Comparative Modeling to Inform Cervical Cancer Control Policies - Moonshot Supplement

比较模型为宫颈癌控制政策提供信息 - Moonshot Supplement

• 批准号: 10455871
• 负责人: Ruanne Vanessa Barnabas
• 金额: $ 44.98万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10455871
• 关键词: Administrative Supplement; COVID-19 pandemic; Cancer Control; Cancer Intervention and Surveillance Modeling Network; Cancer Model; Catalogs; Cervical; Cervical Cancer Screening; Characteristics; Collaborations; Community Healthcare; Complex; Data; Discrimination; Ethnic group; Exposure to; Funding; Health; Healthcare Systems; Indigenous; Latinx; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Mediating; Modeling; Morbidity - disease rate; Outcome; Patients; Policies; Process; Provider; Research Personnel; Structural Models; Structural Racism; Structure; Work; cancer care; cancer health disparity; comparative; health care availability; health care settings; health disparity; mortality; racial and ethnic; racial and ethnic disparities; racism; social; social factors; stem

Project Summary/Abstract While disparities in access to health care and health outcomes have long been apparent, the COVID pandemic has laid bare the structural and interpersonal racism that contribute to the disproportionate morbidity and mortality for people who identify as Black, Indigenous, Latinx, and other minoritized groups. These health disparities are often mediated by complex social factors stemming from discriminatory practices. Prior studies of cancer care disparities have focused primarily on characteristics at the patient or provider level, but increasingly we recognize the importance of macro-level social exposures, particularly those that occur in the community and health care settings. METRICS and CISNET- Cervical investigators propose an administrative supplement to advance our scientific conceptualization of how to measure and model structural racism and discrimination (SRD) and intermediate social exposures (ISEs) to promote equity in cervical cancer screening. We propose to (1) conceptualize measures of and policies directed at SRD and ISEs that are relevant to the cervical cancer screening process and catalogue possible measures available at METRICS healthcare systems; (2) conceptualize the integration of multi-level characteristics into existing CISNET cervical cancer models to estimate the effect of SRD and ISEs on racial/ethnic disparities in cervical cancer outcome; and (3) develop an analytic and collaborative plan to evaluate the impact of a measure/policy related to SRD or ISEs on Black- White cervical cancer disparities, leveraging existing and potentially new data from METRICS and the multi-level CISNET models. This collaboration will extend the scientific scope of our currently funded work and serve as a blueprint for examining the impact of SRD and ISEs on other cancers, among other racial/ethnic groups, and across different health care settings.

项目概要/摘要 虽然在获得医疗保健和健康结果方面的差异长期以来一直很明显，但 新冠疫情大流行暴露了导致结构性和人际种族主义的原因 黑人、原住民、拉丁裔的发病率和死亡率不成比例， 和其他少数群体。这些健康差异往往是由复杂的社会因素造成的 源于歧视性做法的因素。 先前对癌症护理差异的研究主要集中在患者或患者的特征上。 提供者层面，但我们越来越认识到宏观层面社会风险的重要性， 特别是那些发生在社区和医疗机构的情况。指标和 CISNET- 宫颈调查员提出行政补充，以推进我们的科学 如何衡量和建模结构性种族主义和歧视（SRD）的概念化以及 中等社会暴露（ISE），以促进宫颈癌筛查的公平性。 我们建议 (1) 概念化针对 SRD 和 ISE 的措施和政策 与宫颈癌筛查过程相关，并列出可能采取的措施，网址为 METRICS 医疗保健系统； (2)概念化多层次特征的整合 纳入现有的 CISNET 宫颈癌模型，以评估 SRD 和 ISE 对宫颈癌的影响 宫颈癌结果的种族/民族差异； (3) 制定分析和 合作计划，评估与 SRD 或 ISE 相关的措施/政策对黑人的影响 白人宫颈癌差异，利用 METRICS 的现有数据和潜在的新数据 以及多层次的CISNET模型。 这项合作将扩大我们目前资助的工作的科学范围，并作为 检查 SRD 和 ISE 对其他癌症（以及其他种族/民族）影响的蓝图 群体以及不同的医疗保健环境。