Comparative Modeling to Inform Cervical Cancer Control Policies - Moonshot Supplement

项目摘要/摘要 虽然长期以来在获得医疗保健和健康结果方面的差距一直很明显，但 新冠肺炎的流行暴露了结构性和人际种族主义，这些种族主义导致了 黑人、土著、拉丁裔、 和其他小规模的团体。这些健康差距往往是由复杂的社会 产生于歧视性做法的因素。 以前对癌症护理差异的研究主要集中在患者的特征或 提供者层面，但我们越来越认识到宏观层面的社会暴露的重要性， 特别是那些发生在社区和卫生保健环境中的疾病。指标和CINET- 宫颈调查人员提出了一项行政补充，以促进我们的科学 如何衡量结构性种族主义和歧视并为其建模的概念化 中等社会暴露(ISES)，以促进宫颈癌筛查的公平性。 我们建议(1)概念化SRD和ISES的措施和政策，这些措施和政策是 有关子宫颈癌筛查程序和可采取的措施目录，请访问 指标医疗保健系统；(2)将多层次特征的集成概念化 以评估SRD和ISES对宫颈癌的影响 宫颈癌预后的种族/民族差异；以及(3)制定一项分析性和 评估与SRD或ISES相关的措施/政策对Black- 白人宫颈癌差异，利用指标中现有的和潜在的新数据 和多层次的CINET模型。 这一合作将扩大我们目前资助的工作的科学范围，并成为 研究SRD和ISES对其他癌症以及其他种族/民族影响的蓝图 在不同的医疗保健环境中。

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.