Assessment to Inform Programming to Increase Screening in Hawaiian Homesteads

描述（由申请人提供）：夏威夷土著人比夏威夷其他种族更容易被诊断为晚期癌症，并且癌症筛查率较低。全州大约有23,000名夏威夷土著居民居住在夏威夷土著宅基地社区，这些社区为拥有50%或更多夏威夷血统的个人提供负担得起的住房和农业用地。虽然高血液量可以作为其他变量的代表（例如，社会经济地位低，医疗保险普及率低），它与发病风险增加有关。对宅基地居民知之甚少，但我们预计与一般人群中的夏威夷人相比，宅基地居民的保险普及率和癌症筛查参与率较低。我们要求资金，以确定障碍和促进者，以癌症筛查在瓦伊马纳洛土著夏威夷宅基地社区对奥肯，并衡量接受干预发现成功的其他土著夏威夷社区。通过与夏威夷大学医学院和瓦伊马纳洛宅基地的合作，面试将由学生社区成员团队进行。房屋将根据科学和夏威夷传统的协议进行选择。采用配额法选择家庭内的访谈对象，并估计参与率为85%，我们的目标是在4个类别中分别进行70次访谈-25-50岁的女性、50岁以上的女性、25-50岁的男性和50岁以上的男性。在安德森和阿代卫生保健利用模型的指导下，调查项目将挖掘人口的特征（例如，知识、态度、保险状况）和现有服务的特征（例如，获得、补贴筛查、文化定位），以评估推荐的癌症筛查的障碍和促进因素。调查项目还将挖掘其他夏威夷社区对增加癌症筛查的干预措施的接受度，包括家庭癌症筛查日、小组癌症教育和个人癌症教育。评估数据将在4个基于家园的焦点小组进行审查，目的是设计瓦伊马纳洛宅基地需要和想要的干预措施。这种干预措施将在未来的研究中进行测试，涉及该州的瓦伊马纳洛宅基地和其他宅基地社区。

DESCRIPTION (provided by applicant): Native Hawaiians are more likely than members of Hawai'i's other ethnic groups to be diagnosed with late- stage cancer and to have low cancer screening rates. About 23,000 Native Hawaiians statewide reside in Native Hawaiian Homestead Communities, which offer affordable housing and agricultural land to individuals with 50% or greater Hawaiian blood quantum. Although high blood quantum may serve as a proxy for other variables (e.g., low socio-economic status, low prevalence of health insurance), it has been associated with increased risk of morbidity. Little is known about Homestead residents, but we expect lower prevalence of insurance and lower participation in cancer screening among Homestead dwellers compared to Hawaiians in the general population. We request funds to identify barriers and facilitators to cancer screening in the Waimanalo Native Hawaiian Homestead community on O'ahu, and to gauge receptivity to interventions found successful in other Native Hawaiian communities. Through partnership with the University of Hawaii medical school and the Waimanalo Homestead, interviews will be conducted by student-community member teams. Houses will be selected based on protocol informed by science and Hawaiian tradition. Using the quota method for selecting whom to interview within a household and estimating a 85% participation rate, we aim for 70 interviews in each of 4 categories -- females age 25-50, females older than 50, males age 25-50, and males older than 50. Guided by the Anderson and Aday model of health care utilization, survey items will tap characteristics of the population (e.g., knowledge, attitudes, insurance status) and characteristics of existing services (e.g., access, subsidized screening, cultural targeting) to assess barriers and facilitators to recommended cancer screening. Survey items also will tap receptivity of interventions shown to increase cancer screening in other Hawaiian communities, including a family cancer screening day, small group cancer education, and individual cancer education. Assessment data will be reviewed in 4 Homestead-based focus groups, with the purpose of designing an intervention needed and wanted by the Waimanalo Homestead. This intervention will be tested in future research that involves the Waimanalo Homestead and other Homestead communities in the state.