Assessment to Inform Programming to Increase Screening in Hawaiian Homesteads

描述(申请人提供)：夏威夷原住民比夏威夷其他种族的成员更有可能被诊断为晚期癌症，癌症筛查率较低。全州约有23,000名夏威夷原住民居住在夏威夷原住地社区，该社区为拥有50%或更多夏威夷血量的个人提供负担得起的住房和农地。尽管高血液量可以作为其他变量(例如，低社会经济地位、低健康保险普及率)的替代指标，但它与发病率的增加有关。人们对宅基地居民知之甚少，但我们预计，与普通夏威夷人相比，宅地居民的保险普及率和癌症筛查参与率更低。我们要求提供资金，以确定O‘ahu上的怀马纳罗夏威夷原住民家园社区癌症筛查的障碍和促进者，并衡量对在其他夏威夷原住民社区成功的干预措施的接受度。通过与夏威夷大学医学院和怀马纳罗家园的合作，将由学生社区成员小组进行面试。房屋的选择将基于科学和夏威夷传统的礼仪。使用配额方法选择家庭内部的采访对象，并估计85%的参与率，我们的目标是在4个类别中每类进行70次采访--25-50岁的女性，50岁以上的女性，25-50岁的男性，以及50岁以上的男性。在Anderson和Aday卫生保健利用模式的指导下，调查项目将利用人口的特征(如知识、态度、保险状况)和现有服务的特征(如可获得性、补贴筛查、文化定位)来评估推荐的癌症筛查的障碍和促进者。调查项目还将利用在其他夏威夷社区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个以宅基地为基础的焦点小组中进行审查，目的是设计怀马纳罗宅基地需要和想要的干预措施。这种干预将在未来涉及怀马纳罗宅基地和该州其他宅基地社区的研究中得到测试。

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.