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CRC Screening in Primary Care Settings: Factors for Low Income Urban Hispanics

初级保健机构中的 CRC 筛查：低收入城市西班牙裔人的因素

基本信息

批准号：
7363720
负责人：
KATHERINE N DUHAMEL
金额：
$ 21.27万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-03-01 至 2010-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7363720
关键词：
Acculturation Address Adherence Age Area Behavioral Behavioral Model Behavioral Research Belief Cancer Control Cancer Etiology Caring Categories Cessation of life Clinical Research Collection Colonoscopy Colorectal Cancer Communication Country Cross-Sectional Studies Data Data Analyses Data Collection Development Plans Diagnostic Disease Dominican Evaluation Flexible fiberoptic sigmoidoscopy Focus Groups Gatekeeping Goals Grant Health Health Promotion Health Promotion and Care Health Services Accessibility Health Services Research Healthcare Hispanics Indigenous Individual Internet Intervention Knowledge Lead Length Location Low income Malignant Neoplasms Malignant neoplasm of prostate Medical Methodology Methods Mexican Minority Minority Groups Modality Modeling Motivation Nature New York Numbers Operative Surgical Procedures Patients Persons Phase Physicians Polyps Population Prevention Primary Care Physician Primary Health Care Printing Progress Review Group Puerto Rican Race Rate Readiness Recommendation Recording of previous events Reporting Research Research Personnel Research Priority Risk Screening procedure Staging Standards of Weights and Measures Surveys System Testing Theoretical model Time Underserved Population United States Woman base behavioral health cancer prevention colorectal cancer prevention colorectal cancer screening cultural values design health belief innovation men mortality preference prevent programs social therapy development

项目摘要

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the 3rd leading cause of cancer death among Hispanic women and ties with prostate cancer as the 2nd deadliest cancer among Hispanic men. A key and modifiable way to decrease mortality from CRC among Hispanics is to increase their rates of CRC screening and early detection of CRC. Unfortunately, the majority of Hispanics do not get screened. All the more troubling is that CRC screening rates are even low for individuals who seek routine medical care. Prior to developing interventions to increase CRC screening in Hispanics, the factors that are barriers and facilitators to screening among Hispanics need to be identified. To that end, the proposed R21 will identify barriers and facilitators to CRC screening among urban Hispanics treated in three primary practice settings, involving over 35 full-time physicians, located in East Harlem, New York. This proposal directly addresses the priorities identified by NCI for social, behavioral, and health services research in colorectal cancer. The proposal focuses on behavioral models that can guide interventions to increase the use of CRC screening in urban Hispanics, cultural considerations are a theme throughout, and the research team is interdisciplinary. The specific aims are: 1) To identify barriers and facilitators to endoscopic CRC screening in urban Hispanics (Dominicans, Mexicans and Puerto Ricans) treated in a primary care practice and 2) To investigate health care, health promotion, and cultural factors associated with Hispanics': a) stage of readiness to undergo endoscopic CRC screening; and b) endoscopic CRC screening adherence. The study will also explore if there are intra-Hispanic differences (i.e., differences among Dominicans, Mexicans, and Puerto Ricans), for the factors associated with stage of readiness to undergo endoscopic CRC screening and endoscopic CRC screening adherence. There will be two phases to the study. Each of the two study phases will use a different approach to data collection and analysis. The first phase will use focus group methodology with six focus groups comprised of up to 10 Hispanics in each group. Qualitative analyses of the data from the focus groups will identify barriers and facilitators of CRC screening among Hispanics and suggest revisions to the survey that will be used for the 2nd study approach. The second phase will use a cross-sectional survey of 300 Hispanics men and women), over the age of 50 at average risk for CRC. The results of the quantitative analyses with the data from the study's cross-sectional survey will indicate health care, health promotion, and cultural factors associated with Hispanics' stage of readiness to undergo endoscopic CRC screening and endoscopic CRC screening adherence. The results from this second study approach will also suggest if there are intra-Hispanic differences in the factors identified as barriers and facilitators to CRC screening. Lay Summary: The proposed study seeks to investigate the barriers and facilitators of CRC screening among Hispanics. The study results will lead to the development of intervention materials to increase CRC screening among diverse Hispanics based on the factors that are most relevant to them. Interventions to increase CRC screening in this rapidly growing minority group could increase their rates of CRC screening and thereby decreased their mortality from CRC.

描述(申请人提供)：结直肠癌(CRC)是西班牙裔女性癌症死亡的第三大原因，与前列腺癌有关，在西班牙裔男性中排名第二。降低拉美裔结直肠癌死亡率的一个关键和可修改的方法是增加他们的结直肠癌筛查和早期发现结直肠癌的比率。不幸的是，大多数拉美裔美国人没有接受筛查。更令人不安的是，对于寻求常规医疗护理的个人来说，结直肠癌筛查率甚至很低。在制定干预措施以增加对拉美裔美国人的CRC筛查之前，需要确定阻碍和促进在拉美裔美国人中进行筛查的因素。为此，拟议的R21将确定在三个初级诊所环境中接受治疗的城市拉美裔人中进行结直肠癌筛查的障碍和促进者，涉及位于纽约东哈莱姆区的35名全职医生。这项建议直接解决了NCI为结直肠癌的社会、行为和健康服务研究确定的优先事项。该提案的重点是可以指导干预措施的行为模式，以增加城市拉美裔美国人对结直肠癌筛查的使用，文化考虑是贯穿始终的主题，研究团队是跨学科的。具体目标是：1)在接受初级保健治疗的城市拉美裔人(多米尼加人、墨西哥人和波多黎各人)中找出进行内窥镜结直肠癌筛查的障碍和促进者；2)调查与拉美裔相关的医疗保健、健康促进和文化因素：a)准备接受内窥镜结直肠癌筛查的阶段；以及b)内窥镜结直肠癌筛查的依从性。这项研究还将探索拉美裔内部是否存在差异(即多米尼加人、墨西哥人和波多黎各人之间的差异)，这些因素与接受内窥镜结直肠癌筛查的准备阶段和内窥镜结直肠癌筛查依从性相关。这项研究将分为两个阶段。两个研究阶段中的每个阶段都将使用不同的方法来收集和分析数据。第一阶段将使用焦点小组方法，每组有六个焦点小组，最多由10名西班牙裔组成。对来自焦点小组的数据进行定性分析，将找出拉美裔儿童中儿童结直肠癌筛查的障碍和促进者，并建议对将用于第二项研究方法的调查进行修订。第二阶段将对300名拉美裔男性和女性进行横断面调查，其中50岁以上的人患结直肠癌的风险平均。这项研究的横断面调查数据的定量分析结果将表明，与拉美裔准备接受内窥镜结直肠癌筛查和内窥镜结直肠癌筛查依从性相关的医疗保健、健康促进和文化因素。第二个研究方法的结果还将表明，在被确定为结直肠癌筛查障碍和促进者的因素中，拉美裔内部是否存在差异。外行总结：这项拟议的研究旨在调查拉美裔美国人中结直肠癌筛查的障碍和促进者。研究结果将导致制定干预材料，根据与不同拉美裔最相关的因素，增加对不同拉美裔美国人的CRC筛查。在这一快速增长的少数群体中增加结直肠癌筛查的干预措施可以提高他们的结直肠癌筛查率，从而降低他们死于结直肠癌的死亡率。