Cervical Cancer Screening in Homeless Women: A Discrete Choice Experiment

无家可归妇女的宫颈癌筛查：离散选择实验

• 批准号: 8515363
• 负责人: Eve Wittenberg
• 金额: $ 18.78万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-23 至 2014-12-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8515363
• 关键词: Address; Appointment; Attitude; Behavior; Belief; Beryllium; Cancer Control; Cervical Cancer Screening; Cessation of life; Characteristics; Childhood; Clothing; Data; Decision Analysis; Decision Making; Development; Disease; Early Diagnosis; Elements; Face; Focus Groups; Food; Future; General Population; Goals; Grant; HIV Infections; Health; Healthcare; High Prevalence; Homelessness; Housing; Income; Indium; Individual; Intervention; Language; Lead; Location; Low income; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methodology; Methods; Morbidity - disease rate; Outcome; Phase; Population; Prevention; Preventive; Privacy; Provider; Questionnaires; Recruitment Activity; Relative (related person); Research; Research Methodology; Risk; Risk Factors; Sampling; Screening for cancer; Shelter facility; Surveys; Testing; Time; United States; Vulnerable Populations; Woman; cancer prevention; control trial; cost; design; disorder risk; effective intervention; experience; high risk; improved; innovation; interest; literacy; mortality; preference; prevent; research study; screening

DESCRIPTION (provided by applicant): Cervical cancer is one of the few preventable forms of cancer, yet it still causes over 4,000 deaths in the US each year. Prevention and early detection could successfully eradicate the disease if practiced by the entire population. Most of the new cases of cervical cancer in the US are in women who have never been screened or have been screened infrequently. While most women in the US are screened for cervical cancer, pockets of the population remain unscreened or under-screened and are at risk of the disease. Homeless women are one of these pockets where cervical cancer still exerts a toll. Homeless women are screened for cervical cancer far less than all women, and even less than poor, housed women. The number of homeless women in the US is increasing, and these women will contribute more cases of cervical cancer unless effective methods to prevent new cases are developed. This research will identify the specific health and non-health aspects of cervical cancer screening that are important to homeless women in order to be screened. The study results will lead to the design of homeless-specific cervical cancer screening interventions to increase early detection among this unique population, and to prevent future cases of this disease. The proposed study will apply an innovative method of decision analysis to study individual choice in the context of cervical cancer screening. The approach uses a questionnaire to collect data on the choices people would make when faced with different combinations of factors that are important to a decision. For this study, we will first determine the relevant healh and non-health factors for the cervical cancer screening decision for homeless women, such as cost, location where the test is performed, the provider performing the test, etc. We will use this information to develop a survey including different screening scenarios that include these elements in different combinations. Homeless women recruited to the survey will choose between pairs of different combinations of screening scenarios to demonstrate their decision priorities. The resulting survey data will be analyzed to put numerical estimates on how important each element is to the choice to be screened for all homeless women in our study. The study findings will inform the design of screening interventions that can achieve the highest rate of screening for this particular population. What is preferred for homeless women may be different than that for housed, poor women, or for women of other incomes, etc. This research method allows strategies to be tailored to the preferences and desires of a particular group, to maximize the outcome of interest (in this case, screening). As an exploratory grant, our findings will be used to develop screening interventions for subsequent testing in controlled trials. This research will contribute to the NCI goal of cancer control and prevention, through early detection of disease.

描述（由申请人提供）：宫颈癌是少数可预防的癌症之一，但在美国每年仍导致 4,000 多人死亡。如果全民都采取预防和早期发现的措施，就可以成功根除这种疾病。美国大多数新发宫颈癌病例是从未接受过筛查或很少接受筛查的女性。虽然美国大多数女性都接受了宫颈癌筛查，但仍有部分人群未接受筛查或筛查不足，因此面临罹患该疾病的风险。无家可归的妇女是宫颈癌仍然造成死亡的人群之一。 无家可归的妇女接受的宫颈癌筛查远远低于所有妇女，甚至低于贫困的有住房妇女。美国无家可归的妇女人数正在增加，除非开发出有效的方法来预防新病例，否则这些妇女将导致更多的宫颈癌病例。这项研究将确定宫颈癌筛查的具体健康和非健康方面，这些方面对于无家可归的妇女进行筛查非常重要。研究结果将有助于设计针对无家可归者的宫颈癌筛查干预措施，以提高这一独特人群的早期发现率，并预防未来出现这种疾病。 拟议的研究将应用一种创新的决策分析方法来研究宫颈癌筛查背景下的个人选择。该方法使用问卷来收集人们在面临对决策很重要的不同因素组合时会做出的选择的数据。在本研究中，我们将首先确定无家可归妇女宫颈癌筛查决策的相关健康和非健康因素，例如费用、进行测试的地点、进行测试的提供者等。我们将使用此 制定调查的信息，包括不同的筛选场景，其中包括这些元素的不同组合。参与调查的无家可归妇女将在不同的筛选场景组合之间进行选择，以展示她们的决策优先顺序。我们将对由此产生的调查数据进行分析，以数值估计每个因素对于我们研究中所有无家可归妇女选择筛查的重要性。 研究结果将为筛查干预措施的设计提供信息，从而实现该特定人群的最高筛查率。无家可归的妇女的偏好可能不同于有住房的贫困妇女或其他收入的妇女等。这种研究方法允许根据特定群体的偏好和愿望制定策略，以最大限度地提高利益结果（在本例中为筛选）。作为一项探索性资助，我们的研究结果将用于制定筛查干预措施，以便在对照试验中进行后续测试。这项研究将通过疾病的早期检测，为 NCI 癌症控制和预防的目标做出贡献。

项目成果

Using Best-Worst Scaling to Understand Patient Priorities: A Case Example of Papanicolaou Tests for Homeless Women.

使用最佳-最差尺度来了解患者的优先顺序：无家可归妇女的巴氏测试案例。

• DOI: 10.1370/afm.1937
• 发表时间: 2016
• 期刊: Annals of family medicine
• 影响因子: 4.4
• 作者: Wittenberg,Eve;Bharel,Monica;Bridges,JohnFP;Ward,Zachary;Weinreb,Linda
• 通讯作者: Weinreb,Linda

Measuring the Preferences of Homeless Women for Cervical Cancer Screening Interventions: Development of a Best-Worst Scaling Survey.

衡量无家可归妇女对宫颈癌筛查干预措施的偏好：制定最佳-最差规模调查。

• DOI: 10.1007/s40271-014-0110-z
• 发表时间: 2015
• 期刊: The patient
• 作者: Wittenberg,Eve;Bharel,Monica;Saada,Adrianna;Santiago,Emely;Bridges,JohnFP;Weinreb,Linda
• 通讯作者: Weinreb,Linda