A Collectivist Approach to Cervical Cancer Screening Among Latinos

拉丁裔宫颈癌筛查的集体主义方法

• 批准号: 8525094
• 负责人: Patricia Isabel Documet
• 金额: $ 13.57万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-28 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8525094
• 关键词: Adherence; African American; Area; Behavior; Behavior Therapy; Behavioral; Cancer Model; Caring; Cervical Cancer Screening; Cessation of life; Communities; Cost Savings; Data; Data Analyses; Disease; Educational workshop; Ensure; Family; Goals; Guidelines; Health Care Costs; Individual; Institutes; Instruction; Intervention; Intervention Trial; K-Series Research Career Programs; Knowledge; Latina; Latino; Light; Longitudinal Surveys; Malignant neoplasm of cervix uteri; Measures; Mediation; Minority; Outcome; Pap smear; Procedures; Process; Randomized; Recruitment Activity; Research; Screening for cancer; Social Network; Social support; Surveys; Testing; Training; Underserved Population; Visit; Woman; base; burden of illness; design; deviant; experience; health care service utilization; improved; longitudinal analysis; new growth; peer; prevent; psychosocial; screening; skills; social; theories; therapy design

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.

拉丁美洲人和其他少数民族对宫颈癌的筛查不足，并且分担了不成比例的宫颈癌负担。 疾病和死亡是由这个原因引起的。有迹象表明，社会支持可以提高筛查率， 但提供这种支持的最佳方式及其所依据的机制还没有 明确研究。这个K奖将提供进行癌症行为试验所需技能的培训 在服务不足的人群中进行筛查。培训目标是：1）获得必要的技能， 设计和分析行为干预试验; 2）进一步发展与文化相关的社会培训 生态和行为理论，以指导干预设计;和3）磨练技能的整合， 定性和定量数据分析。培训目标将通过课程、机构、 研讨会和指导性研究。关于这些目标，研究部分将作为培训部分， 获得统计技能的基础（纵向、中介和调节分析）， 基于定性数据的定量尺度，并定性研究异常（“异常”）结果， 纵向分析拟议的研究议程将确立集体主义方法的可行性， 对94名拉丁裔妇女进行筛查（“小组访问”）。最终目标是提炼 在拉丁美洲人和非洲人中测试这种方法的随机行为试验中使用的程序 我假设美国人会增加对筛查指南的依从性。具体目标是：（1） 评估拉丁美洲人在“新增长地区”（快速增长但仍然孤立）进行集体访问的可行性 拉丁裔社区）; 2）评估团体访问对癌症筛查相关结果的影响， 拉丁美洲人使用纵向调查来比较结果，并得出点估计， 这些结果的可变性和效应大小; 3）探索集体主义者的心理社会基础 通过分析妇女集体就诊的经验，向使用巴氏试验进行癌症筛查提供指导， 制定和试点测试有关集体主义筛选和社会的基于文化的调查问题 支持，以及B）阐明纵向分析中主要结果变量中“离群值”结果。 相关性（参见说明）： 如果成功的话，集体访问的方法有可能提供文化上合格的护理， 改善对筛查指南的遵守，从而预防疾病和死亡， 节省医疗成本。它还将促进自然社交网络和 家庭癌症筛查