Cultural Sensitivity in CRC Screening with AA's

AA 筛查 CRC 的文化敏感性

• 批准号: 6854569
• 负责人: KATHERINE N DUHAMEL
• 金额: $ 53.09万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-03-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6854569
• 关键词: African American; attitude; behavioral /social science research tag; cancer prevention; clinical research; colorectal neoplasms; culture; disease /disorder prevention /control; health behavior; human middle age (35-64); human old age (65+); human subject; neoplasm /cancer diagnosis; neoplasm /cancer education; socioeconomics

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the second most common cancer among African Americans (AAs) in the United States and CRC mortality is greater for AAs than for Caucasians. Clinical research indicates that a substantial number of CRC deaths could be prevented through appropriate screening, followed by relatively simple surgical procedures to remove polyps. Unfortunately the majority of the population does not get screened. This problem is even worse for AAs, whose adherence to national screening recommendations is significantly lower than for white. Unfortunately, efforts to increase screening participation through the provision of educational materials have been largely ineffective. Growing evidence suggests that traditional interventions are not sensitive to the diverse levels of motivation, or differences in cultural values of those targeted for intervention. Traditional interventions present standard information in a single idiom and format, which do not insure a match between what is presented, and what the individual needs or can use. It comes down to the problem that one size does not fit all; one intervention is unlikely to be effective with all individuals. Interventions must be designed so that they can be individualized to meet the level of a person's motivation/readiness to change, and his/her cultural values and beliefs. Research suggests that these issues are especially important in the development of interventions to change preventive health behaviors in minority populations. This problem will be examined in the proposed randomized clinical trial of stage matched, culturally sensitive intervention to increase participation in CRC screening of AAs age 51 years or older. The proposed research builds on: the investigators' prior research on cancer screening in minority groups, their studies of staged-matched intervention in cancer prevention, and their research on barriers to adequate standards of care in minority groups. It will be conducted in collaboration with the East Harlem Partnership for Cancer Awareness, an NCI funded program seeking to: increase knowledge about cancer, its prevention and treatment among medically underserved minority groups and increase their participation in cancer prevention and control research. Specific Aims: 1. Investigate the impact of the combination of culturally sensitive and stage-matched (CS/S-M) psychoeducational intervention to increase CRC screening in AAs 51 years of age and older on: a) their readiness to undergo endoscopic CRC screening (stage); b) their participation in endoscopic CRC screening; and c) their knowledge, attitudes and feeling about CRC and CRC. The impact of the CS/S-M intervention will be compared to that of culturally sensitive, stage-matched and standard CRC interventions. 2. Explore the influence of socio-demographic, health care, and cultural factors on the impact of the culturally sensitive and stage-matched intervention. 3. Develop a mediational model of how the interventions work (e.g., through their impact on knowledge or attitudes).

描述（由申请人提供）：结直肠癌（CRC）是美国非裔美国人（AAs）中第二大常见癌症，非裔美国人的CRC死亡率高于白种人。临床研究表明，通过适当的筛查，然后进行相对简单的手术切除息肉，可以预防大量的结直肠癌死亡。不幸的是，大多数人没有接受筛查。asa的问题更严重，他们对国家筛查建议的依从性明显低于白人。不幸的是，通过提供教育材料来增加筛查参与的努力基本上是无效的。越来越多的证据表明，传统的干预措施对动机的不同水平或干预目标的文化价值观差异并不敏感。传统的干预以单一的习语和格式呈现标准信息，这不能确保所呈现的内容与个人需要或可以使用的内容之间的匹配。这归结为一个问题，即一种方式不适合所有人；一种干预不可能对所有个体都有效。干预措施的设计必须使其能够因材施教，以满足个人改变的动机/准备程度以及他/她的文化价值观和信仰。研究表明，这些问题在制定干预措施以改变少数民族人群的预防性健康行为方面尤为重要。这一问题将在一项随机临床试验中进行研究，该试验采用分期匹配、文化敏感的干预措施，以增加51岁及以上AAs的CRC筛查参与度。