Pilot Project 1: Reducing Cervical Cancer Screening Health Disparities among Pacific Islanders Living in Guam (GU) and Hawaii (HI)

试点项目 1：减少居住在关岛 (GU) 和夏威夷 (HI) 的太平洋岛民之间的宫颈癌筛查健康差异

• 批准号: 9341919
• 负责人: Neal A. Palafox
• 金额: $ 7.57万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9341919
• 关键词: Address; Advanced Malignant Neoplasm; Affect; Age; Area; Attitude; Behavior; Belief; Biometry; Cancer Burden; Cancer Center; Car Phone; Cervical Cancer Screening; Communities; Community Outreach; Diagnosis; Disease; Economics; Effectiveness; English Language; Environment; Family; Federated States of Micronesia; Future; Goals; Guam; Hawaii; Health Care Costs; Health Promotion; Health Services; Health Status; Healthcare Systems; Healthy People 2020; Human Resources; Incidence; Indigenous; Information Technology; Intention; Intervention; Knowledge; Language; Mainstreaming; Malignant neoplasm of cervix uteri; Marshall Islands; Methods; Micronesia; Mission; Morbidity - disease rate; Nomads; Outcome; Pacific Island Americans; Participant; Pilot Projects; Population; Population Intervention; Populations at Risk; Prevalence; Randomized; Research Project Grants; Resource Sharing; Risk; Services; Social Welfare; Socialization; Societies; Target Populations; Testing; Text; Textiles; Transportation; Treatment Efficacy; United States; Universities; Ursidae Family; Woman; Women' s Group; Work; base; cancer health disparity; community based participatory research; cost; design; disorder prevention; experience; health care availability; health disparity; health equity; health literacy; high risk; improved; mortality; neoplasm registry; peer; post intervention; programs; screening; secondary outcome

Project Summary/Abstract Pilot 1 is a 3 year hypothesis-driven research project aimed at decreasing cervical cancer screening disparities in Chuukese and Marshallese Pacific Islander women. This group of women has among the highest incidence rates of cervical cancer in the world (79.7 per 100,000 and 42.4 per 100,000 (2007-2011)) in the Republic of the Marshall Islands (RMI) and Pohnpei, Federated States of Micronesia (FSM) respectively, compared to 9.9 per 100,000 women in the US(1). Therefore, identifying culturally appropriate methods to increase screening for this preventable disease is essential for these women and the welfare of their family. Prior work has persuaded us that text messaging on mobile phones is an effective method for reaching this population of Pacific Islanders. Pilot Project 1 has three objectives: 1) to understand the knowledge, attitudes, and beliefs of Micronesian Pacific Islander migrant populations that affect cervical cancer screening behavior; 2) to develop SMS (Short Message Service) strategies that will lead to increased screening rates in the target populations; 3) to support an environment for community-based participatory research and engagement for this study. Target Population: The intervention will focus on women ages 21-65 (inclusive) from two migrant groups of Pacific Islanders who bear a disproportionate burden of cervical cancer morbidity and mortality: 1) the indigenous Chuukese women of the Federated States of Micronesia (FSM) who recently migrated to GU and 2) women from the RMI who recently migrated to HI. The overarching goal of the project is to evaluate the effectiveness of community-based SMS strategies to increase cervical cancer screening rates in underserved Pacific Islander populations who have migrated to GU and HI within the last 5 years. Specific Aim 1 Evaluate the effectiveness of community-based SMS strategies to increase cervical cancer screening rates in underserved indigenous Chuukese and Marshallese populations who have migrated to GU and HI within the last 5 years Aim 1.1: Develop SMS messaging materials encouraging cervical cancer screening in three languages: English, Chuukese and Marshallese. Aim 1.2: Implement a randomized delayed control intervention to assess the effectiveness of SMS to increase completion of cervical cancer screening among Marshallese in HI and Chuukese in GU. Hypothesis: Cervical cancer screening completion will be higher for recently migrated (2007-2014) Chuukese and Marshallese women, ages 21-65, who received the peer-led, SMS-based intervention compared to those who did not receive the intervention. The efficacy of the intervention will be assessed by comparing the prevalence of completion of cervical cancer screening between the two randomized groups in an intention-to-treat analysis at 9 months post- randomization; we will also compare the change in these outcomes before and after intervention in women across both randomized groups. As a secondary outcome, intent to screen will be tracked; the study participants who intend to obtain cervical cancer screening following the intervention but ultimately do not receive cervical cancer screening to understand what other factors, such as transportation, cultural barriers, or a low priority of screening, influence their completion of cervical cancer screening. Knowledge these barriers will be used to develop and design a more robust cervical cancer screening program in the future. SMS health messages directed to this population may be an effective method to reach these culturally isolated and vulnerable Pacific Islander populations. The pilot project will support the overall goals of the Comprehensive Partnership to Advance Cancer Health Equity (CPACHE) by focusing on decreasing the disparity in cancer burden in under-served Pacific Islanders in HI and GU. The pilot will draw support from the Community Outreach Core (COC) and Shared Resources (Biostatistics, Information Technology and Cancer Registry). Pilot project personnel are well-versed in working with Pacific Islander community coalitions, and with the implementation of CBPR within these communities. This design is consistent with the mission and overarching goals of Healthy People 2020 and its Community-Based Objectives to expand culturally relevant approaches to health promotion and disease prevention (www.healthypeople.gov). Most importantly, this project addresses an urgent need to act to reduce the extremely high risk for cervical cancer, which is a preventable disease, in at-risk under-served Pacific Islander women.

