Development of a theory-based framework and measures of acculturation for African immigrants.

项目总结/摘要 非洲血统的男性与其他男性相比，前列腺癌（CaP）负担不成比例。 种族/族裔群体，但对不同结果的主要驱动因素知之甚少。研究往往 将美国的非洲血统男子归类为一个同质群体（黑人）， 了解亚人群独特的健康实践、行为和文化， 加剧差距。例如，最近的一项研究发现，撒哈拉以南非洲移民（SSAI） 美国出生的黑人前列腺癌的发病率高出1.5倍。因此， 了解可能导致健康结果差异的独特健康实践和行为。 文化适应或SSAI改变其信仰、价值观、饮食和其他生活方式的性质和程度 可能会影响前列腺癌的早期检测。在本研究中，我们将SSAI定义为个人 他们来自撒哈拉沙漠以南的非洲大陆。迄今为止， 评估非洲裔人口的文化适应情况。然而，这些措施都没有纳入 尽管研究表明环境和饮食的改变与前列腺相关， 癌症风险。此外，现有的文化适应量表没有捕捉到文化适应的背景特征， 例如移民之前的事件和情况以及美国的政治和社会气候， 抵达本研究的具体目标是：1）建立文化适应的概念框架 在美国诊断为CaP的第一代SSAI男性和健康的第一代SSAI男性中， 2）制定措施，以评估社会适应、CaP筛查和早期发现， 在美国的SSAI男性;以及3）在行为研究方面培训一批学生研究人员，旨在减少健康 差距。为了实现目标1，我们将对32名40-70岁的SSAI男性进行深入访谈， 并阐明文化适应的具体组成部分以及它们如何影响健康行为。我们将确定 文化适应结构在目前的尺度中缺失。为了实现目标2，我们将为 根据我们在目标1中开发的类别进行分级。我们将寻求内容顾问委员会的意见， 在实地测试和试点测试这些措施之前，专家们会对这些措施进行评估，并对这些措施的规模进行细化。为达致目标三，我们会 让学生参与数据收集，数据分析，现场和仪器的试点测试。我们将采用混合- 定性和定量相结合的方法，以获得更深入的了解的机制 这是美国SSAI男性中文化适应和健康行为之间联系的基础。短期目标 本研究的贡献是文献的理论指导措施，以评估文化适应， 和行为因素之间的关系。长期目标是， 研究将转化为新的、创新的和基于文化的干预措施的发展， 减少前列腺癌的差异。

Project Summary/Abstract Men of African ancestry are disproportionately burdened by prostate cancer (CaP) compared to other racial/ethnic groups, yet the main drivers of disparate outcomes are poorly understood. Research studies often categorize men of African ancestry in the United States (US) as a homogenous group (Blacks) which hinders understanding about the unique health practices, behaviors and culture of subpopulations that contribute to or exacerbate disparities. For example, a recent study found that sub-Saharan African immigrants (SSAI) compared to US-born Blacks have a 1.5 times higher incidence rate for prostate cancer. Therefore, it is important to understand the unique health practices and behaviors that may contribute to disparities in health outcomes. Acculturation or the nature and extent to which SSAI modify their, beliefs, values, diet and other lifestyle patterns may impact early detection of prostate cancer. For the purposes of this study, we define SSAI as individuals immigrating from the region of the African continent located south of the Saharan desert. To date, three measures exist to assess acculturation among African-descent populations. However, none of these measures incorporate lifestyle factors despite research that suggest a change in environment and diet is associated with prostate cancer risk. Moreover, existing scales on acculturation do not capture the contextual features of acculturation, such as events and circumstances preceding immigration and the political and social climate of the US upon arrival. The specific aims of this study are: 1) develop conceptual frameworks illuminating acculturation, CaP screening and lifestyle factors among first-generation SSAI men in the US diagnosed with CaP and healthy first- generation SSAI men; 2) Create measures to assess acculturation, CaP screening and early detection among SSAI men in the US; and 3) train a cadre of student-researchers in behavioral research aimed at reducing health disparities. To address Aim 1, we will conduct in-depth interviews with 32 SSAI men aged 40-70 years to identify and illuminate specific components of acculturation and how they affect health behaviors. We will identify acculturation constructs missing in current scales. To achieve Aim 2, we will generate content and items for a scale informed by the categories that we develop in Aim 1. We will seek input from an advisory board of content experts and refine the scale before field testing and pilot testing of the measures. To achieve Aim 3, we will involve students in data collection, data analysis, field and pilot testing of the instrument. We will employ mixed- methods combining qualitative and quantitative approaches to gain a deeper understanding of the mechanisms that underlie links between acculturation and health behavior among SSAI men in the US. The short-term goal of this study is a contribution to the literature of theory-guided measures to assess acculturation, CaP screening and behavioral factors among SSAI men in the US. The long-term goal is that knowledge gained from this research will translate to the development of new, innovative, and culturally-based interventions aimed at reducing prostate cancer disparities.