A mixed methods study examining early onset anal cancer and current screening practices, attitudes, and perceived risk among people living with and without HIV in the Deep South

一项混合方法研究，调查了南方腹地感染者和未感染艾滋病毒的人的早发性肛门癌以及当前的筛查实践、态度和感知风险

• 批准号: 10387325
• 负责人: Anna D Junkins
• 金额: $ 4.03万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10387325
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Age; Age-Years; Alabama; Attitude; Behavior; Cancer Control Research; Cancer Patient; Caring; Cause of Death; Certification; Characteristics; Clinic; Clinical; Complex; Data; Data Analyses; Databases; Deep South; Detection; Development; Diagnosis; Disease; Doctor of Philosophy; Early Diagnosis; Electronic Health Record; Epidemic; Epidemiology; Face; Foundations; General Population; Goals; HIV; HIV Infections; HPV-High Risk; Health Personnel; Hospitals; Human Papillomavirus; Incidence; Individual; Infection; Interview; Knowledge; Malignant Neoplasms; Malignant neoplasm of anus; Methods; National Cancer Institute; Not Hispanic or Latino; Nurse Practitioners; Outcome; Pathogenesis; Patients; Persons; Physicians; Play; Population; Privacy; Prognosis; Provider; Public Health; Questionnaires; Recommendation; Recording of previous events; Reporting; Research; Research Methodology; Research Personnel; Research Training; Risk; Risk Factors; Role; Screening for cancer; Social Behavior; Statistical Data Interpretation; Surveys; System; Testing; Time; Training; Universities; anal pap smear; black men; black men who have sex with men; black women; cancer prevention; co-infection; cohort; cost; digital; early onset; early screening; experience; high risk; improved; insight; men; men who have sex with men; pathogen; patient subsets; racial and ethnic; rectal; research and development; routine screening; screening; screening guidelines; sex; sexual risk behavior; social stigma; targeted treatment; uptake

PROJECT SUMMARY/ABSTRACT The purpose of the proposed F31 application is to support Ms. Anna Junkins (PI) in research training and development during her PhD training in Epidemiology on her trajectory to becoming an independent cancer researcher. The primary goals of the proposed research are 1) to identify predictors of early onset anal cancer (<50 years of age at diagnosis), and 2) utilize a mixed methods research (MMR) approach to identify and explain factors associated with anal cancer screening uptake among men living with HIV (MLHIV) and their providers in the Deep South. The first Aim will identify predictors of early onset anal cancer who have received care at the University of Alabama at Birmingham (UAB) Hospital. Electronic health records (EHR) at UAB provide detailed demographic, clinical, and socio-behavioral data which will be used in the statistical analyses to predict early onset cancer. Next, using a MMR approach, Aim 2 and Aim 3 will identify and explain barriers and facilitators to anal cancer screening, and explore attitudes about screening and perceived risk among MLHIV and their healthcare providers. The quantitative part of the MMR approach (Aim 2) will include analysis of survey data from UAB’s 1917 Clinic cohort database to identify predictors of screening. Following the data analysis in Aim 2, an in-depth interview (IDI) guide will be developed to explain predictors of screening uptake in Aim 3. This qualitative Aim will include IDI among a subpopulation of patients whose data was analyzed in Aim 2, and healthcare providers (physicians and nurse practitioners) at the UAB 1917 Clinic. The IDIs will aim to further explore attitudes about screening, history of screening, barriers and facilitators to screening, and perceived risk. The long-term goal of the proposed research is to improve the lives of people living with HIV (PLHIV) and those most at risk for early onset anal cancer by informing national anal cancer screening guidelines through 1) identifying risk factors of early onset anal cancer; and 2) identifying and explaining patient-level and provider- level facilitators and barriers to screening among PLHIV in the Deep South. The primary training goals include: 1) increase knowledge and experience in the utilization of EHR to answer complex research questions regarding early onset anal cancer; 2) gain certification in applied MMR in early detection and screening of anal cancer among PLHIV in the South; and 3) increase expertise and independence in cancer prevention and control research. The overall goal of the proposed training is to prepare Ms. Anna Junkins with a strong foundation for independent research in early detection of cancer among PLHIV. .

项目总结/摘要 拟议的F31申请的目的是支持安娜Junkins女士（PI）进行研究培训， 在她的流行病学博士培训期间，她的发展轨迹成为一个独立的癌症 研究员这项研究的主要目的是：1）确定早发性肛门癌的预测因子 （诊断时年龄<50岁），以及2）利用混合方法研究（MMR）方法来识别和解释 与男性艾滋病毒感染者（MLHIV）及其提供者的肛门癌筛查摄取相关的因素， 南方腹地第一个目标将确定在医院接受治疗的早发性肛门癌的预测因素。 亚拉巴马大学伯明翰分校（UAB）医院。UAB的电子健康记录（EHR）提供详细的 人口统计学、临床和社会行为数据，这些数据将用于统计分析， 初发癌症接下来，目标2和目标3将使用MMR方法，确定并解释实现以下目标的障碍和促进因素： 肛门癌筛查，并探讨MLHIV及其感染者对筛查的态度和感知风险 医疗保健提供者。产妇死亡率方法的定量部分（目标2）将包括对调查数据的分析 从UAB的1917年临床队列数据库，以确定筛选的预测因素。根据目标2中的数据分析， 将制定一份深入访谈（IDI）指南，以解释目标3中筛查摄入的预测因素。这 定性目标将包括在目标2中分析数据的患者亚群中的IDI，以及 医疗保健提供者（医生和护士执业）在UAB 1917诊所。IDIs将致力于进一步 探讨对筛查的态度，筛查的历史，筛查的障碍和促进因素，以及感知的风险。 拟议研究的长期目标是改善艾滋病毒感染者（PLHIV）和 通过1）告知国家肛门癌筛查指南， 确定早发性肛门癌的危险因素;和2）确定和解释患者水平和提供者- 一级的促进者和障碍，以筛选艾滋病毒感染者在南方腹地。 主要培训目标包括：1）增加使用EHR的知识和经验， 回答关于早发性肛门癌的复杂研究问题; 2）获得应用MMR的认证， 在南方，艾滋病毒感染者肛门癌的早期发现和筛查;以及3）增加专业知识， 在癌症预防和控制研究中的独立性。拟议培训的总体目标是准备 女士安娜朱金斯与一个强大的基础，独立研究在早期发现癌症的艾滋病毒感染者。 .