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Examining Disparities in Cancer Screening for Persons with Disabilities

检查残疾人癌症筛查的差异

基本信息

批准号：
8461151
负责人：
LISA I. IEZZONI
金额：
$ 21.15万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-19 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8461151
关键词：
Age Aging American Attention Attitude Automobile Driving Body mass index Breast Cancer Detection Caring Characteristics Child Childhood Cognitive Colorectal Cancer Data Diabetes Mellitus Diagnosis Diagnostic Disabled Persons Education Educational Background Epidemiologic Studies Equipment Ethnic Origin Face Failure Geographic Locations Health Health Insurance Health Services Research Health Surveys Health behavior Healthcare Healthy People 2010 Healthy People 2020 Hearing Hearing Impaired Persons Household Impairment Income Individual Late Effects Life Link Longevity Low income Lung diseases Malignant Neoplasms Malignant neoplasm of cervix uteri Mammography Medical Mental Health Minority Groups Modeling Movement Movement Disorders National Health Interview Survey Obesity Outcome Pap smear Patient Self-Report Patients Pattern Persons Population Population Sizes Public Health Race Reporting Research Risk Rural Science Screening for cancer Services Smoking Source Staging Statistical Methods Surgeon System Testing Time Tobacco use Vision Visual impairment Woman Work World Health Organization blind cancer diagnosis colorectal cancer screening disability ethnic minority population evidence base experience health care delivery health care quality improved malignant breast neoplasm middle age prevent racial and ethnic research study residence screening sex social trend young adult

项目摘要

DESCRIPTION (provided by applicant): Today in the U.S., at least 54 million persons live with disabilities, and these numbers will increase substantially in coming decades with the aging "baby boomers." At the other end of the life span, rising numbers of children and young adults are also living with disabilities. Healthy People 2020, as well as research and epidemiological studies, have found that persons with disabilities frequently experience large health care disparities. In particular, evidence documents much lower rates of screening for breast and cervical cancers. Various factors could contribute to these disparities in cancer screening. Nonetheless, little research has systematically explored factors associated with cancer screening disparities for persons with disabilities. The overall purpose of this project is to use data from the National Health Interview Survey (NHIS) from 1998 through 2010 to understand better the patterns, trends, and potential contributors to screening for breast, cervical, and colorectal cancers among persons with disabilities. We plan to build our analyses around the World Health Organization's model of disability. In addition to more global indicators of disabilit, we plan to look specifically at self-reported impairments relating to: vision (blind and low vision; hearing (deaf and hard of hearing); movement difficulties; cognitive difficulties; and mental health concerns. Our major specific aims are to: 1. Compare rates of screening for breast, cervical, and colorectal cancers between persons with and without disabilities, cross-sectionally and over time; 2. Identify and compare those factors associated with receipt of breast, cervical, or colorectal cancer screening for persons with and without disabilities, respectively, cross-sectionally and over time; and 3. Identify those factors that explain any observed disparities in breast, cervical, or colorectal cancer screening between persons with and without disabilities, cross-sectionally and over time. NHIS did not ask questions about all three cancer screening services during each year; we must therefore restrict the analyses for each type of screening service to those years where information was collected. We shall consider a variety of independent variables as covariates in multivariable models to predict cancer screening, including: specific types of disabilities; interactions among disability types; demographic characteristics, such as age, sex (colorectal cancer), race, ethnicity, education, household composition, household income, geographic region, and urban-rural residence; comorbid health conditions, such as cardio respiratory diseases and diabetes; health behavior-related attributes, such as body mass index and tobacco use; and health care delivery system considerations, such as having health insurance and a usual source of care. In addition to other statistical methods, we shall explore the factors most associated with identified cancer screening disparities using the Peters-Belson analytical approach.

描述（由申请人提供）：今天在美国，至少有5 400万人生活在残疾之中，而且随着“婴儿潮一代”的老龄化，今后几十年这一数字还将大幅增加。“在生命的另一端，越来越多的儿童和年轻人也患有残疾。《2020年健康人》以及研究和流行病学研究发现，残疾人经常面临巨大的保健差距。特别是，有证据表明，乳腺癌和宫颈癌的筛查率要低得多。各种因素可能导致癌症筛查中的这些差异。然而，很少有研究系统地探讨与残疾人癌症筛查差异相关的因素。该项目的总体目的是使用本研究收集了1998年至2010年全国健康访谈调查（NHIS）的数据，以更好地了解残疾人乳腺癌、宫颈癌和结肠直肠癌筛查的模式、趋势和潜在因素。我们计划围绕世界卫生组织的残疾模型进行分析。除了更多的全球残疾指标外，我们计划具体关注自我报告的与以下方面有关的障碍：视力（失明和视力低下）;听力（失聪和听力障碍）;行动困难;认知困难;以及心理健康问题。我们的主要具体目标是：1.比较乳腺癌、宫颈癌和结肠直肠癌的筛查率，残疾人和非残疾人之间，跨部门和随着时间的推移; 2。识别和比较那些与接受乳腺癌，宫颈癌，或结肠直肠癌筛查的残疾人和非残疾人，分别，跨部门和随着时间的推移相关的因素;和3。确定那些因素，解释任何观察到的差异，乳腺癌，宫颈癌，或结直肠癌筛查之间的人与残疾人，横截面和随着时间的推移。 NHIS并没有在每一年中询问所有三种癌症筛查服务的问题;因此，我们必须将每种筛查服务的分析限制在收集信息的年份。我们将考虑各种自变量作为多变量模型中的协变量来预测癌症筛查，包括：特定类型的残疾;残疾类型之间的相互作用;人口统计学特征，如年龄、性别、性别、年龄、性别、年龄、性别、性别、年龄、性别、（结直肠癌）、种族、民族、教育、家庭组成、家庭收入、地理区域和城乡居住;共病健康状况，如心脏呼吸系统疾病和糖尿病;与健康行为相关的属性，如体重指数和烟草使用;以及医疗保健提供系统的考虑因素，如拥有医疗保险和通常的护理来源。除了其他的统计方法，我们将探讨最相关的因素与确定的癌症筛查差异使用Peters-Belson分析方法。