The Feasibility of a Peer-Driven Pap Testing Intervention for Young Bronx Women

对年轻布朗克斯女性进行同伴驱动的巴氏检查干预的可行性

• 批准号: 8510049
• 负责人: Laurie J Bauman
• 金额: $ 21.83万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8510049
• 关键词: 21 year old; AIDS prevention; Adherence; Advocate; Affect; Age; Area; Behavior; Cancer Prevention Intervention; Cervical Cancer Screening; Communication; Communities; County; Data; Diagnosis; Education and Outreach; Educational Intervention; Ethnic group; Feasibility Studies; Federally Qualified Health Center; Foundations; Guidelines; Health; Health behavior change; Human Papillomavirus; Immigration; Incentives; Individual; Insurance Coverage; Intervention; Knowledge; Latina; Latino; Lead; Literature; Low income; Malignant neoplasm of cervix uteri; Mediating; Methods; Minority; Modeling; Morbidity - disease rate; Outcome; Pap smear; Participant; Peer Pressure; Persons; Population; Prevention Research; Prevention strategy; Provider; Recommendation; Recruitment Activity; Research; Respondent; Rewards; Risk Behaviors; Sampling; Self Efficacy; Social Controls; Social Work; Subgroup; System; Testing; Vaccination; Woman; Work; base; behavior change; behavior influence; cervical cancer prevention; community based participatory research; cost effective; design; efficacy testing; innovation; interest; mortality; novel strategies; older women; outreach; peer; peer influence; population based; preference; prevent; public health relevance; racial and ethnic; research study; response; screening; social norm; success; theories; young woman

DESCRIPTION (provided by applicant): Nationally, Latina women have the highest cervical cancer rates of all racial/ethnic groups, and Black women have the highest cervical cancer mortality rates. In Bronx County, NY, which is the poorest urban county in the U.S. and is composed predominantly of Latino and Black residents, the rate of cervical cancer is about 35% higher than in the U.S. overall. Cervical cancer is preventable through regular Pap screening, yet it is estimated that 50% of women in the U.S. who are diagnosed with cervical cancer have never had a Pap test. Current cervical cancer screening guidelines recommend that women begin regular Pap screening at age 21 and continue screening every three years through age 29. Nonetheless, no interventions for increasing Pap screening have focused specifically on women under 30; thus, there is a particular need for evidence about effective ways to reach young minority women. Developing successful prevention strategies for these women necessitates a novel approach that recognizes and leverages the ways in which social norms and close personal relationships influence behaviors. Using a community-based participatory research approach, and drawing on cervical cancer screening literature and successful HIV prevention methods, we propose to assess the feasibility of using a peer-driven intervention (PDI) to reach and educate minority women 21-29 in the Bronx who are not adherent with Pap screening guidelines. A PDI is different from other peer education interventions because it gives all participants the opportunity to be peer educators (i.e., to become "Health Advocates") and receive associated rewards and recognition. Underpinning the PDI model is a cost-effective recruitment mechanism called respondent-driven sampling, a form of chain-referral sampling that is ideally suited to dense urban networks. In this participatory feasibility study, we will wok closely with a partnership of young Bronx women and local social service providers, as well as a federally qualified health center in the South Bronx that will provide Pap screening regardless of a woman's insurance status, immigration status, or ability to pay, in order to: 1) Assess the success of respondent-driven sampling in terms of the extent to which Health Advocates are effective in referring their peers to become Health Advocates themselves, and the factors related to successful referral; and 2) Determine the degree to which the PDI leads to Pap screening among women 21-29 in the Health Advocates' networks who are not adherent with screening guidelines, and to an increase in knowledge and self-efficacy among Health Advocates. This study will yield data needed to establish the value of conducting a larger, R01-scale study to assess the efficacy of a population-based, peer-driven cervical cancer prevention intervention, using respondent-driven sampling, to reach and change the behavior of a large number of young, low-income minority women who are not adherent with Pap screening guidelines.

描述（由申请人提供）：在全国范围内，拉丁裔妇女在所有种族/族裔群体中宫颈癌发病率最高，黑人妇女宫颈癌死亡率最高。在纽约州的布朗克斯县，这是美国最贫穷的城市县，主要由拉丁美洲人和黑人居民组成，宫颈癌的发病率比美国整体高出约35%。宫颈癌是可以通过定期的巴氏筛查来预防的，但据估计，美国50%被诊断患有宫颈癌的妇女从未进行过巴氏试验。目前的宫颈癌筛查指南建议女性在21岁时开始定期进行巴氏筛查，并每三年继续筛查一次，直到29岁。尽管如此，没有增加巴氏筛查的干预措施专门针对30岁以下的妇女;因此，特别需要有证据表明如何有效地接触到年轻的少数民族妇女。为这些妇女制定成功的预防战略需要一种新的方法，认识到并利用社会规范和密切的个人关系影响行为的方式。使用以社区为基础的参与性研究方法，并借鉴宫颈癌筛查文献和成功的艾滋病预防方法，我们建议评估使用同伴驱动的干预（PDI），以达到和教育少数民族妇女21-29在布朗克斯谁不遵守巴氏筛查指南的可行性。PDI与其他同伴教育干预措施不同，因为它使所有参与者都有机会成为同伴教育者（即，成为“健康倡导者”），并获得相关奖励和认可。PDI模型的基础是一种具有成本效益的招募机制，称为响应者驱动抽样，这是一种非常适合密集城市网络的连锁推荐抽样形式。在这项参与性可行性研究中，我们将与年轻布朗克斯妇女和当地社会服务提供者以及南布朗克斯联邦合格的健康中心密切合作，该中心将提供巴氏筛查，无论妇女的保险状况，移民状况或支付能力如何，以便：1）评估受访者驱动抽样的成功程度，即健康倡导者在推荐其同行成为健康倡导者方面的有效程度，以及与成功推荐相关的因素;以及2）确定在健康倡导者网络中不遵守筛查指南的21-29岁妇女中，PDI导致巴氏筛查的程度，以及增加健康倡导者知识和自我效能的程度。这项研究将产生所需的数据，以建立一个更大的，R 01规模的研究，以评估基于人群的，同行驱动的宫颈癌预防干预措施的有效性，使用响应驱动的抽样，达到和改变大量的年轻，低收入的少数民族妇女谁不遵守巴氏筛查指南的行为。