Empowering Latinas to Obtain Breast Cancer Screenings

帮助拉丁裔获得乳腺癌筛查

• 批准号: 9757718
• 负责人: Yamile Molina
• 金额: $ 14.68万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9757718
• 关键词: Address; Adherence; Advisory Committees; Advocate; Affect; Applications Grants; Area; Behavior; Breast; Breast Cancer Detection; Breast Cancer survivor; Cancer Center; Caring; Chicago; Clinical; Communities; Community Health; Community Health Aides; Control Groups; Detection; Development; Diagnosis; Diffusion; Education; Educational Intervention; Educational workshop; Environment; Evaluation; Family; Focus Groups; Friends; Funding; Gender; Goals; Grant; Guidelines; Health; Health Fairs; Health Promotion; Health Services; Health behavior; Hispanic-serving Institution; Illinois; Individual; Institutes; Institution; International Union Against Cancer; Intervention; K-Series Research Career Programs; Knowledge; Latina; Latino; Lead; Learning; Light; Literature; Malignant Neoplasms; Manuscripts; Measures; Medical Records; Mentors; Mentorship; Meta-Analysis; Methods; Minority; Observation in research; Outcome; Participant; Pathway Analysis; Patient Self-Report; Patients; Pattern; Policies; Population Heterogeneity; Positioning Attribute; Preventive; Preventive service; Process; Psychosocial Factor; Public Health Schools; Recording of previous events; Records; Research; Research Personnel; Resources; Sampling; Science; Scientist; Screening for cancer; Self Efficacy; Social Network; Source; System; Time; Training; Trust; United States National Institutes of Health; Universities; Urban Health; Woman; Work; Writing; anticancer research; arm; base; bilingualism; cancer health disparity; career; career development; community based participatory research; comparative; comparative efficacy; data format; density; design; disparity reduction; empowered; empowerment; evidence base; experience; health empowerment; health equity; improved; interest; intervention effect; investigator training; longitudinal analysis; malignant breast neoplasm; meetings; metropolitan; mortality; neoplasm resource; outreach; peer; pilot trial; post intervention; programs; protective effect; psychosocial; public health priorities; radiologist; research study; residence; responsible research conduct; screening; screening guidelines; secondary analysis; social; symposium; therapy development; volunteer

Candidate. I am a driven early career investigator with the long-term goal of becoming an independent scientist in the field of cancer disparities. My major research interests concern identification and incorporation of psychosocial facilitators to breast cancer screening into interventions to reduce disparities in late stage detection. In that light, I have conducted observational, mixed method, community-based participatory research (CBPR) studies and led secondary analyses which indicate social outreach (e.g., conversations with family and friends) and volunteerism are associated with breast cancer screening among Latinas. The next logical step is to develop an intervention that would empower women to engage in social outreach and volunteerism and examine its effects on these women and their networks. I however need training and mentorship to take this next step. My four career objectives are thus to gain expertise in: 1) leading empowerment interventions; 2) implementing CBPR interventions; 3) using social network analysis; and 4) competitive grant writing. My training plan at the University of Illinois at Chicago (UIC) consists of didactic training (coursework, seminars, and workshops), participation in scientific conferences, manuscript development, submission of NIH grant applications, and mentorship from scientists with strong track records in mentorship and expertise in empowerment strategies (Dr. Ferrans), intervention science (Drs. Ferrans, Mermelstein, Geller), social network analysis (Dr. Schneider), and grant writing (all). I will also be trained in the responsible conduct of research. These experiences will position me to be a unique investigator that can compare the potential of different participatory-based interventions to improve individual- and network-level outcomes for the underserved. Environment. UIC is ideally suited for my career progression into independence and implementation of the proposed research. It is one of the top 50 research-funded institutions in the nation and a designated Hispanic- Serving Institution. It has strong partnerships with local Latino communities and is committed to cancer health equity. There are a number of career development opportunities, including, but limited to, seminars, workshops, and other resources through the School of Public Health, Cancer Center (UICC), Center for Research on Women and Gender, and the Institute for Health Research and Policy. Research Plan. Latinas suffer disproportionately from breast cancer relative to non-Latina Whites (NLWs), including late stage detection. While there have been controversies in breast cancer screening, non-adherence to guideline-concordant screening continues to be a major modifiable determinant of breast cancer outcome disparities. Thus, increasing participation in breast cancer screening among Latinas, especially care that corresponds with clinical and academic guidelines, is a public health priority. Participatory approaches are popular methods to improve screening within this group and have included approaches that 1) deliver education to non-adherent Latinas and 2) train community health advocates (community health workers, breast cancer survivors) to engage in breast health promotion. The second approach (empowerment interventions) concerns training participants to engage in social outreach (e.g., having conversations with family and friends about breast health) and volunteering (e.g., helping in health fairs, engaging in civic campaigns about breast cancer programs). Patient activation and volunteerism literature suggest that empowerment interventions may have `added value' for participants themselves over delivering education in terms of preventive health psychosocial factors and practices. Relative to education interventions, empowerment interventions may also affect women's networks, as they may be more likely to disseminate evidence-based breast health promotion among their family and friends. To date, little research has compared interventions' effects on individual-level outcomes or used formal social network analysis to examine network effects. The proposed work adds to the literature through empirically comparing two approaches (education versus empowerment) on three sets of outcomes: 1) women's own screening, 2) women's own self-efficacy, norms, support, knowledge; and 3) women's networks (measured by egocentric analysis). I will lead this work and will benefit from the collective expertise and resources of my mentors (Drs. Ferrans, Mermelstein, Geller) and collaborators (Dr. Schneider, The Resurrection Project, Metropolitan Chicago Breast Cancer Task Force, Sinai Urban Health Institute, University of Illinois Cancer Center). Aim 1 intervention development will be accomplished through continuous stakeholder engagement and specifically through meetings and focus groups with a bilingual, bicultural community advisory engagement board (CEAB), UICC radiologists and target participants (non-adherent Latinas). We have already begun this process and are obtaining formative data. After we develop intervention materials, a pilot trial will be conducted with an area-level treatment control group design in Chicago. Participants will be 150 Latinas with no history of health volunteerism, residence in one of two targeted areas, and non-adherence to US Preventive Services Task Force screening guidelines. Aim 1 intervention evaluation will involve an analysis to compare differences in receipt of a medical record-confirmed screening within six months of participating in the study. Aim 2 will be an analysis to compare interventions' effects on self-efficacy, norms, support, knowledge across three time points – pre-intervention, immediately post-intervention, and six months post-intervention. Aim 3 will be a social network analysis, specifically egocentric, to compare interventions' effects on breast health, network size, and network density as well as will number of peers referred to the study.

