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，文献显示，结果喜忧参半，以社区为基础的干预措施取得的成功有限。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，即社区对健康的影响是通过复杂和动态的过程产生的，强调不仅要研究社区特征对健康结果的个体影响，还要研究它们的协同效应。一种有前途的方法是在一个单一的分类系统中包含多个维度，即原型，它可以捕捉到社区之间有意义的区别（例如，低社会经济地位，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来源的可用信息的邻里特征，并有可能确定改善的机会进行干预和减少健康差距。利用关于社会和建成的邻里环境的小区域水平数据的综合数据库并应用新颖的统计方法，本申请提出围绕两个时间段（2000年和2010年）为大的、多样化的加州州开发邻里原型。核心假设是：1）多个邻里因素可以组合在一起形成邻里原型; 2）乳腺癌和前列腺癌患者的癌症死亡率将因这些邻里原型而异，这些关联将因种族/民族和出生地而异。本研究的具体目的是：（1）探讨原型方法在描述加州不同社区特征中的实用性。具体来说，我们将扩展到人口普查块组水平以前开发的人口普查区邻里原型使用验证性潜在类分析（LCA）。我们还将扩大，与其他建成和社会环境的功能，以前的社区原型使用探索性LCA。2)研究社区原型与基于人群的、种族/民族多样化的乳腺癌和前列腺癌患者生存率之间的关联。具体来说，我们将测试邻居原型是否与所有原因和癌症特异性死亡率相关，以及这种相关性是否受种族/民族的调节。我们还将测试是否耶稣诞生温和的拉美裔和亚裔美国人之间的邻里原型协会。由此产生的邻里原型将为未来的研究提供一个创新的资源。应用原型来调查加州不同人群中乳腺癌和前列腺癌的生存率，这项研究将深入了解邻里特征如何相互协同作用，并与个人特征相互作用，以影响健康。这项研究有可能有助于更广泛，更根本的了解地方对健康的影响，与人口健康和健康差异的研究应用。