Improving Routine Asymptomatic Cancer Screening among Federally Qualified Health Center Users in Florida: Application of a Health Literacy Framework

改善佛罗里达州联邦合格健康中心用户的常规无症状癌症筛查：健康素养框架的应用

• 批准号: 9902378
• 负责人: Alicia Lynette Best
• 金额: $ 15.46万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9902378
• 关键词: Active Learning; Acute; Address; Adherence; Age; Award; Behavioral Research; Breast Cancer Detection; Cancer Burden; Chronic; Clinic; Collaborations; Colorectal Cancer; Communication; Communication Research; Competence; Complex; Consultations; Decision Analysis; Decision Making; Decision Trees; Development Plans; Diabetes Mellitus; Diagnosis; Disease; Educational workshop; Ethnography; Evaluation; Federally Qualified Health Center; Fees; Florida; Foundations; Future; General Population; Goals; HCV screening; Health; Health Communication; Health Promotion; Health Status; Healthy People 2020; Hepatitis C Vaccination; Home environment; Human Papilloma Virus Vaccination; Incidence; Individual; Injury; Intervention; Intervention Studies; Interview; Knowledge; Level of Evidence; Location; Low Income Population; Low income; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Medically Underserved Area; Mentors; Mentorship; Mission; Modeling; Motivation; Not Hispanic or Latino; Patients; Phase; Physicians; Population; Preventive care; Primary Health Care; Process; Production; Provider; Public Health; Recommendation; Research; Research Personnel; Research Project Grants; Resources; Risk; Role; Screening for cancer; Services; Slide; Socioeconomic Status; Structure; Surveys; System; Testing; Time; Training; Translating; Uninsured; Vulnerable Populations; base; cancer health disparity; cancer prevention; career; career development; colorectal cancer screening; design; disparity reduction; eHealth; ethnic minority population; evidence base; experience; health equity; health literacy; improved; innovation; literacy; low socioeconomic status; malignant breast neoplasm; medically underserved; mortality; mortality disparity; operation; professor; racial and ethnic; research to practice; routine screening; screening; service delivery; skills; social; socioeconomics; tenure track; therapy design; tool

ABSTRACT As a recently appointed tenure-track Assistant Professor of Public Health, my long-term career goal is to make a meaningful contribution to the elimination of cancer disparities. In doing this, I wish to establish myself as a nationally-recognized independent investigator with expertise in the use of health communication to address cancer disparities. I have substantial training in behavioral research, primarily focused on understanding the role of various social and cultural factors on cancer disparities. Building on this foundation, I require additional training to fill gaps related to the design, implementation, and evaluation of health communication interventions. My Mentorship Team and I have prepared a comprehensive career development plan that consists of mentorship, coursework, expert consultations, workshops, experiential learning, and an innovative research project. My proposed research plan aligns with my overarching career goal in seeking to improve routine cancer screening within federally qualified health centers (FQHCs), where the burden of cancer is greater compared to the general population, but screening rates are much lower than national averages. Despite the significant contribution of routine screening in the reduction of breast, cervical, and colorectal cancer (CRC) incidence and mortality, disparities persist among racial/ethnic minority and low socioeconomic (SES) populations who continue to underutilize screening. FQHCs can be invaluable partners in reducing these disparities due to their sliding-fee pay structure and location in medically underserved areas. The goal of the proposed K01 research project is to understand how current FQHC users perceive routine asymptomatic cancer screening, and develop and pre- test an eHealth tool that promotes screening among FQHC users. The specific aims are to: (1) Conduct formative research with FQHC users to understand how they perceive and make decisions about routine asymptomatic cancer screening; (2) Design and pre-test an eHealth tool that addresses each domain of the health literacy framework, and incorporates key decision criteria of asymptomatic cancer screening among FQHC users; and (3) Pilot test an eHealth intervention within an FQHC setting aimed at delivering literacy appropriate, “decision- relevant” information about routine asymptomatic cancer screening to FQHC users. This Mentored Research Award would provide the necessary protected time to achieve the following training goals: (1) Develop expertise in the application of decision analysis to health communication, within a health literacy framework; (2) Become familiar with clinic operations, user profiles, and service delivery within FQHCs, along with successful research collaboration with FQHCs; (3) Build competence in health communication intervention design, implementation, and evaluation; and (4) Develop the necessary skills to translate communication research into practice, specifically within an FQHC setting. This research would set the stage for a larger R01-level health communication intervention study. Findings might inform not only cancer screening, but also other health promotion interventions in FQHCs, which are increasingly becoming medical homes for low SES populations.

摘要