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: 8386032
• 负责人: Eve Wittenberg
• 金额: $ 18.07万
• 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 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8386032
• 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; Screening procedure; 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

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. PUBLIC HEALTH RELEVANCE: This research addresses cancer screening behavior in an under-screened population, homeless women. Our study will identify the relevant health and non-health decision factors that explain whether homeless women seek screening for cervical cancer, through a decision analytic method that examines choice. The ultimate goal of the research is to reduce cervical cancer morbidity and mortality among homeless women, and prevent cervical cancer in the US.

描述(申请人提供)：宫颈癌是为数不多的可预防的癌症之一，但在美国每年仍有4000多人死于宫颈癌。如果所有人都这样做，预防和及早发现就可以成功地根除这种疾病。在美国，大多数新的宫颈癌病例都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，但仍有一些人没有接受筛查或筛查不足，面临着患宫颈癌的风险。无家可归的妇女是宫颈癌仍然造成严重后果的地区之一。无家可归的妇女接受宫颈癌筛查的人数远远少于所有妇女，甚至少于贫穷的有住房的妇女。美国无家可归的妇女人数正在增加，除非找到有效的方法来预防新的病例，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，这些方面对无家可归的妇女来说是重要的，以便进行筛查。研究结果将导致设计针对无家可归者的宫颈癌筛查干预措施，以增加这一独特人群的早期发现，并防止未来出现这种疾病。这项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中的个人选择。这种方法使用问卷来收集人们在面对对决策重要的不同因素组合时会做出的选择的数据。在这项研究中，我们将首先确定无家可归妇女宫颈癌筛查决定的相关健康和非健康因素，如费用、进行检测的地点、进行检测的提供者等。 制定一项包括不同筛选方案的调查所需的信息，这些方案以不同的组合包含这些要素。调查招募的无家可归妇女将在不同组合的筛查方案中进行选择，以展示她们的决定优先顺序。我们将对调查数据进行分析，以对每个因素对我们研究中为所有无家可归妇女进行筛查的选择的重要性进行数字估计。研究结果将为筛查干预措施的设计提供信息，以实现对这一特定人群的最高筛查率。无家可归妇女的喜好可能不同于有住房的妇女、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喜好和愿望制定战略，以最大限度地提高感兴趣的结果(在这种情况下，是筛查)。作为一项探索性拨款，我们的发现将用于开发筛查干预措施，用于随后的对照试验测试。这项研究将通过早期发现疾病，为NCI癌症控制和预防的目标做出贡献。 公共卫生相关性：这项研究针对筛查不足的人群--无家可归的妇女--的癌症筛查行为。我们的研究将通过一种检查选择的决策分析方法，确定解释无家可归妇女是否寻求宫颈癌筛查的相关健康和非健康决策因素。这项研究的最终目标是降低无家可归妇女的宫颈癌发病率和死亡率，并在美国预防宫颈癌。