A Collectivist Approach to Cervical Cancer Screening Among Latinos

拉丁裔和其他少数民族对宫颈癌的筛查不足，承担着不成比例的负担

Latinas and other minorities are underscreened for cervical cancer and share a disproportionate burden of disease and death due to this cause. There are indications that social support can improve screening rates, but the best way to deliver such support and the mechanism through which it acts upon have not been clearly studied. This K award will provide training in skills needed to conduct behavioral trials on cancer screening among underserved populations. The training goals are: 1) To acquire the necessary skills to design and analyze behavioral intervention trials; 2) To further develop training in culturally relevant social ecological and behavioral theories to guide intervention designs; and 3) To hone skills in the integration of qualitative and quantitative data analysis. The training goals will be achieved via courses, institutes, workshops, and directed studies. In relation to these goals, the research component will serve as training ground for acquiring statistical skills (longitudinal, mediation and moderation analyses), creating of quantitative scales based on qualitative data, and qualitatively studying unusual ("deviant") results in longitudinal analysis. The proposed research agenda will establish the feasibility of a collectivist approach to screening ("group visits") among 94 Latina women recruited by peers. The ultimate goal is to refine procedures to be used in a randomized behavioral trial to test this approach among Latinas and African Americans, which I hypothesize, will increase adherence to screening guidelines. The Specific Aims are to 1) Assess the feasibility of group visits among Latinas in "new growth areas" (fast growing but still isolated Latino communities); 2) Assess the effect of group visits on cancer screening related outcomes among Latinas using longitudinal surveys to compare outcomes and to derive point estimates, measures of variability and effect sizes on these outcomes; and 3) Explore the psychosocial basis for a collectivist orientation to cancer screening using Pap tests by analyzing women's experiences with group visits to a) develop and pilot test culturally-grounded survey questions regarding collectivist screening and social support, and b) shed light on "outlier" results in main outcome variables in longitudinal analysis. RELEVANCE (See instructions): If successful,the group visit approach has the potential to deliver culturally competent care and therefore improve compliance with screening guidelines, thus preventing disease and deaths and also resulting in healthcare cost savings. It will also advance knowledge in the integration natural social networks and the family in cancer screening.