Examining Racial/Ethnic Differences and Determinants of Self-Sample HPV Testing and Usual Care Cervical Cancer Screening Uptake in a Safety Net Health System

检查安全网卫生系统中自检样本 HPV 检测和常规护理宫颈癌筛查的种族/民族差异和决定因素

• 批准号: 10544259
• 负责人: Jane R Montealegre
• 金额: $ 10.19万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-16 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10544259
• 关键词: American; Area; Behavioral; Caring; Censuses; Cervical; Cervical Cancer Screening; Characteristics; Clinic; Community Surveys; Data; Data Set; Diagnostic Reagent Kits; Disease; Early Diagnosis; Economically Deprived Population; Economics; Educational Status; Effectiveness; Enrollment; Epidemiologist; Future; Goals; HPV-High Risk; Health; Health Services Research; Health system; Human Papillomavirus; Intervention; Language; Lesion; Malignant neoplasm of cervix uteri; Measures; Mentors; Minority Women; Neighborhoods; Pap smear; Parents; Participant; Patients; Pattern; Periodicity; Provider; Randomized Controlled Trials; Research; Research Personnel; Risk; Sampling; Scientist; Self-Examination; Subgroup; Testing; Training; Training Support; Vaccination; Viral; Vulnerable Populations; Woman; base; care providers; career; career development; deprivation; effectiveness evaluation; ethnic difference; ethnic minority; experience; health care service utilization; health disparity; improved; indexing; innovation; marginalized population; medically underserved; multilevel analysis; neighborhood disadvantage; patient portal; premalignant; programs; prospective; racial and ethnic; safety net; screening; screening participation; segregation; self testing; sexual risk behavior; skills; spatial epidemiology; treatment as usual; uptake

SUMMARY The overarching goal of this Diversity Supplement is to prepare and launch Dr. Trisha Amboree into an academic career as an independent scientist. Dr. Trisha Amboree is a newly-graduated behavioral epidemiologist with research expertise in sexual risk behaviors among marginalized populations. Through the training supported by this Diversity Supplement, she will gain crucial training and experience in health disparities and health services research, as well as spatial epidemiology and multi-level analyses. The overarching goal of her postdoctoral research is to elucidate screening participation patterns in the parent Prospective Evaluation of Self-Testing to Increase Screening (PRESTIS) trial and inform future interventions that expand the reach and enhance the effectiveness of self-sample human papillomavirus (HPV) testing for cervical cancer screening among marginalized and vulnerable populations. The parent trial is a pragmatic randomized controlled trial of mailed self-sample HPV testing in a large, urban safety net health system to circumvent barriers to cervical cancer screening among medically underserved, racial/ethnic minority women. Using data from the PRESTIS Trial, Dr. Amboree will examine screening uptake, acceptability, and experiences across racial/ethnic and language use groups, by patient healthcare utilization characteristics, and by neighborhood-level economic deprivation and racial segregation. The central hypotheses that guide Dr. Amboree’s research are that screening uptake, acceptability, and experiences vary 1) across racial/ethnic and language use groups and by healthcare utilization characteristics; and 2) by area-level characteristics of the neighborhoods in which women live, specifically 2a) neighborhood-level economic disadvantage (measured using the census tract-level area deprivation index--ADI) and 2b) residential racial segregation (measured using the census tract-level local exposure/isolation metric-- LEx/Is). The findings of Dr. Amboree’s mentored research will inform the extent to which self-sample HPV testing may circumvent certain structural, neighborhood-level barriers to screening uptake among safety net health system patients and elucidate how future self-sample HPV testing programs can be refined and expanded to more effectively increase screening coverage. Along with the invaluable training and career development opportunities afforded through this Supplement, the findings of Dr. Amboree’s research will provide crucial preliminary data that will allow her to develop a competitive R99/00 proposal that will launch her career as an independent scientist.

总结 这个多样性补充的总体目标是准备和推出博士。 作为一名独立的科学家。Trisha Amboree博士是一位新毕业的行为流行病学家， 在边缘化人群中的性风险行为的研究专业知识。通过培训， 通过这一多样性补充，她将获得健康差异和健康服务方面的重要培训和经验。 研究以及空间流行病学和多层次分析。她博士后的首要目标是 研究的目的是阐明父母前瞻性自我检测评估中的筛查参与模式， 增加筛查（PRESTIS）试验，并为未来的干预措施提供信息，以扩大覆盖范围并提高 宫颈癌筛查中人乳头瘤病毒（HPV）检测的有效性 边缘化和弱势群体。母体试验是一项实用的随机对照试验， 在大型城市安全网卫生系统中进行自我样本HPV检测，以规避宫颈癌的障碍 在医疗服务不足的种族/少数民族妇女中进行筛查。使用PRESTIS试验的数据，博士。 Amboree将检查不同种族/民族和语言使用的筛查吸收率、可接受性和经验 组，按病人的医疗保健利用特点，并按社区一级的经济剥夺， 种族隔离指导Amboree博士研究的中心假设是， 可接受性和经验各不相同1）不同种族/民族和语言使用组和医疗保健利用 特点; 2）按妇女居住的街区的地区特点，特别是2a） 邻里一级的经济劣势（使用人口普查区一级的地区贫困指数衡量） 和2b）居住地种族隔离（使用人口普查区一级的当地接触/隔离指标衡量- LEx/Is）。Amboree博士的指导研究的结果将告知自我样本HPV检测的程度 可以绕过某些结构性的，社区一级的障碍，以筛选吸收安全网卫生 系统的患者，并阐明未来如何自我采样HPV检测计划可以完善和扩大， 更有效地提高筛查覆盖率。沿着宝贵的培训和职业发展 通过本补充提供的机会，Amboree博士的研究结果将提供至关重要的 初步的数据，这将使她能够制定一个有竞争力的R99/00提案，这将启动她的职业生涯， 独立科学家