权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Community Outreach Program

社区外展计划

基本信息

批准号：
8382498
负责人：
Willie Underwood
金额：
$ 14.1万
依托单位：
ROSWELL PARK CANCER INSTITUTE CORP
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/8382498
关键词：
Address Affect African American Agriculture Ally American Area Assertiveness Attitude Award Behavior Behavioral Model Belief Buffaloes Canada Cancer Control Caring Characteristics Church Cities Clinical Clinical Research Clinical Trials Cognitive Color Communication Communities Community Outreach County Development Development Plans Dimensions Discrimination Disease Economics Education Educational process of instructing Educational workshop Emergency Medicine Emotional Emotions Empathy Employee Environment Ethnic group European Evidence based intervention Family Foundations Fright Future General Population German population Growth Health Health Personnel Health behavior Healthcare Hispanics Home environment Housing Immigrant Implicit Association Test Individual Informal Social Control Institutes Intelligence Internal Medicine International Intervention Latino Lead Leadership Life Literature Malignant Neoplasms Measures Medical Mexico Mind Mission Modeling Monitor Motivation Movement Needs Assessment Neighborhoods New York New York City Nomads Occupational Occupations Outcome Participant Patient Self-Report Patients Pattern Personality Personality Assessment Persons Phase Physicians Policies Polishes Population Poverty Prejudice Procedures Process Productivity Provider Public Health Public Health Schools Puerto Rican Race Railroads Recording of previous events Relative (related person)Reporting Research Resources Risk Role Rural Schools Screening procedure Secondary to Self Perception Services Shipping Ships Slave Smoking Social Network Solutions Steel Stereotyping Structure Subgroup Taxes Testing Time Tobacco Training Training Programs Trust Uncertainty Unconscious State Unemployment Vision Visit War Work World War II acronyms base behavior influence behavior test cancer health disparity cancer site caucasian American computerized evaluation/testing experience falls health care quality improved innovation interest intervention program medical specialties medically underserved member migration neoplasm resource outreach outreach program preference pressure prevent professor programs racial and ethnic racism response satisfaction segregation skills social social capital social cognition social group social skills suburb tobacco control tool volunteer

项目摘要

The historical experiences and cultural environment of the cities of Buffalo, Niagara Falls, their suburbs and the surrounding rural counties is important to the context of the mission of the WNYC(2) Center and proposed Community Outreach Program. Puring the 1850's and Civil War era, WNY was a major journey point in the abolitionist movement serving as final American stops on the Underground Railroad for assisting former slaves to escape into Canada. Then with the growth of shipping and the industrial revolution, Buffalo became the home of the most millionaires per capita at the turn of the 20th century. Puring World War II and post-war boom, more African Americans from southern states moved into Buffalo for industrial jobs and then became the predominate subgroup on the Eastside creating a movement of the previous European ethnic groups from urban Buffalo into other parts of Erie and surrounding counties. These historical waves of migration resulted in what has been characterized as the "color line," referring to the hierarchical categorization of class and resources by ethnic/racial characteristics or origins that included Irish, Italian and Eastern European immigrants as "nonwhite" at the turn ofthe century.(1) By the 1980's, the City of Buffalo had lost 23% of its population, thousands of jobs and major industrial employers like Bethlehem Steel, resulting in a loss of 70% of its tax base.^ Many of these displaced workers¿White and Black- still live in Buffalo, Niagara Falls, Erie and the surrounding counties and embody both the occupational risks from past exposures as well as the economic pressures of unemployment. The resulting sociocultural dynamics are important influences on racial and economic circumstances. This economic decline resulted in social and political repercussions related to fears of class and job displacement such as delayed integration of public schools (1981); patterns for white ethnic flight of Polish, German, and Irish families; development of housing "projects" for both White and Black residents, and continued de facto segregation of neighborhoods.(2,3) A recent story in the media reported that the City of Buffalo "is the home to the emptiest neighborhood in New York State" referring to a neighborhood with the most abandoned homes. (4) The Southern Tier, including the county of Chautauqua, was primarily settled in the late 1700's by European immigrants, lending to its primarily white demographic base. In the 1800's however, with multiple stations of the Underground Railroad throughout the county, Jamestown was host to one of the first settlements of 'free colored people.(5) The first African American Episcopal Zion Church in Chautauqua County opened in Jamestown in 1882.(6) WNY is also home to a large per capita population of Hispanic/Latinos in the Punkirk area, migrating from New York City, primarily of Puerto Rican descent. There is a strong migrant presence in the area's agricultural workforce originating from Mexico. The presence of racial inequities in health and healthcare has been well documented nationally. (7) Several factors are suggested as possible causes of these inequities and resulting disparities, including, but not limited to, health care provider bias, stereotyping, and clinical uncertainty.(7 )Likewise, neighborhood dynamics including segregation, gentrification, built environment and poverty impact behavior and disease.(8) The combination of historical processes and their impact on community and environmental level variables have created significant cancer disparities in Buffalo, Niagara Falls and Chautauqua and these communities and their resources will provide the solutions. Briefly, the theoretical foundation for our Community Outreach Program plans is built upon addressing disparities at multiple levels following a Socioecological Model.(9) For example, in tobacco, RPCI will continue work at a policy level (e.g., taxes and no-smoking policies), (see Facilities and Resources) and we will enhance the community level involvement with new interventions with Block Club Associations, while working at the institutional/provider level to enhance cessation in our proposed research. (See N4.R01) The interventions to reduce disparities proposed in our Center are focused on building social capital among medically underserved residents of WNY to optimize their ability and interest in using available cancer resources and procedures'"; while expanding the experiences of the RPCI staff to improve understanding of the social and cultural context of vulnerable communities.(10) The concept of social capital as used in our Center is defined as the "benefits and challenges that accrue from participation in social networks and groups(11) and includes the positive attributes of civic engagement and norms of reciprocity and trust (as is often used in public health literature).(12)