候选人。我是一名早期职业调查员，其长期目标是成为独立 癌症分布领域的科学家。我的主要研究兴趣涉及识别和就业 心理社会促进者乳腺癌筛查中的干预措施，以减少晚期分布 检测。从这个角度来看，我进行了观察，混合方法，基于社区的参与研究 （CBPR）研究并领导二级分析，该分析表明社会宣传（例如，与家人的对话和对话 朋友）和志愿服务与拉丁裔乳腺癌筛查有关。下一个逻辑步骤是 制定一种干预措施，以赋予妇女从事社会外展和志愿服务以及 检查其对这些妇女及其网络的影响。但是，我需要培训和精神训练才能接受这一点 下一步。因此，我的四个职业目标是获得以下方面的专业知识：1）领导授权干预措施； 2） 实施CBPR干预措施； 3）使用社交网络分析； 4）竞争性赠款写作。我的 伊利诺伊大学芝加哥大学（UIC）的培训计划包括教学培训（课程，半手， 和研讨会），参加科学会议，手稿开发，提交NIH赠款 申请和具有良好往绩记录的科学家的申请和精神训练。 授权策略（Ferrans博士），干预科学（Ferrans博士，Mermelstein，Geller），社交网络 分析（Schneider博士）和授予写作（全部）。我还将接受负责任的研究的培训。 这些经验将使我成为一个独特的研究者，可以比较不同的潜力 基于参与的干预措施，以改善服务不足的个人和网络级别的结果。 环境。 UIC非常适合我的职业发展和实施 拟议的研究。它是全国50个由研究资助的机构之一，也是指定的西班牙裔 - 服务机构。它与当地拉丁裔社区建立了牢固的伙伴关系，并致力于癌症健康 公平。有许多职业发展机会，包括但仅限于半小伙子 研讨会和其他资源通过公共卫生学院，癌症中心（UICC），中心 妇女和性别研究，以及健康研究与政策研究所。 研究计划。拉丁裔相对于非拉丁裔白人（NLW），乳腺癌的痛苦不成比例 包括晚期检测。尽管乳腺癌筛查中存在争议，但不遵守 对于指导方案，筛查仍然是乳腺癌结局的主要可修改决定者 差异。这是增加拉丁裔乳腺癌筛查的参与，特别是在乎 与临床和学术指南相对应，是公共卫生的重点。参与性方法是 改善该组中筛选的流行方法，并包括方法1）交付 对非遵守拉丁裔的教育和2）培训社区卫生倡导者（社区卫生工作者，乳房 癌症幸存者）从事乳房健康促进。第二种方法（授权干预措施） 关注培训参与者参与社会宣传（例如，与家人和朋友进行对话 关于乳房健康）和志愿服务（例如，帮助健康展览会，参与有关乳房的公民运动 癌症计划）。患者激活和志愿服务文献表明，赋权干预措施可能 在预防健康方面为参与者自己提供“增加价值” 社会心理因素和实践。相对于教育干预措施，授权干预措施也可能 影响妇女网络，因为它们可能更有可能传播基于证据的乳房健康促进 在他们的家人和朋友中。迄今为止，很少的研究比较了干预措施对个人级别的影响 结果或使用正式的社交网络分析来检查网络效应。拟议的工作增加了 通过经验比较三组的两种方法（教育与授权）的文献 结果：1）妇女自己的筛查，2）妇女自身的自我效能，规范，支持，知识； 3） 妇女网络（通过以自我为中心分析来衡量）。我将领导这项工作，并将从集体中受益 我的导师的专业知识和资源（Ferrans博士，Mermelstein，Geller）和合作者（Schneider博士， 复活项目，芝加哥大都会乳腺癌工作组，西奈城市健康研究所， 伊利诺伊大学癌症中心）。 AIM 1干预开发将通过继续 利益相关者的参与，特别是通过双语，双文化的会议和焦点小组 社区咨询委员会（CEAB），UICC放射科医生和目标参与者（不遵守者 拉丁裔）。我们已经开始此过程并正在获得形成性数据。开发干预后 材料，将对芝加哥的地区级治疗对照组设计进行试点试验。 参与者将是150个拉丁裔，没有健康志愿服务史，在两个目标地区之一的住所， 对美国预防服务工作队筛查指南的不遵守。 AIM 1干预评估 将涉及分析，以比较六个内的病历确认筛查的差异 参加该研究的几个月。 AIM 2将是比较干预措施对自我效果的影响的分析， 规范，支持，跨三个时间点的知识 - 干预前，干预后立即 干预后几个月。 AIM 3将是社交网络分析，特别是以自我为中心的分析 干预措施对乳房健康，网络大小和网络密度以及同龄人的影响 提到该研究。