项目摘要/摘要 Pilot 1是一项为期3年的假设驱动的研究项目，旨在减少宫颈癌筛查差异。 在楚科塞岛和马绍尔群岛，太平洋岛民妇女。这一女性群体的发病率是最高的 世界宫颈癌发病率(2007-2011年为79.7/10万和42.4/10万) 马绍尔群岛(马绍尔群岛)和密克罗尼西亚联邦波恩佩(密克罗尼西亚联邦)分别为9.9 美国每10万名女性(1)。因此，确定文化上合适的方法来增加筛查 因为这种可预防的疾病对这些妇女及其家庭的福祉至关重要。之前的工作已经完成 让我们相信手机短信是接触这一人群的有效方法 太平洋岛民。试点项目1有三个目标：1)了解以下方面的知识、态度和信念 影响宫颈癌筛查行为的密克罗尼西亚太平洋岛民流动人口；2)发展 将导致目标人群筛查率提高的短信(短消息服务)战略；3) 支持以社区为基础的参与性研究和参与本研究的环境。目标 人口：干预将集中在来自太平洋两个移民群体的21-65岁(含)的女性 承担不成比例的宫颈癌发病率和死亡率负担的岛民：1)土著 最近移民到GU的密克罗尼西亚联邦(FSM)楚克妇女和妇女 来自最近搬到HI的RMI。 该项目的总体目标是评估基于社区的短信战略的有效性，以 提高移民到广州的太平洋岛民中未得到充分服务的人群的宫颈癌筛查率 和最近5年内的HI。 具体目标1评估以社区为基础的短信策略在增加宫颈癌发病率方面的有效性 服务不足的楚克人和马绍尔人移民到广州的筛查率 和HI在过去5年内 目标1.1：开发三种语言的鼓励宫颈癌筛查的短信材料： 英语、楚克语和马绍尔语。 目标1.2：实施随机延迟对照干预以评估SMS的有效性，以增加 完成重庆市马绍尔人和顾州楚克族人宫颈癌筛查。 假设：新移民(2007-2014)的宫颈癌筛查完成率将更高 马绍尔妇女，年龄在21-65岁之间，她们接受了同伴领导的、基于短信的干预，与那些 没有接受干预的人。 干预的效果将通过比较宫颈癌的完成率来评估。 在治疗后9个月进行意向治疗分析的两个随机组之间的筛查 随机化；我们还将比较女性干预前后这些结果的变化 在两个随机分组中。作为次要结果，筛查意图将被跟踪；这项研究 计划在干预后接受宫颈癌筛查但最终未能如愿的参与者 接受宫颈癌筛查，以了解其他因素，如交通、文化障碍或 筛查优先级低，影响了他们宫颈癌筛查的完成。知识这些障碍 将在未来用于开发和设计更强大的宫颈癌筛查程序。 针对这一人群的短信健康信息可能是接触到这些文化隔绝的人的有效方法 和脆弱的太平洋岛民。该试点项目将支持 促进癌症健康公平的全面伙伴关系(CPACHE)，重点是减少 HI和GU中服务不足的太平洋岛民癌症负担的差异。飞行员将得到 社区外联核心(COC)和共享资源(生物统计、信息技术和癌症 注册表)。试点项目人员精通与太平洋岛民社区联盟的合作，以及 在这些社区内实施CBPR。这个设计与使命是一致的， 2020年健康人的总体目标及其基于社区的目标，以扩大与文化相关的范围 促进健康和预防疾病的方法(www.Health People.gov)。最重要的是，这 该项目解决了采取行动降低宫颈癌极高风险的迫切需要，宫颈癌是一种 在高危、服务不足的太平洋岛民妇女中，可预防的疾病。