Using mHealth to investigate cancer inequities: The impact of discrimination on tobacco cessation among underserved populations

利用移动医疗调查癌症不平等：歧视对服务不足人群戒烟的影响

• 批准号: 10389128
• 负责人: JANNA GORDON
• 金额: $ 1.18万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10389128
• 关键词: Acute; Address; Affect; African American population; Black race; Cancer Control; Cause of Death; Cessation of life; Chronic stress; Communities; Complement; Data; Development; Discrimination; Disease; Ecological momentary assessment; Environment; Exposure to; Fellowship; General Population; Goals; Grant; Health; Health Technology; Health behavior; Individual; Institutes; Intervention; Knowledge; Link; Longitudinal Studies; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Mediating; Mental Health; Mentors; Methods; Minority; Morbidity - disease rate; NCI-Designated Cancer Center; Outcome; Pathway interactions; Physiological; Population; Populations at Risk; Prejudice; Primary Cancer Prevention; Research; Research Activity; Research Ethics; Risk; Self Efficacy; Sexual and Gender Minorities; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Statistical Methods; Stigmatization; Stress; Time; Tobacco; Tobacco Use Cessation; Tobacco use; Training; Training Activity; Underserved Population; Work; Writing; adaptive intervention; cancer prevention; cancer risk; cigarette smoking; design; experience; gender minority group; health assessment; health disparity; health inequalities; improved; innovation; insight; mHealth; marginalized community; marginalized population; member; minority stress; minority stressor; mortality; negative affect; novel; perceived discrimination; physical conditioning; programs; racial discrimination; research data dissemination; sensor; skills; smoking abstinence; smoking cessation; smoking-related cancer; social; social health determinants; stressor; time use; tobacco control; trend

PROJECT SUMMARY/ABSTRACT Cigarette smoking is a leading cause of morbidity and mortality in the U.S. Marginalized communities, such as Black/African Americans (B/AA) and sexual and gender minorities (SGM), experience increased risk for smoking-related cancers and unique social and contextual stressors that may hinder successful quitting. For example, B/AA and SGM experience pervasive minority stressors (e.g., stigmatization and discrimination) known to negatively impact mental health, health behaviors, and physical health outcomes. Although extensive research has linked perceived discrimination with current smoking behavior among B/AA and SGM, no studies have examined how discrimination impacts smoking cessation within these groups. Mobile health (mHealth) technologies such as ecological momentary assessment (EMA) and AutoSense – a suite of wearable physiological sensors – can provide real-time, real-world assessments of lived experiences during a quit attempt to predict smoking behavior and inform the development of adaptive interventions. The objective of the proposed research is to use mHealth approaches to advance current knowledge of the mechanisms by which minority stressors such as discrimination contribute to inequities in cancer risk among B/AA and SGM. Aim 1 will utilize data from a recently completed study to analyze pathways linking real-time, real-world experiences of discrimination and smoking lapse during a quit attempt among B/AA (N = 300). Aim 2 will utilize data from an ongoing study to elucidate pathways linking real-time, real-world experiences of discrimination and smoking lapse during a quit attempt among SGM, and further compare experiences of discrimination, associated intrapersonal experiences (e.g., stress, affect), and smoking lapse between SGM and non-SGM during a quit attempt (N = 375 [300 non-SGM + 75 SGM]). Key mechanisms hypothesized to mediate the temporal association between discrimination and smoking lapse are stress, negative affect, urge, and self- efficacy. This research will be conducted at Huntsman Cancer Institute, an NCI-Designated Cancer Center that offers an exceptionally supportive and collaborative training environment. The applicant’s comprehensive training plan, developed in conjunction with an expert mentoring team, will directly support the completion of the proposed research and complement the applicant’s prior training in cancer inequities research. Fellowship training goals focus on: 1) advanced statistical methods for analyzing intensive longitudinal data; 2) mHealth assessment and intervention approaches; 3) primary cancer prevention and smoking cessation; 4) health inequities and the social determinants of health; and 5) professional development, including grant writing, research dissemination, research ethics, and mentoring. The proposed research and training activities will provide the applicant with the necessary knowledge and skills needed to establish an independent and productive research program dedicated to eliminating cancer inequities across the cancer control continuum.

项目总结/摘要 吸烟是美国边缘化社区发病率和死亡率的主要原因，如 黑人/非裔美国人（B/AA）和性和性别少数群体（SGM）的风险增加， 与吸烟有关的癌症以及可能阻碍成功戒烟的独特社会和环境压力因素。为 例如，B/AA和SGM经历普遍的少数压力源（例如，污名化和歧视） 已知会对心理健康、健康行为和身体健康结果产生负面影响。虽然广泛 研究表明，在B/AA和SGM中，感知到的歧视与当前的吸烟行为有关， 研究了歧视如何影响这些群体中的戒烟。移动的健康 生态瞬时评估（EMA）和AutoSense等技术-一套可穿戴设备 生理传感器-可以在戒烟期间提供实时，真实世界的生活体验评估 试图预测吸烟行为，并为适应性干预措施的发展提供信息。的目标 拟议的研究是使用移动健康方法来推进目前的机制知识， 少数压力源，如歧视，导致B/AA和SGM之间癌症风险的不平等。 Aim 1将利用最近完成的研究数据来分析连接实时、真实世界 在B/AA（N = 300）中尝试戒烟期间的歧视和吸烟失败经历。目标2将利用 数据来自一项正在进行的研究，以阐明将实时、真实世界的歧视经历联系起来的途径 和吸烟失败在SGM之间的戒烟尝试，并进一步比较歧视的经验， 相关的自我体验（例如，压力、情感）和吸烟在SGM和非SGM之间变化 尝试退出期间（N = 375 [300例非SGM + 75例SGM]）。假设的介导 歧视与吸烟成瘾之间时间关联是压力、消极情绪、冲动和自我 功效这项研究将在亨斯迈癌症研究所进行，这是一个NCI指定的癌症中心， 提供了一个非常支持和协作的培训环境。申请人的综合 与专家指导小组共同制定的培训计划将直接支持完成 拟议的研究和补充申请人的癌症不公平研究的先前培训。研究金 培训目标侧重于：1）分析密集纵向数据的先进统计方法; 2）移动健康 评估和干预方法; 3）初级癌症预防和戒烟; 4）健康 不平等和健康的社会决定因素; 5）专业发展，包括撰写赠款， 研究传播、研究伦理和指导。拟议的研究和培训活动将 为申请人提供必要的知识和技能，以建立一个独立的， 富有成效的研究计划，致力于消除整个癌症控制过程中的癌症不平等现象。