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: 8928061
• 负责人: Salma Shariff-Marco
• 金额: $ 19.44万
• 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 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8928061
• 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; built environment; 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; social; suburb; success

DESCRIPTION (provided by applicant): 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 utiity 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.

描述（由申请人提供）：癌症生存的差异继续依靠种族/种族，社会经济地位（SES）和耶稣诞生。邻里因素是差异和永久差异的关键途径。但是，文献表现出不同的结果，基于邻里的干预措施的成功有限。为了促进对社区和健康的研究，新方法需要反映以下事实：邻里对健康的影响通过复杂而动态的过程产生，强调不仅研究邻里特征对健康结果的个人影响，而且还研究其协同影响的重要性。一种有希望的方法是涵盖单个分类系统中的多个维度，原型捕获了各个社区之间有意义的区别（例如，低SES，农村；贫穷，城市少数民族；中产阶级郊区/外城家庭）。原型方法是最大程度地整合有关邻里特征的多种可用信息来源的有效方法，并有可能确定改善介入和降低健康差异的机会。利用有关社交和建筑社区环境的小区域级别数据的全面数据库，并采用新颖的统计方法，该应用程序建议针对加利福尼亚州的大型，多样化的州开发两个时间段的邻里原型。中心假设是1）可以将多个邻域因素组合在一起形成邻里原型； 2）乳腺癌和前列腺癌患者之间的癌症死亡率将因这些邻里原型而有所不同，这些关联将因种族/民族和诞生而有所不同。这项研究的具体目的是：1）研究原型方法的UTIITY，以表征整个加利福尼亚州不同社区。具体而言，我们将使用确认性潜在类别分析（LCA）扩展到以前开发的人口普查区域的人口普查组级别。我们还将使用探索性LCA的其他邻里原型扩展，并具有额外的建筑环境和社交环境功能。 2）检查邻里原型与基于种群的种族/种族多样性乳腺癌和前列腺癌患者的关联。具体而言，我们将测试邻里原型是否与所有原因和癌症特定的死亡率相关联，以及这种关联是否受到种族/民族的调节。我们还将测试耶稣诞生是否会在西班牙裔和亚裔美国人之间调节社区原型协会。由此产生的邻里原型将为未来的研究提供创新的资源。该研究应用原型调查了加利福尼亚州多样化的人群中的乳腺癌和前列腺癌的生存，这将为邻里特征如何彼此协同起作用并与个人特征相互作用以影响健康。这项研究有可能为对位置对健康的影响产生更广泛，更基本的了解，并在人口健康和健康差异研究中应用。