Leveraging Implementation Science to Promote Behavior Change and Reduce Cancer Health Disparities among American Indian and Alaska Native Older Adults

利用实施科学促进美洲印第安人和阿拉斯加原住民老年人的行为改变并减少癌症健康差异

• 批准号: 10401497
• 负责人: Maja Pedersen
• 金额: $ 8.88万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-04 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10401497
• 关键词: Address; Adult; Age; Aging; Alaska; Alaska Native; American Indians; Attention; Award; Behavior; Behavior Therapy; Behavioral; Biometry; Cancer Control; Collaborations; Colorectal Cancer; Communities; Consensus; Data; Dislocations; Educational workshop; Elderly; Ethics; Evidence based intervention; Experimental Designs; Fellowship; Geography; Goals; Health; Inflammation; Intervention; Intervention Studies; Malignant Neoplasms; Mentors; Metabolism; Methods; National Cancer Institute; Obesity; Outcome; Pathway interactions; Phase; Physical activity; Pilot Projects; Population; Postdoctoral Fellow; Process; Public Health; Public Health Practice; Randomized; Reach Effectiveness Adoption Implementation and Maintenance; Reading; Recording of previous events; Reporting; Research; Research Personnel; Research Training; Risk Factors; Scientist; Training; Training Programs; Underserved Population; Voice; Waiting Lists; Walking; base; behavior change; cancer health disparity; cancer prevention; career; caucasian American; colon cancer risk; colorectal cancer prevention; colorectal cancer risk; community based participatory research; community-level factor; design; dissemination science; effectiveness trial; exercise intervention; experience; high risk population; implementation science; implementation trial; improved; meetings; modifiable risk; multidisciplinary; northern plains; physical inactivity; practice setting; pre-doctoral; public health priorities; public health research; resilience; rural Americans; rural area; rurality; skills; social

Project Summary American Indian and Alaska Native (AIAN) adults are more likely to develop cancer and die from it than white American adults, reflecting pronounced and persistent cancer health disparities (CHDs). Colorectal cancer (CRC) rates are disproportionately high among AIANs in the Northern Plains and Alaska regions; likewise, risk factors for CRC are also high, including non-modifiable factors such as increasing age and rurality, and proven modifiable risk factors such as physical inactivity, and obesity. A recent consensus report indicates strong evidence that physical activity (PA) lowers risk for colon cancer through systemic (i.e., metabolism, inflammation) and obesity reduction pathways. However, despite availability of efficacious behavioral interventions to increase PA among older adults, a critical gap exists between evidence generated and action taken to implement such interventions among AIAN older adults. This gap represents a missed opportunity to implement current evidence-based interventions (EBIs) in cancer prevention among high-risk populations experiencing pronounced CHDs. Implementation science concentrates on understanding and accelerating integration of such EBIs into public health practice settings to improve health and can be leveraged here to address this critical public health gap, thus addressing persistent CHDs and improving overall health among AIAN communities. This F99/K00 Predoctoral to Postdoctoral Fellow Transition Award application assists a promising trainee - Maja Pedersen, who has 15 years of experience in community-based behavioral interventions among rural AIAN communities in the Northern Plains and Alaska regions - to embark on a rigorous research and training program to confront this critical gap using best practices for intervention research with AIAN communities and current implementation science methods. Pedersen’s long-term goal is to become an independent investigator in designing and implementing PA interventions among underserved populations - including AIANs - to improve cancer-related health outcomes and reduce CHDs. Her short-term goals include gaining expertise in the use of multilevel intervention methods, dissemination and implementation science, cancer prevention and control among geriatric populations, experimental design, and intensive longitudinal methods. In collaboration with her multidisciplinary team of predoctoral mentors, she has developed a training plan to initiate these goals via coursework, workshops, scientific meetings, directed readings, and mentored research (F99 Phase). As she transitions into the postdoctoral phase, she will assemble a team of high-level, cancer-focused mentors to support her through continued mentored training with an explicit focus on cancer prevention and control. Her postdoctoral research (K00 Phase) executes the logical next steps in her research sequence on a trajectory toward a full-scale implementation and effectiveness trial as an independent scientist.

项目摘要 美洲印第安人和阿拉斯加原住民（AIAN）成年人比白色人更容易患癌症并死于癌症 美国成年人，反映了明显和持续的癌症健康差异（CHDs）。结直肠癌 (CRC)在北方平原和阿拉斯加地区的AIAN中， CRC的因素也很高，包括不可改变的因素，如年龄增加和农村化，并证明 可改变的风险因素，如缺乏运动和肥胖。最近的一份共识报告显示， 体力活动（PA）通过全身（即，新陈代谢， 炎症）和肥胖减少途径。然而，尽管有效的行为 增加老年人PA的干预措施，在所产生的证据和行动之间存在重大差距 在AIAN老年人中实施这些干预措施。这一差距意味着错失了一个机会， 在高危人群中实施现有的基于证据的癌症预防干预措施（EBI） 患有严重的冠心病实施科学专注于理解和加速 将这些EBI整合到公共卫生实践环境中以改善健康，并可在此利用， 解决这一关键的公共卫生差距，从而解决持续存在的冠心病问题，并改善 AIAN社区。这个F99/K 00博士前博士后研究员过渡奖申请协助 有前途的实习生-玛雅彼得森，谁拥有15年的经验，以社区为基础的行为 在北方平原和阿拉斯加地区的农村AIAN社区中进行干预-着手 开展严格的研究和培训计划，利用最佳干预做法来应对这一重大差距 与AIAN社区的研究和当前的实施科学方法。彼得森的长期目标是 成为一名独立的调查员，在服务不足的人群中设计和实施PA干预措施 包括AIAN在内的人群，以改善癌症相关的健康结果并减少CHD。她的短期 目标包括获得使用多层次干预方法的专门知识， 科学，老年人群中的癌症预防和控制，实验设计， 纵向方法。在与她的多学科博士前导师团队合作，她有 制定了培训计划，通过课程、讲习班、科学会议、指导 阅读和指导研究（F99阶段）。随着她进入博士后阶段，她将 组建一个高水平的、专注于癌症的导师团队，通过持续的辅导培训来支持她 明确关注癌症预防和控制。她的博士后研究（K 00阶段）执行 在她的研究序列中，逻辑上的下一步是走向全面实施的轨道， 作为独立科学家进行有效性试验。