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.

项目摘要/摘要 吸烟是美国边缘化社区发病和死亡率的主要原因，例如 黑人/非裔美国人（B/AA）以及性和性别少数群体（SGM），经历了增加的风险 与吸烟有关的癌症以及独特的社会和上下文压力源，可能会阻碍成功的安静。为了 例如，B/AA和SGM经历了普遍的少数族裔压力源（例如，污名和歧视） 已知会对心理健康，健康行为和身体健康成果产生负面影响。虽然广泛 研究将感知的歧视与当前的B/AA和SGM之间的吸烟行为联系在一起，没有研究 已经检查了歧视如何影响这些群体中的戒烟。移动健康（MHealth） 生态瞬时评估（EMA）和AutoSense等技术 - 一套可穿戴的套件 物理传感器 - 可以在退出期间对现实体验进行实时的现实评估 尝试预测吸烟行为并告知自适应干预措施的发展。目的 拟议的研究是使用MHealth方法来提高当前对机制的了解 哪些少数压力源（例如歧视）导致B/AA和SGM中癌症风险的不平等。 AIM 1将利用最近完成的研究中的数据来分析链接实时，现实世界的途径 在b/aa之间进行歧视和吸烟失误的经历（n = 300）。 AIM 2将使用 从正在进行的研究中的数据阐明了连接实时，现实世界经验的途径 以及在SGM之间戒烟期间的吸烟失误，并进一步比较歧视的经历， 相关的人际经验（例如，压力，情感）和SGM和非SGM之间的吸烟 在退出尝试期间（n = 375 [300非SGM + 75 SGM]）。假设介导的关键机制 歧视与吸烟失误之间的临时关联是压力，负面影响，敦促和自我 效率。这项研究将在NCI指定的癌症中心Huntsman Cancer Institute进行。 提供了一个非常支持和协作的培训环境。申请人的全面 与专家心理团队共同制定的培训计划将直接支持完成 拟议的研究并补充了申请人对癌症不平等研究的先前培训。奖学金 培训目标的重点是：1）用于分析密集纵向数据的高级统计方法； 2）MHealth 评估和干预方法； 3）预防原发性癌症和戒烟； 4）健康 不平等和健康的社会决定者； 5）专业发展，包括赠款写作， 研究传播，研究伦理和心理。拟议的研究和培训活动将 向申请人提供建立独立和的必要知识和技能 致力于消除整个癌症控制连续性的癌症不平等的生产研究计划。