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Reducing Colorectal Cancer Health Disparities: An mHealth Intervention to Improve Screening among African American Men

减少结直肠癌健康差异：改善非裔美国男性筛查的移动医疗干预措施

基本信息

批准号：
9907523
负责人：
Samantha L. Leaf
金额：
$ 22.41万
依托单位：
ISA ASSOCIATES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-11 至 2020-09-10
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9907523
关键词：
Address Adherence Adoption Adult African American Age Behavior Belief Cancer Etiology Car Phone Caring Cellular Phone Cessation of life Clinic Clinical Colorectal Cancer Communication Communities Complex Death Rate Development Diagnosis Education Electronic Health Record Enrollment Exclusion Familiarity Federally Qualified Health Center Focus Groups Frequencies Gender Health Human Resources Imagery Incidence Individual Instruction Intervention Knowledge Language Lead Link Malignant Neoplasms Malignant neoplasm of cervix uteri Methods Modeling Online Systems Participant Patient Care Patients Persons Phase Positioning Attribute Poverty Precancerous Polyp Primary Health Care Privacy Provider Race Recording of previous events Reporting Research Resources Screening for cancer Security Series Shapes Site Socioeconomic Status Survival Rate Telephone Testing Text Text Messaging Underinsured Underserved Population Uninsured United States base cancer health disparity cancer invasiveness colorectal cancer screening cost design group intervention health belief health disparity health literacy improved intervention cost low socioeconomic status mHealth male malignant breast neoplasm medically underserved member men mobile computing mortality non-compliance outreach patient-level barriers peer personalized intervention preference prevent primary care setting programs prototype racial disparity racism recruit satisfaction screening screening guidelines skills systematic review theories therapy design tool uptake usability web-based assessment

项目摘要

PROJECT SUMMARY/ABSTRACT Poverty has a myriad of pernicious effects on health, including higher incidence and mortality for most forms of cancer. Colorectal cancer (CRC), the second overall leading cause of cancer death, is no exception. CRC is diagnosed 40% more often in those lower in socioeconomic status (SES). In the United States, race and SES are inextricably linked, leading to profound health disparities. Indeed, CRC is particularly burdensome for Black people; most notably African American men. CRC incidence is 20% higher in Black men as compared to white men with death rates 52% higher. African American men have the lowest survival rates at all CRC stages. Because the precancerous polyps that cause most CRCs grow slowly, adherence to CRC screening can prevent most cases from becoming invasive cancer. Unfortunately, use of screening tests is inadequate, especially among low SES African American men. Indeed, 40% of the racial disparity in CRC incidence and 20% of the mortality differences can be attributed to lack of screening. Being Black, male, and low SES in the United States intersect to form a complex set of institutional, provider, and patient-level barriers that lead to these differential screening rates. Most existing approaches to increase CRC screening in this group utilize in- person or telephone-based education and patient navigation. While effective, these approaches are costly and resource intensive, limiting their adoption among organizations that primarily serve low SES African American men, such as Federally Qualified Health Centers (FQHCs). To address the need for an effective, affordable, and scalable intervention to increase CRC screening among medically underserved African American men, this project will develop a theory-based, tailored, and culturally- targeted CRC screening mHealth intervention for this group. The proposed intervention will be based on the health belief model (HBM) and delivered via mobile phone. It will include text messages designed to improve CRC knowledge and health beliefs. Additionally, the program will present three web-based video components: scripted vignettes, unscripted peer narratives, and educational instruction. All program content will be designed to reduce health literacy barriers and promote adherence to CRC screening recommendations. Finally, it will be culturally targeted by contextualizing HBM constructs with the health beliefs most relevant to low SES African American men and by integrating gender- and race-congruent imagery, language, and values. Eight FQHC staff members and 20 African American men will be recruited for focus group discussions to shape the proposed intervention. When a prototype version of the program is completed, 20 African American men who are nonadherent to CRC screening (i.e., target end-users) will be recruited for usability testing. The usability test will include a series of tasks intended to highlight the different features of the proposed intervention. Three usability metrics will be assessed: efficiency, accuracy, and subjective satisfaction.

项目总结/文摘