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Community Outreach Program

社区外展计划

基本信息

批准号：
8728596
负责人：
Willie Underwood
金额：
$ 17.7万
依托单位：
ROSWELL PARK CANCER INSTITUTE CORP
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8728596
关键词：
Address Affect African American Agriculture Ally American Area Assertiveness Attitude Award Behavior Behavioral Model Belief Buffaloes Canada Cancer Control Caring Characteristics Church Cities Clinical Clinical Research Clinical Trials Cognitive Color Communication Communities Community Outreach County Development Development Plans Dimensions Discrimination Disease Economics Education Educational process of instructing Educational workshop Emergency Medicine Emotional Emotions Empathy Employee Environment Ethnic group European Evidence based intervention Family Foundations Fright Future General Population German population Growth Health Health Personnel Health behavior Healthcare Hispanics Home environment Housing Immigrant Implicit Association Test Individual Informal Social Control Institutes Intelligence Internal Medicine International Intervention Latino Lead Leadership Life Literature Malignant Neoplasms Measures Medical Mexico Mind Mission Modeling Monitor Motivation Movement Needs Assessment Neighborhoods New York New York City Nomads Occupational Occupations Outcome Participant Patient Self-Report Patients Pattern Personality Personality Assessment Persons Phase Physicians Policies Polishes Population Poverty Prejudice Procedures Process Productivity Provider Public Health Public Health Schools Puerto Rican Race Railroads Recording of previous events Relative (related person)Reporting Research Resources Risk Role Rural Schools Secondary to Self Perception Services Shipping Ships Slave Smoking Social Network Solutions Steel Stereotyping Structure Subgroup Taxes Testing Time Tobacco Training Training Programs Trust Uncertainty Unconscious State Unemployment Vision Visit War Work World War II acronyms base behavior influence behavior test cancer health disparity cancer site caucasian American computerized evaluation/testing experience falls health care quality improved innovation interest intervention program medical specialties medically underserved member migration neoplasm resource outreach outreach program preference pressure prevent professor programs racial and ethnic racism response satisfaction screening segregation skills social social capital social cognition social group social skills suburb tobacco control tool volunteer

项目摘要

The historical experiences and cultural environment of the cities of Buffalo, Niagara Falls, their suburbs and the surrounding rural counties is important to the context of the mission of the WNYC(2) Center and proposed Community Outreach Program. Puring the 1850's and Civil War era, WNY was a major journey point in the abolitionist movement serving as final American stops on the Underground Railroad for assisting former slaves to escape into Canada. Then with the growth of shipping and the industrial revolution, Buffalo became the home of the most millionaires per capita at the turn of the 20th century. Puring World War II and post-war boom, more African Americans from southern states moved into Buffalo for industrial jobs and then became the predominate subgroup on the Eastside creating a movement of the previous European ethnic groups from urban Buffalo into other parts of Erie and surrounding counties. These historical waves of migration resulted in what has been characterized as the "color line," referring to the hierarchical categorization of class and resources by ethnic/racial characteristics or origins that included Irish, Italian and Eastern European immigrants as "nonwhite" at the turn ofthe century.(1) By the 1980's, the City of Buffalo had lost 23% of its population, thousands of jobs and major industrial employers like Bethlehem Steel, resulting in a loss of 70% of its tax base.^ Many of these displaced workers¿White and Black- still live in Buffalo, Niagara Falls, Erie and the surrounding counties and embody both the occupational risks from past exposures as well as the economic pressures of unemployment. The resulting sociocultural dynamics are important influences on racial and economic circumstances. This economic decline resulted in social and political repercussions related to fears of class and job displacement such as delayed integration of public schools (1981); patterns for white ethnic flight of Polish, German, and Irish families; development of housing "projects" for both White and Black residents, and continued de facto segregation of neighborhoods.(2,3) A recent story in the media reported that the City of Buffalo "is the home to the emptiest neighborhood in New York State" referring to a neighborhood with the most abandoned homes. (4) The Southern Tier, including the county of Chautauqua, was primarily settled in the late 1700's by European immigrants, lending to its primarily white demographic base. In the 1800's however, with multiple stations of the Underground Railroad throughout the county, Jamestown was host to one of the first settlements of 'free colored people.(5) The first African American Episcopal Zion Church in Chautauqua County opened in Jamestown in 1882.(6) WNY is also home to a large per capita population of Hispanic/Latinos in the Punkirk area, migrating from New York City, primarily of Puerto Rican descent. There is a strong migrant presence in the area's agricultural workforce originating from Mexico. The presence of racial inequities in health and healthcare has been well documented nationally. (7) Several factors are suggested as possible causes of these inequities and resulting disparities, including, but not limited to, health care provider bias, stereotyping, and clinical uncertainty.(7 )Likewise, neighborhood dynamics including segregation, gentrification, built environment and poverty impact behavior and disease.(8) The combination of historical processes and their impact on community and environmental level variables have created significant cancer disparities in Buffalo, Niagara Falls and Chautauqua and these communities and their resources will provide the solutions. Briefly, the theoretical foundation for our Community Outreach Program plans is built upon addressing disparities at multiple levels following a Socioecological Model.(9) For example, in tobacco, RPCI will continue work at a policy level (e.g., taxes and no-smoking policies), (see Facilities and Resources) and we will enhance the community level involvement with new interventions with Block Club Associations, while working at the institutional/provider level to enhance cessation in our proposed research. (See N4.R01) The interventions to reduce disparities proposed in our Center are focused on building social capital among medically underserved residents of WNY to optimize their ability and interest in using available cancer resources and procedures'"; while expanding the experiences of the RPCI staff to improve understanding of the social and cultural context of vulnerable communities.(10) The concept of social capital as used in our Center is defined as the "benefits and challenges that accrue from participation in social networks and groups(11) and includes the positive attributes of civic engagement and norms of reciprocity and trust (as is often used in public health literature).(12)

