Cervical Cancer Beliefs in Ethnic Subgroups of Latina Immigrants

描述（由申请人提供）：研究强调，在美国，与非西班牙裔白人相比，西班牙裔妇女（拉丁裔）的宫颈癌发病率、流行率和不成比例的高死亡率更高，这表明了健康差距和创新方法的必要性。有效的以社区为基础的干预措施需要解决这些健康差异，但是这种干预措施的发展受到我们理解的差距的限制：1)西班牙裔人对宫颈癌和HPV的信仰取决于原籍国，以及2)为社区卫生工作者（促进者）项目设计的文化特定课程与这些亚人群群体一起工作。当前的应用扩展了先前的研究，表明教育和推广计划必须解决文化信仰问题才能有效。这项协作性的人种学试点研究旨在通过与一个农村、西班牙裔服务社区组织合作，解决宫颈癌的差异，以便对西班牙裔对宫颈癌和HPV的看法进行跨文化检查。研究结果将为宫颈癌和人乳头瘤病毒课程模块的开发提供信息，这些课程模块将被一个非专业健康顾问干预项目所使用。具体目的是：1)探索西班牙裔亚人群的知识水平、文化态度、对宫颈癌和HPV风险的认识以及使用人种学方法的筛查行为；2)开发针对宫颈癌和HPV的试点课程模块，融入第一阶段的人种学发现。随着美国西班牙裔移民人口的增加，人们越来越认识到需要针对不同国籍和教育水平的西班牙裔进行干预。通过收集有关各个亚群体的知识、风险认知和文化态度的信息，可以有针对性地开展有文化针对性的公共卫生外展工作，并可能更有效地影响受该疾病负担最重的群体的宫颈癌差异。本文提出了系统的人种志研究技术，以探讨西班牙裔人对宫颈癌和HPV的知识，风险认知和文化态度，以便制定文化和识字水平适当的教育干预措施。文化共识分析将引出对宫颈癌的认知信念的文化模型，共同告知一个全面的教育方法。本研究的新颖之处在于：1)利用系统的民族志研究技术开发针对不同西班牙裔受众的宫颈癌课程模块；2)招募西班牙裔CNA学生试点课程模块，并将他们介绍给癌症推广活动。PHS 398/2590（09/04修订版，4/2006修订版）第1页延续格式页

DESCRIPTION (provided by applicant): Research has highlighted the higher incidence, prevalence, and disproportionately high mortality rates of cervical cancer among Hispanic women (Latinas) compared to non-Hispanic whites in the U.S., signaling health disparities and the need for innovative approaches. Effective community-based interventions are needed to address these health disparities, but the development of such interventions are limited by gaps in our understanding of: 1) Hispanic beliefs toward cervical cancer and HPV depending on country of origin, and 2) culturally specific curriculum designed for community health worker (promotora) programs working with these subpopulation groups. The current application extends previous research suggesting that education and outreach programs have to address cultural beliefs in order to be effective. This collaborative, ethnographic pilot study aims to address cervical cancer disparities by partnering with a rural, Hispanic-serving community organization in order to conduct a cross-cultural examination of Hispanic beliefs toward cervical cancer and HPV. The findings will inform the development of curriculum modules on cervical cancer and HPV designed to be used by a promotora de salud (lay health adviser) intervention program. The specific aims are: 1) to explore levels of knowledge, cultural attitudes, perceptions of risk of cervical cancer and HPV, and screening behaviors with Hispanic subpopulations using ethnographic methods; and 2) to develop a pilot curriculum module on cervical cancer and HPV targeted to promotoras, infused with the ethnographic findings from Phase I. As the Hispanic immigrant population increases in the U.S., there is a growing recognition that interventions need to be tailored to Hispanics of different national origins and education levels. By gathering information on knowledge, risk perceptions, and cultural attitudes among various subgroups, culturally tailored public health outreach efforts can be targeted and potentially be more effective for impacting cervical cancer disparities in groups suffering the greatest burden of the disease. Systematic ethnographic research techniques are proposed to explore the knowledge, risk perceptions, and cultural attitudes of Hispanics toward cervical cancer and HPV in order to develop culturally and literacy-level appropriate educational interventions. Cultural consensus analysis will elicit cultural models of cognitive beliefs toward cervical cancer to collectively inform a comprehensive educational approach. This study is novel in that it 1) utilizes systematic ethnographic research techniques to develop curriculum modules on cervical cancer targeted to a diverse Hispanic audience, 2) recruits Hispanic CNA students to pilot the curriculum modules and introduces them to cancer outreach activities. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page 1 Continuation Format Page