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Ethnicity and Lung Cancer Survival: A Test of the Hispanic Sociocultural Hypothesis

种族与肺癌生存：对西班牙裔社会文化假说的检验

基本信息

批准号：
10662284
负责人：
Heidi Ann Hamann
金额：
$ 64.06万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10662284
关键词：
Acculturation Adopted Affective Age Behavioral Black race Cancer Etiology Cancer Patient Cancer Survivorship Cellular Phone Cessation of life Clinical Computerized Medical Record Data Death Rate Diagnosis Early Diagnosis Ecological momentary assessment Ethnic Origin Ethnic Population Family Fostering Frequencies Health Health Sciences Hispanic Hispanic Populations Incidence Individual Intervention Interview Investigation Life Longitudinal, observational study Malignant Neoplasms Malignant neoplasm of lung Measurement Measures Mediating Mediator Medical Methodology Methods Morality Neighborhoods Non-Small-Cell Lung Carcinoma Not Hispanic or Latino Outcome Patient Self-Report Patients Persons Process Public Health Publishing Race Reporting Research Personnel Risk Risk Factors Role Sampling Science Site Social Environment Social Interaction Social Processes Social support Surveys Survival Rate Testing Time Underserved Population United States Variant Work burden of illness cancer survival cultural values demographics ethnic difference ethnic minority experience follow-up health care disparity health economics health related quality of life in vivo innovation low dose computed tomography mortality novel primary outcome psychosocial racial minority recruit resilience resilience factor resilience research screening secondary outcome social social culture social integration socioeconomics survival disparity survival outcome treatment adherence

项目摘要

PROJECT SUMMARY/ABSTRACT As the leading cause of cancer death, lung cancer represents the most significant cancer-related public health challenge in the United States. Although low-dose CT-based screening holds promise for earlier detection, currently, most lung cancer cases are not diagnosed until advanced stages (III, IV) and have 5-year survival rates of 21% or less. In contrast to Black-White survival disparities, Hispanic patients have markedly lower age-adjusted death rates than their non-Hispanic White (NHW) counterparts despite later stage diagnoses and broader SES and healthcare disparities; these findings are well established and consistent with the “Hispanic Health Paradox”, a phenomenon characterized by Hispanic advantages in objective health outcomes (e.g., mortality) despite significant health and socioeconomic risk factors. The leading explanatory hypothesis concerns the role of cultural factors facilitating social integration. Social integration is among the most robust psychosocial predictors of a range of objective health outcomes, including cancer survival. However, no published work has directly tested this sociocultural hypothesis in relation to Hispanic resilience. Consistent with the emerging science of resilience, we propose a multisite, two-study, mixed-methods investigation to evaluate this sociocultural hypothesis. Study 1 is a multisite, longitudinal observational study of 672 Hispanic and NHW individuals with advanced stage lung cancer sampled from three regions across the U.S. Interviews using gold-standard and culturally-informed survey measures (demographics, social integration, cultural values, acculturation) will be conducted in English and Spanish from a centralized coordinating center with a 6- week follow-up to examine change in perceived support provision/needs. The primary outcome of survival and secondary outcomes (e.g., treatment adherence), will be gathered from electronic medical records over mean follow-up time of 33-months. Study 2 is a single-site, 7-day, intensive measurement investigation into the daily units of social integration that mediate outcomes. Study 2 integrates two novel in vivo sampling methods (Electronically Activated Recorder [EAR] and ecological momentary assessments [EMA]) using a mobile phone platform. The current aims are to (1) investigate whether the observed Hispanic survival advantage is mediated by ethnic differences in social integration among recently diagnosed late-stage lung cancer patients and (2) to examine the processes/mechanisms that underlie these relationships in daily life including the role of individual, family, network, and neighborhood-level factors. The highly experienced investigator team includes leaders in all relevant content areas, including the Hispanic health paradox, lung cancer survivorship, social integration, and ecological sampling methodologies. The results will contribute to better understanding of social processes among cancer patients, inform psychosocial interventions based on social integration, and contribute to the emerging science of health resilience as well as racial/ethnic and cultural variations in health outcomes.

项目摘要/摘要作为癌症死亡的主要原因，肺癌是与癌症相关的最重要的公共卫生问题。在美国的挑战。尽管基于CT的低剂量筛查有望实现更早的检测，目前，大多数肺癌病例直到晚期(III、IV期)才被诊断出来，并有5年的生存期税率为21%或更低。与黑人和白人的生存差距相比，西班牙裔患者的生存差距明显较低年龄调整死亡率高于非西班牙裔白人(NHW)，尽管后期诊断和更广泛的社会经济地位和医疗保健差距；这些发现得到了很好的证实，并与“西班牙裔”一致健康悖论“，一种以西班牙裔在客观健康结果中的优势为特征的现象(例如，死亡率)，尽管存在重大的健康和社会经济风险因素。主要的解释性假说关注促进社会融合的文化因素的作用。社会融合是最有活力的包括癌症存活率在内的一系列客观健康结果的心理社会预测者。然而，没有已发表的研究直接验证了这一社会文化假说与西班牙裔韧性的关系。一致随着恢复力科学的兴起，我们提出了一种多点、两项研究、混合方法的调查方法评估这一社会文化假说。研究1是一项对672名西班牙裔美国人的多点纵向观察研究 NHW晚期肺癌患者从美国三个地区抽样采访使用黄金标准和了解文化的调查措施(人口统计、社会融合、文化价值观、文化适应)将在一个中央协调中心用英语和西班牙语进行，有6- 一周的跟踪，以检查感知的支持提供/需求的变化。生存和生存的主要结果次要结果(例如，治疗依从性)将从电子医疗记录中平均收集随访时间33个月。研究2是一项为期7天的单站点密集测量调查调解结果的社会融合单位。研究2整合了两种新的活体采样方法 (电子激活记录器[EAR]和生态瞬时评估[EMA])使用移动电话站台。目前的目标是(1)调查观察到的西班牙裔生存优势是否被中介新近确诊的晚期肺癌患者在社会融合方面的种族差异和(2) 检查日常生活中这些关系的基础过程/机制，包括个人、家庭、网络和邻里层面的因素。经验丰富的调查团队包括所有相关内容领域的领导者，包括西班牙裔健康悖论，肺癌存活率，社会整合和生态抽样方法。研究结果将有助于更好地理解社会癌症患者的治疗过程，为基于社会融合的心理社会干预提供信息，以及促进关于健康复原力以及健康方面的种族/民族和文化差异的新兴科学结果。