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

项目摘要/摘要 非洲血统的男性与其他血统的男性相比，前列腺癌(CAP)的负担不成比例 然而，造成不同结果的主要驱动因素却鲜为人知。经常进行研究性研究 将美国的非洲裔男性归类为同质群体(黑人)，这阻碍了 了解亚群独特的健康做法、行为和文化 加剧了差距。例如，最近的一项研究发现，撒哈拉以南非洲移民(SSAI)与 对于在美国出生的黑人来说，前列腺癌的发病率是后者的1.5倍。因此，重要的是要 了解可能导致健康结果差异的独特健康做法和行为。 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。出于本研究的目的，我们将SSAI定义为个体 从撒哈拉沙漠以南的非洲大陆地区移民过来的。到目前为止，有三项措施 评估非洲裔人口的文化适应情况。然而，这些措施都不包括 生活方式因素，尽管研究表明环境和饮食的改变与前列腺癌有关 癌症风险。此外，现有的关于文化适应的量表没有反映文化适应的语境特征， 如移民之前的事件和情况，以及美国在 到了。本研究的具体目的是：1)建立阐释文化适应的概念框架 美国第一代SSAI男性被诊断为CAP和健康First的筛查和生活方式因素 一代SSAI男子；2)制定措施，评估文化适应、帽子筛查和早期发现 美国的SSAI男性；以及3)培训一批学生研究人员，进行旨在减少健康的行为研究 差距。为了解决目标1，我们将对32名年龄在40-70岁的SSAI男性进行深入访谈，以确定 并说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 文化适应结构在当前的天平中缺失。为了实现目标2，我们将为 由我们在目标1中开发的类别提供信息的规模。我们将征求内容咨询委员会的意见 并在现场测试和中试测试前对量表进行细化。为了达到目标3，我们将 让学生参与仪器的数据收集、数据分析、现场和试点测试。我们将采用混合- 方法采用定性和定量相结合的方法，加深对发病机制的理解 这就是美国SSAI男性的文化适应和健康行为之间的联系。短期目标 这项研究的一部分是对评估文化适应的理论指导措施的文献的贡献，上限筛选 以及美国SSAI男性的行为因素。长期目标是从这一过程中获得的知识 研究将转化为开发新的、创新的和基于文化的干预措施，旨在 缩小前列腺癌差距。

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.