Developing Neighborhood Archetypes for Understanding Disparities in Cancer

开发社区原型以了解癌症的差异

• 批准号: 8604276
• 负责人: Salma Shariff-Marco
• 金额: $ 16.2万
• 依托单位: CANCER PREVENTION INSTIT OF CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-16 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8604276
• 关键词: Accounting; Address; Affect; African American; Area; Asian Americans; Asians; California; Cancer Etiology; Cancer Patient; Censuses; Characteristics; Classification; Communities; Community Healthcare; Complex; Critical Pathways; Data; Data Set; Data Sources; Databases; Diagnosis; Dimensions; Disease; Environment; Ethnic Origin; Family; Food; Goals; Health; Health Policy; Hispanics; Home environment; Household; Individual; Intervention; Link; Literature; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Minority; Mission; Neighborhoods; Not Hispanic or Latino; Outcome; Pacific Island Americans; Pathway interactions; Policies; Population Heterogeneity; Population Research; Process; Public Health; Race; Research; Resources; Rural; Safety; Sampling; Shapes; Social Characteristics; Social Environment; Socioeconomic Status; Source; System; Testing; Time; United States National Institutes of Health; Vulnerable Populations; Work; base; food environment; health disparity; improved; innovation; insight; low socioeconomic status; malignant breast neoplasm; mortality; neoplasm registry; novel; novel strategies; patient population; population based; population health; public health relevance; social; suburb; success

PROJECT SUMMARY/ABSTRACT Disparities in cancer survival continue to persist by race/ethnicity, socioeconomic status (SES) and nativity. Neighborhood factors are critical pathways through which disparities are shaped and perpetuated. However, the literature has shown mixed results and neighborhood-based interventions have had limited success. To advance research on neighborhoods and health, new approaches need to reflect the fact that neighborhood effects on health arise through complex and dynamic processes, underscoring the importance of studying not only the individual effects of neighborhood features on health outcomes, but also their synergistic effects. A promising approach is to encompass multiple dimensions within a single classification system, archetypes, that capture meaningful distinctions across neighborhoods (e.g., Low SES, rural; Poor, urban minority; Middle-class suburban/exurban families). The archetype approach is an efficient way to maximally integrate multiple sources of available information on neighborhood characteristics and has the potential to identify improved opportunities for intervening and reducing health disparities. Leveraging a comprehensive database of small- area level data on social and built neighborhood environments and applying novel statistical approaches, this application proposes to develop neighborhood archetypes around two time periods, 2000 and 2010, for the large, diverse state of California. The central hypotheses are that 1) multiple neighborhood factors can be combined together to form neighborhood archetypes; and 2) that cancer mortality among breast and prostate cancer patients will vary by these neighborhood archetypes, and these associations will vary by race/ethnicity and nativity. The specific aims of this study are to: 1) Investigate the utility of the archetypes approach to characterize distinct neighborhoods across California. Specifically, we will extend to the census block group level previously developed census tract neighborhood archetypes using confirmatory latent class analysis (LCA). We will also expand, with additional built and social environment features, prior neighborhood archetypes using exploratory LCA. 2) Examine the associations between neighborhood archetypes and survival among a population-based, racially/ethnically diverse set of breast and prostate cancer patients. Specifically, we will test whether neighborhood archetypes are associated with all cause and cancer- specific mortality and whether this association is moderated by race/ethnicity. We will also test whether nativity moderates the neighborhood archetype associations among Hispanics and Asian Americans. The resulting neighborhood archetypes will provide an innovative resource for future research. Applying the archetypes to investigate breast and prostate cancer survival among California's diverse population, this research will yield insights into how neighborhood characteristics work synergistically with each other and interact with individual characteristics to influence health. This research has the potential to contribute to a broader, more fundamental understanding of place effects on health, with applications to both population health and health disparities research.

项目总结/摘要 癌症生存率的差异继续存在于种族/民族，社会经济地位（SES）和出生地。 邻里因素是形成和延续差异的关键途径。然而，在这方面， 文献表明，结果好坏参半，基于社区的干预措施取得的成功有限。到 为了推进对社区和健康的研究，新的方法需要反映这样一个事实， 对健康的影响是通过复杂和动态的过程产生的，这强调了研究不健康的重要性。 不仅是邻里特征对健康结果的个体影响，而且是它们的协同效应。一 一种有前途的方法是在一个单一的分类系统，原型， 捕获相邻区域之间有意义的区别（例如，社会经济地位低，农村;穷人，城市少数民族;中产阶级 郊区/远郊家庭）。原型方法是一种有效的方法，最大限度地整合多个 关于邻里特征的可用信息来源，并有可能确定改进的 干预和减少健康差距的机会。利用一个全面的数据库， 区域层面的社会和建成邻里环境的数据，并应用新的统计方法，这 应用程序提出了两个时间段，2000年和2010年，为社区发展原型， 美国加州一个大的、多样化的州。中心假设是：1）多个邻域因子可以 结合在一起，形成邻里原型; 2）乳腺癌和前列腺癌的死亡率 癌症患者将因这些社区原型而异，并且这些关联将因种族/民族而异 和耶稣诞生本研究的具体目的是：1）探讨原型法的实用性 来描述加州不同的社区。具体来说，我们将扩大到人口普查区， 组水平先前开发的人口普查区邻里原型使用验证潜在类 分析（LCA）我们还将扩大，与额外的建成和社会环境的特点，以前的社区， 使用探索性LCA的原型。2)研究邻里原型之间的联系， 基于人群的、种族/人种多样化的乳腺癌和前列腺癌患者的生存率 患者具体来说，我们将测试邻居原型是否与所有原因和癌症有关- 特定死亡率以及这种关联是否受种族/民族的调节。我们还将测试耶稣诞生 缓和了拉美裔和亚裔美国人之间的邻里原型关联。所得 邻里原型将为未来的研究提供创新资源。将原型应用于 通过调查加州不同人群中乳腺癌和前列腺癌的存活率， 深入了解邻里特征如何相互协同工作，并与个人互动 影响健康的特征。这项研究有可能有助于更广泛，更 对健康的地方效应的基本理解，适用于人口健康和健康 差距研究。