布法罗、尼亚加拉福尔斯、其郊区和周围农村县的历史经验和文化环境对WNYC（2）中心的使命和拟议的社区外展方案的背景很重要。在19世纪50年代和内战时期，WNY是废奴主义运动的一个主要旅程点，是美国地下铁路的最后一站，帮助前奴隶逃往加拿大。随着航运业的发展和工业革命，布法罗在世纪之交成为人均百万富翁最多的地方。第二次世界大战和战后随着经济繁荣，更多的非洲裔美国人从南部各州搬到布法罗寻找工业工作，然后成为东部占主导地位的亚群体，从而使以前的欧洲种族群体从城市布法罗迁移到伊利的其他地区和周围的县。这些历史上的移民浪潮导致了被称为“肤色线”的现象，指的是在世纪之交，根据民族/种族特征或起源对阶级和资源进行的等级分类，其中包括爱尔兰、意大利和东欧移民作为“非白人”。（一）到20世纪80年代，布法罗市失去了23%的人口，数千个工作岗位和主要的工业雇主，如伯利恒钢铁公司，导致其税基损失70%。这些流离失所的工人中有许多是白色和黑色的，他们仍然生活在布法罗、尼亚加拉福尔斯、伊利和周围的县，既体现了过去暴露的职业风险，也体现了失业的经济压力。由此产生的社会文化动态对种族和经济环境产生了重要影响。这种经济衰退造成了社会和政治影响，人们担心阶级和工作岗位被取代，公立学校的融合（1981年）;波兰、德国和爱尔兰家庭的白色种族逃离模式;为白色和黑人居民开发住房“项目”，以及继续事实上的社区隔离。（2，3）最近媒体报道说，布法罗市“是纽约州最空旷的社区”，指的是一个拥有最多废弃房屋的社区。（四）南部地区，包括肖托夸县，主要由欧洲移民在1700年代后期定居，主要是白色人口基础。然而，在19世纪，随着地下铁路的多个车站遍布全县，詹姆斯敦成为“自由有色人种”的第一批定居点之一。(5)肖托夸夸县的第一座非裔美国人圣公会锡安教堂于1882年在詹姆斯敦开业。(6)西纽约州也是庞克地区大量西班牙裔/拉丁裔人口的家园，他们从纽约市移民过来，主要是波多黎各人后裔。有一个强大的移民存在，该地区的农业劳动力来自墨西哥。在卫生和医疗保健方面存在的种族不平等在全国范围内都有充分的记录。(7)有几个因素被认为是这些不平等和由此产生的差异的可能原因，包括但不限于，医疗保健提供者的偏见，刻板印象和临床的不确定性。（7）同样，邻里动态包括隔离，绅士化，建筑环境和贫困影响行为和疾病。(8)历史进程及其对社区和环境水平变量的影响的组合，在布法罗、尼亚加拉福尔斯和肖托夸造成了显著的癌症差异，这些社区及其资源将提供解决方案。简而言之，我们的社区外展计划的理论基础是建立在解决社会生态模型后，在多个层面上的差距。(9)例如，在烟草方面，RPCI将继续在政策层面上工作（例如，税收和禁烟政策），（见设施和资源），我们将通过街区俱乐部协会的新干预措施加强社区层面的参与，同时在机构/提供者层面开展工作，以加强我们拟议研究中的戒烟工作。(See N4.R01）干预措施，我们中心提出的减少差距的建议侧重于在纽约西部医疗服务不足的居民中建立社会资本，以优化他们使用现有癌症资源和程序的能力和兴趣“;同时扩大RPCI工作人员的经验，以提高对弱势社区社会和文化背景的理解。(10)我们中心使用的社会资本概念被定义为“参与社交网络和团体（11）所产生的好处和挑战，包括积极的公民参与的属性以及互惠和信任的规范（如公共卫生文献中经常使用的）。（十二）