Cervical Cancer Beliefs in Ethnic Subgroups of Latina Immigrants

描述（由申请人提供）：研究强调，与美国非西班牙裔白人相比，西班牙裔妇女（拉丁裔）宫颈癌的发病率、患病率和死亡率较高，表明健康差距和创新方法的必要性。有效的社区为基础的干预措施是必要的，以解决这些健康差距，但这种干预措施的发展是有限的差距，我们的理解：1）西班牙裔对宫颈癌和HPV的信仰取决于原籍国，和2）文化特定的课程设计的社区卫生工作者（promotora）计划与这些亚群群体。目前的应用程序扩展了以前的研究，表明教育和推广计划必须解决文化信仰，以便有效。这项合作，人种学试点研究旨在解决宫颈癌的差异，通过与农村，西班牙裔服务社区组织合作，以进行跨文化检查西班牙裔对宫颈癌和HPV的信仰。研究结果将为宫颈癌和HPV课程模块的开发提供信息，这些课程模块旨在由promotora de salud（非专业健康顾问）干预计划使用。具体目标是：1）使用人种学方法探索知识水平、文化态度、对宫颈癌和HPV风险的看法以及西班牙裔亚群的筛查行为; 2）开发针对促进者的宫颈癌和HPV试点课程模块，并注入第一阶段的人种学研究结果。随着西班牙裔移民人口在美国的增加，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西班牙裔人。通过收集有关知识的信息，风险认知，以及不同亚群的文化态度，文化上有针对性的公共卫生外展工作可以有针对性，并可能更有效地影响宫颈癌的群体中的差异遭受疾病的最大负担。系统的人种学研究技术，提出了探索知识，风险认知和文化态度的西班牙裔对宫颈癌和HPV，以发展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，以集体告知全面的教育方法。这项研究是新颖的，因为它1）利用系统的民族志研究技术，以开发针对不同的西班牙裔观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，并向他们介绍癌症外展活动。PHS 398/2590（2004年9月修订，2006年4月重新印发）第1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