人: Yamile Molina
• 金额: $ 65.56万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-08 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10518742
• 关键词: Address; Advisory Committees; Breast; Breast Cancer Detection; Caring; Chicago; Clinical; Collaborations; Communication; Communities; Community Health Aides; Community Health Education; Data; Education; Enrollment; Equation; Family; Federally Qualified Health Center; Friends; Fright; Future; Goals; Guidelines; Health; Healthcare; Individual; Intervention; Knowledge; Latina; Latina Population; Latino; Lead; Learning; Long-Term Effects; Mammography; Measures; Mediating; Mediation; Modeling; Motivation; Pathway Analysis; Pilot Projects; Population; Preventive service; Process; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Role; Services; Social Network; Solid; Testing; Time; Translations; Woman; arm; base; breast cancer diagnosis; cancer care; community based participatory research; community engagement; community intervention; community organizations; comparison intervention; cost; design; diagnosis quality; empowered; empowerment; experience; implementation science; improved; innovation; intervention effect; intervention participants; leadership development; malignant breast neoplasm; member; models and simulation; novel; peer; prospective; psychosocial; recruit; role model; screening; screening guidelines; skills; skills training; social observations; volunteer

ABSTRACT Latinas suffer disproportionately from late stage breast cancer (BC) diagnoses and worse post-diagnosis quality of life relative to non-Latina Whites (NLWs), in part due to lower guideline-concordant screening. Education+navigation (educate) approaches have offered Latinas community education to address psychosocial barriers (e.g., fear) and navigated Latinas to free/low-cost breast cancer care. Our transdisciplinary team has developed a promising empowerment+navigation (empower) approach that may lead to greater BC screening among Latino networks. In the empower approach, Latinas who are non-adherent to US Preventive Services Task Force (USPSTF) guidelines learn about BC; are navigated to free/low cost breast cancer care; and gain communication skills to promote BC screening throughout their networks. Our premise is that empowering non-adherent Latinas as breast health agents may lead to greater BC screening among non-adherent Latinas and their networks than treating non-adherent Latinas as passive recipients of education. The current proposal tests our premise and identifies “active ingredients” of the empower approach. In Aim 1, we will conduct an individual randomized controlled trial (RCT) in a federally qualified health center (FQHC). This trial will build on our team’s current service projects to provide free/low-cost BC screening in the FQHC, including leveraging its relationship with a community organization committed to leadership development among Latinas. Among non-adherent Latinas, we will compare the effects of empower and educate approaches on initial and repeat BC screening, in line with USPSTF guidelines. In Aim 2, we conduct an observational social network study. We will recruit network members through non- adherent Latinas enrolled in our RCT. Among network members, we will compare the effects of empower and educate approaches on initial and repeat BC screening across four years. In Aim 3, we will explore theoretical mechanisms of change that could contribute to intervention differences in BC screening. For non-adherent Latinas’ BC screening, we will examine the mediating roles of greater BC knowledge and motivation to be healthy role model. For network members’ BC screening, we will examine the mediating role of non-adherent Latinas’ enhanced capacity to promote BC screening. Specifically, we will test the independent effects of volunteerism in community BC initiatives, potential to “bridge” network members with formal change agents (e.g., community health workers, navigators), acceptability to promote BC, feasibility to promote BC, and BC promotion to network members. Our innovative, robust approach has direct implications for expediting the translation of promising community interventions into practice.

摘要 拉丁美洲人患晚期乳腺癌（BC）的比例不成比例， 生活质量相对于非拉丁裔白人（NLW），部分原因是较低的指南一致性筛选。 教育+导航（教育）的方法提供了拉丁社区教育，以解决 心理障碍（例如，恐惧），并引导拉丁美洲人接受免费/低成本的乳腺癌治疗。我们 跨学科团队开发了一种有前途的授权+导航（授权）方法， 导致拉丁裔网络之间更大的BC筛选。在授权方法中，不遵守规定的拉丁美洲人 美国预防服务工作组（USPSTF）指南了解BC;导航到免费/低成本 乳腺癌护理;并获得沟通技巧，以促进整个网络的BC筛查。 我们的前提是，授权非坚持拉丁美洲作为乳房健康代理人可能会导致更大的BC 在非粘附拉丁美洲人及其网络中进行筛查，而不是将非粘附拉丁美洲人视为被动的 教育的接受者。目前的提案测试了我们的前提，并确定了“活性成分”的 授权方法。 在目标1中，我们将在一个联邦合格的健康中心进行一项个体随机对照试验（RCT） （美属维尔京群岛）。这项试验将建立在我们团队目前的服务项目之上，在 社区卫生组织，包括利用其与致力于领导的社区组织的关系 拉丁美洲的发展。在不遵守拉丁美洲，我们将比较的影响，授权和 根据USPSTF指导方针，对初次和重复BC筛查的方法进行教育。 在目标2中，我们进行了一项观察性社交网络研究。我们将通过非- 参加我们随机对照试验的拉丁裔。在网络成员中，我们将比较授权和 在四年的时间里，对初次和重复BC筛查的方法进行教育。 在目标3中，我们将探索可能导致干预差异的理论机制， BC筛选。对于非遵守拉丁' BC筛选，我们将研究更大的BC的中介作用 知识和动机是健康的榜样。对于网络成员的BC筛选，我们将检查 非粘附拉丁美洲人的能力增强促进BC筛查的中介作用。具体来说，我们将测试 志愿服务在社区BC倡议中的独立影响，“桥梁”网络成员的潜力 与正式的变革推动者（例如，社区卫生工作者，导航员），推广BC的可接受性，可行性 推广BC，并向网络成员推广BC。 我们的创新、稳健的方法对加快有前途的社区的翻译有直接的影响， 干预措施付诸实践。