布法罗、尼亚加拉大瀑布等城市及其郊区和周边乡村县的历史经历和文化环境对于 WNYC(2) 中心的使命和拟议的社区外展计划非常重要。在 1850 年代和内战时期，西纽约州是废奴运动的一个重要旅程点，也是美国地下铁路的最后一站，帮助前奴隶逃往加拿大。随后，随着航运业的发展和工业革命，布法罗在 20 世纪初成为人均百万富翁最多的家园。净化二战及战后随着经济繁荣，更多来自南部各州的非裔美国人搬到布法罗从事工业工作，然后成为东区的主要群体，导致以前的欧洲族裔群体从布法罗城市迁移到伊利的其他地区和周边县。这些历史性的移民浪潮导致了所谓的“肤色线”，指的是按民族/种族特征或出身对阶级和资源进行等级分类，其中包括世纪之交的爱尔兰、意大利和东欧移民作为“非白人”。(1) 到 1980 年代，布法罗市已经失去了 23% 的人口、数千个工作岗位和伯利恒钢铁公司等主要工业雇主，导致其税基损失了 70%。^ 其中许多流离失所的工人（白人和黑人）仍然居住在布法罗、尼亚加拉瀑布、伊利和周边县，他们既承受着过去暴露带来的职业风险，也承受着失业的经济压力。由此产生的社会文化动态对种族和经济环境具有重要影响。这种经济衰退导致了与阶级和工作取代的担忧相关的社会和政治影响，例如延迟公立学校一体化（1981年）；波兰、德国和爱尔兰家庭的白人逃亡模式；为白人和黑人居民开发住房“项目”，并继续实行事实上的社区隔离。(2,3) 最近媒体报道称，布法罗市“是纽约州最空旷的社区的所在地”，指的是废弃房屋最多的社区。 (4) 包括肖托夸县在内的南部地区主要由欧洲移民于 1700 年代末定居，其人口基础以白人为主。然而，在 1800 年代，随着地下铁路遍布全县的多个车站，詹姆斯敦成为了第一批“自由有色人种”的定居点之一。(5) 肖托夸县第一座非裔美国圣公会锡安教堂于 1882 年在詹姆斯敦开业。(6) 西纽约州也是庞克尔克地区人均从纽约市移民而来的大量西班牙裔/拉丁裔人口的家园，主要是波多黎各血统。存在大量移民该地区的农业劳动力来自墨西哥。健康和医疗保健领域种族不平等的存在在全国范围内都有据可查。 (7) 有几个因素被认为是造成这些不平等和由此产生的差异的可能原因，包括但不限于医疗保健提供者偏见、刻板印象和临床不确定性。(7)同样，社区动态，包括隔离、高档化、建筑环境和贫困，影响行为和疾病。(8) 历史进程及其对社区和环境水平变量的影响的结合，在布法罗、尼亚加拉瀑布和肖托夸造成了巨大的癌症差异，这些社区及其资源将提供解决方案。简而言之，我们的社区外展计划计划的理论基础是建立在遵循社会生态模型解决多个层面的差异的基础上。(9) 例如，在烟草方面，RPCI 将继续在政策层面开展工作（例如税收和禁烟政策）（参见设施和资源），我们将通过街区俱乐部协会的新干预措施加强社区层面的参与，同时在机构/提供商层面开展工作，以在我们提议的研究中加强戒烟。（参见 N4.R01）干预措施我们中心提出的减少差异的重点是在 WNY 医疗服务不足的居民中建立社会资本，以优化他们使用现有癌症资源和手术的能力和兴趣”；同时扩大 RPCI 工作人员的经验，以提高对弱势社区的社会和文化背景的了解。(10) 我们中心使用的社会资本概念被定义为“通过参与社交网络和团体而产生的好处和挑战(11)，包括积极的方面” 公民参与的属性以及互惠和信任的规范（公共卫生文献中经常使用的）。(12)