Cervical Cancer Beliefs in Ethnic Subgroups of Latina Immigrants

描述(由申请人提供)：研究表明，在美国，与非拉美裔白人相比，拉美裔女性(拉丁裔)的宫颈癌发病率、患病率和死亡率都更高，这表明了健康差距和创新方法的必要性。需要有效的基于社区的干预措施来解决这些健康差距，但此类干预措施的发展受到以下认识差距的限制：1)拉美裔人对宫颈癌和HPV的看法取决于原籍国，以及2)为社区卫生工作者(促进者)与这些亚群群体合作的计划设计的特定文化课程。目前的应用扩展了之前的研究，该研究表明，教育和外联计划必须解决文化信仰问题，才能有效。这项协作性、人种学的试点研究旨在通过与一个服务于拉美裔的农村社区组织合作，解决宫颈癌的差异，以便对拉美裔对宫颈癌和HPV的信念进行跨文化检查。这一发现将为宫颈癌和HPV课程模块的开发提供信息，该课程模块旨在为一项非专业健康顾问干预计划的推广使用。具体目标是：1)探索知识水平、文化态度、对宫颈癌和HPV风险的看法，以及使用人种学方法筛查拉美裔亚群的行为；2)开发一个针对推动者的关于宫颈癌和HPV的试点课程模块，将第一阶段的人种学结果注入其中。随着美国拉美裔移民人口的增加，人们越来越认识到，干预措施需要针对不同国籍和教育水平的拉美裔美国人量身定做。通过收集不同亚群之间的知识、风险认知和文化态度的信息，根据文化定制的公共卫生宣传努力可以有针对性地进行，并有可能更有效地影响遭受疾病负担最重的群体的宫颈癌差异。提出了系统的人种学研究技术，以探索拉美裔人对宫颈癌和HPV的知识、风险认知和文化态度，以便开发文化和扫盲水平的适当教育干预措施。文化共识分析将引出对宫颈癌认知信念的文化模式，共同形成一种全面的教育方法。这项研究的新颖之处在于：1)利用系统的人种学研究技术，针对不同的西班牙裔受众开发宫颈癌课程模块；2)招募西班牙裔CNA学生试行课程模块，并向他们介绍癌症外展活动。PHS 398/2590(09/04版，2006年4月4日重新发布)第1页续订格式页

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