The Feasibility of a Peer-Driven Pap Testing Intervention for Young Bronx Women

对年轻布朗克斯女性进行同伴驱动的巴氏检查干预的可行性

• 批准号: 8640117
• 负责人: Laurie J Bauman
• 金额: $ 16.32万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8640117
• 关键词: 21 year old; AIDS prevention; Adherence; Advocate; Affect; Age; Area; Behavior; Cancer Prevention Intervention; Cervical Cancer Screening; Communication; Communities; County; Data; Diagnosis; Education and Outreach; Educational Intervention; Ethnic group; Feasibility Studies; Federally Qualified Health Center; Foundations; Guidelines; Health; Health behavior change; Human Papilloma Virus Vaccination; Immigration; Incentives; Individual; Insurance Coverage; Intervention; Knowledge; Latina; Latino; Lead; Literature; Low income; Malignant neoplasm of cervix uteri; Mediating; Methods; Minority; Modeling; Morbidity - disease rate; Outcome; Pap smear; Participant; Peer Pressure; Persons; Population; Prevention Research; Prevention strategy; Provider; Recommendation; Recruitment Activity; Research; Respondent; Rewards; Risk Behaviors; Sampling; Self Efficacy; Social Controls; Social Work; Subgroup; System; Testing; Woman; Work; base; behavior change; behavior influence; cervical cancer prevention; community based participatory research; cost effective; design; efficacy testing; innovation; interest; mortality; novel strategies; older women; outreach; peer; peer influence; population based; preference; prevent; public health relevance; racial and ethnic; research study; response; screening; social norm; success; theories; young woman

DESCRIPTION (provided by applicant): Nationally, Latina women have the highest cervical cancer rates of all racial/ethnic groups, and Black women have the highest cervical cancer mortality rates. In Bronx County, NY, which is the poorest urban county in the U.S. and is composed predominantly of Latino and Black residents, the rate of cervical cancer is about 35% higher than in the U.S. overall. Cervical cancer is preventable through regular Pap screening, yet it is estimated that 50% of women in the U.S. who are diagnosed with cervical cancer have never had a Pap test. Current cervical cancer screening guidelines recommend that women begin regular Pap screening at age 21 and continue screening every three years through age 29. Nonetheless, no interventions for increasing Pap screening have focused specifically on women under 30; thus, there is a particular need for evidence about effective ways to reach young minority women. Developing successful prevention strategies for these women necessitates a novel approach that recognizes and leverages the ways in which social norms and close personal relationships influence behaviors. Using a community-based participatory research approach, and drawing on cervical cancer screening literature and successful HIV prevention methods, we propose to assess the feasibility of using a peer-driven intervention (PDI) to reach and educate minority women 21-29 in the Bronx who are not adherent with Pap screening guidelines. A PDI is different from other peer education interventions because it gives all participants the opportunity to be peer educators (i.e., to become "Health Advocates") and receive associated rewards and recognition. Underpinning the PDI model is a cost-effective recruitment mechanism called respondent-driven sampling, a form of chain-referral sampling that is ideally suited to dense urban networks. In this participatory feasibility study, we will wok closely with a partnership of young Bronx women and local social service providers, as well as a federally qualified health center in the South Bronx that will provide Pap screening regardless of a woman's insurance status, immigration status, or ability to pay, in order to: 1) Assess the success of respondent-driven sampling in terms of the extent to which Health Advocates are effective in referring their peers to become Health Advocates themselves, and the factors related to successful referral; and 2) Determine the degree to which the PDI leads to Pap screening among women 21-29 in the Health Advocates' networks who are not adherent with screening guidelines, and to an increase in knowledge and self-efficacy among Health Advocates. This study will yield data needed to establish the value of conducting a larger, R01-scale study to assess the efficacy of a population-based, peer-driven cervical cancer prevention intervention, using respondent-driven sampling, to reach and change the behavior of a large number of young, low-income minority women who are not adherent with Pap screening guidelines.

描述（由申请人提供）：在全国范围内，拉丁裔妇女在所有种族/族裔群体中的宫颈癌率最高，黑人妇女的宫颈癌死亡率最高。在纽约州布朗克斯县，这是美国最贫穷的城市县，主要由拉丁裔和黑人居民组成，宫颈癌的发生率比美国总体上高约35％。可以通过常规的子宫颈抹片检查来预防宫颈癌，但据估计，被诊断出患有宫颈癌的女性中有50％从未进行过子宫颈抹片检查。当前的宫颈癌筛查指南建议，女性在21岁开始定期进行PAP筛查，并继续每三岁到29岁每三岁一次筛查。尽管如此，没有针对30岁以下的妇女进行尚未提高PAP筛查的干预措施；因此，特别需要证据证明有效的少数族裔妇女。为这些女性制定成功的预防策略需要采取一种新颖的方法来认识并利用社会规范和紧密的人际关系影响行为的方式。使用基于社区的参与性研究方法，并利用宫颈癌筛查文献和成功的HIV预防方法，我们建议评估使用同伴驱动的干预措施（PDI）在布朗克斯（Bronx）中触及和教育少数族裔女性的可行性，而这些妇女不使用PAP筛查指南。 PDI与其他同伴教育干预措施不同，因为它使所有参与者都有机会成为同伴教育者（即成为“健康倡导者”）并获得相关的奖励和认可。 PDI模型的基础是一种具有成本效益的招聘机制，称为受访者驱动的抽样，这是一种链条推荐采样的形式，非常适合致密的城市网络。 In this participatory feasibility study, we will wok closely with a partnership of young Bronx women and local social service providers, as well as a federally qualified health center in the South Bronx that will provide Pap screening regardless of a woman's insurance status, immigration status, or ability to pay, in order to: 1) Assess the success of respondent-driven sampling in terms of the extent to which Health Advocates are effective in referring their peers to become Health提倡自己，以及与成功推荐有关的因素； 2）确定在不遵守筛查指南的卫生倡导者网络中，PDI导致21-29岁女性的PAP筛查程度，以及在健康倡导者中的知识和自我效能增强的程度。这项研究将产生所需的数据，以建立进行更大的R01尺度研究的价值，以评估使用受访者驱动的采样来评估基于人群的，同伴驱动的宫颈癌预防干预措施，以达到和改变大量年轻，低收入的少数少数妇女的行为。