Predictors of Cancer-risk Behaviors among Hispanic Americans

 描述(由申请人提供)：拉美裔美国人(HAS)是美国增长最快的人口群体。哈族人之间存在癌症健康差异，因此与非西班牙裔白人相比，哈族人更有可能具有更高的某些类型癌症的发病率和死亡率统计数据(NCI，2008)。本项目的目标是进一步了解HAS的文化适应、环境和致癌行为(即饮酒、吸烟和水果/蔬菜消费)之间的关系。为了实现这一点，该项目将研究1)个人层面的文化适应变量与癌症危险行为之间的关系，2)在考虑了个人层面的文化适应变量后，邻里变量与癌症风险行为的关系，以及3)邻里变量如何影响个人层面的文化适应变量与癌症风险行为之间的关系。文化适应对于了解人类的健康和健康行为至关重要。尽管社会经济地位与健康之间存在着积极的关系，而且在穷人中的比例也不成比例，但与非西班牙裔白人相比，他们的健康状况往往更好。研究人员假设，尽管社会经济地位普遍较低，但由于积极的健康行为与他们的文化和规范相关，他们的健康状况更好。此外，随着他们对美国的文化适应程度越来越高，并采用了美国文化的习俗和行为，他们往往会从事更多不利的健康行为。研究表明，总体趋势是存在的，即更多地适应美国文化与更多有害的健康行为相关。然而，根据主题领域和所用措施的不同，结果往往是不一致的。研究呼吁使用潜在的方法和多维的文化适应措施来进一步探索文化适应与健康行为之间的关系。此外，将文化适应与健康联系起来的研究中缺少的一个关键方面是对环境影响的理解。众所周知，一个人所处的环境会影响健康和健康行为。然而，很少有研究联合研究文化适应和环境与健康行为的关系。在这项拟议的研究中，将使用多水平建模来探索来自大都市边界城市的436名HA成年人癌症危险行为的相关性。多级数据结构包含一个分析级别的观测，这些观测嵌套在另一个分析级别的观测中。个人层面的文化适应变量将包括在模型的最低水平，并将分层嵌套在参与者的邻里数据中。社区将使用美国人口普查区域来定义。研究文化适应程度和环境如何独立和交互地影响癌症危险行为，可能会促进有效干预措施和政策的发展，以减少人类癌症之间的差异。

 DESCRIPTION (provided by applicant): Hispanic Americans (HAs) are the fastest growing demographic group in the United States (US). Cancer health disparities exist among HAs, whereby HAs are more likely to have higher incidence and mortality statistics for certain types of cancer in comparison to non-Hispanic Whites (NCI, 2008). The goal of this project is to further understanding of the relationships among acculturation, the environment, and cancer-risk behaviors (i.e., alcohol, tobacco, and fruit/vegetable consumption) in HAs. To accomplish this, the project will examine how 1) person-level acculturation variables relate to cancer-risk behaviors, 2) neighborhood variables relate to cancer- risk behaviors, after accounting for person-level acculturation variables, and 3) neighborhood variables impact the relationship between person-level acculturation variables and cancer-risk behaviors in this population. Acculturation is critical to the understanding of health and health behaviors among HAs. Although there is a positive relationship between socio-economic status and health, and HAs are disproportionately represented among the poor, they tend to have better health compared to non-Hispanic Whites. Researchers hypothesize that HAs have more favorable health, despite generally low socio-economic status, because of positive health behaviors associated with their culture and norms. Furthermore, as HAs become more acculturated to the US, and adopt customs and behaviors of US culture, they tend to engage in more adverse health behaviors. Research has indicated that general trends exist, whereby more acculturation to the US is associated with more adverse health behaviors. However, dependent on the subject area and measures used, findings are often inconsistent. Studies have called for further exploration of the relationship between acculturation and health behaviors using latent methodologies and multidimensional measures of acculturation. Additionally, a critical aspect missing from research relating acculturation to health is an understanding of the impact of the environment. It is well known that the environment in which one lives influences health and health behavior. However, few studies have jointly examined how acculturation and the environment relate to health behaviors. For the proposed study, multi-level modeling will be used to explore correlates of cancer-risk behaviors among 436 HA adults from a metropolitan border city. A multi-level data structure contains observations at one level of analysis that are nested within observations of another level of analysis. Person-level acculturation variables will be included at the lowest leve of the model, and will be hierarchically nested within participants' neighborhood data. Neighborhoods will be defined using US census tracts. Examining how level of acculturation and the environment independently and interactively affect cancer-risk behaviors may enhance the development of effective interventions and policies to reduce cancer disparities among HAs.