Evidence-Based Approach to Empower Asian American Women in Cervical Cancer Screening

增强亚裔美国女性宫颈癌筛查能力的循证方法

• 批准号: 10675168
• 负责人: Carolyn Y. Fang
• 金额: $ 42.58万
• 依托单位: RESEARCH INST OF FOX CHASE CAN CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675168
• 关键词: Accounting; Administrative Supplement; Adult; African American; Asian; Asian Americans; Asian population; Black race; Cervical Cancer Screening; Chinese; Chinese American; Chinese population; Clinic; Communities; Community Health Education; Data; Emerging Technologies; English Language; Ethnic group; Evidence based program; Face; Future; Goals; Health Personnel; Human Papillomavirus; Immigrant; Insurance; Language; Light; Limited English Proficiency; National Health Interview Survey; Not Hispanic or Latino; Pap smear; Population; Randomized; Reporting; Research; Resource-limited setting; Sampling; Screening for cancer; Subgroup; Testing; Time; Woman; base; community setting; design; empowered; evidence base; evidence based guidelines; follow-up; medically underserved; programs; racial and ethnic; screening

PROJECT SUMMARY Asian Americans are the fastest growing population across all US racial/ethnic groups, and individuals of Chinese origin represent the largest US Asian subgroup, accounting for up to 24% of the total US Asian population. Among adult Chinese Americans, approximately 43% report limited English language proficiency (LEP); this rate is even higher among foreign-born Chinese Americans, among which 56% have LEP. These data are meaningful in light of studies demonstrating a strong negative association between LEP and participation in cancer screening. Indeed, LEP may be contributing to the disparity observed in cervical cancer screening rates, which are lower among Chinese American women (65.8%) compared with non-Hispanic White women (82.8%). Estimates from the National Health Interview Survey (NHIS) also note similar disparities in screening, with Chinese women reporting lower Pap test use (68.7%) compared to Black/African American women (84.3%) and AI/AN women (81.2%) and in comparison with other Asian subgroups such as Filipinas (82.7%). Importantly, among recent immigrants, proportions of Pap test use were lowest for Chinese women. Multiple factors contribute to non-screening among Chinese American women with LEP including lack of insurance or regular healthcare provider, lack of time, language difficulties, and embarrassment. Emerging technologies supporting self-sampling for human papillomavirus (HPV) testing may offer a valuable, evidence-based strategy for empowering underscreened and medically underserved Chinese American women with LEP to be able to participate in cervical cancer screening. Although prior studies have demonstrated that HPV self-sampling can be feasibly offered in low-resource community settings, not one study has focused on Chinese American women, despite the fact that this population has among the lowest cervical cancer screening rates. Therefore, the goal of this administrative supplement is to examine HPV self-sampling in a community sample of 150 Chinese American women with LEP. In this randomized study, 75 women will receive our previously tested community education program on cervical cancer screening plus navigation, along with HPV self-sampling kits; and 75 women will receive our previously tested community education program plus navigation to clinic-based screening. The aim of the proposed supplement is to: (1) Compare rates of providing a self-collected sample vs. obtaining clinic-based cervical cancer screening among 150 Chinese American women with LEP. Participation in self-sampling or clinic-based screening will be assessed at 6-month follow-up. It is hypothesized that the proportion of Chinese American women in the HPV self-sampling program who provide a self-collected sample will be higher than the proportion of women in the clinic-based program who obtain clinic- based screening. The research proposed in this supplement will be the first randomized study to evaluate HPV self-sampling among underserved Chinese American women with LEP. Our findings will inform future evidence- based programs to enhance screening in this understudied population.

项目总结 亚裔美国人是美国所有种族/民族中增长最快的人口， 华裔是美国最大的亚裔群体，占美国亚裔总数的24% 人口。在成年华裔美国人中，大约43%的人表示英语水平有限 (LEP)；在外国出生的华裔美国人中，这一比例甚至更高，其中56%患有LEP。这些 数据是有意义的，因为研究表明LEP和 参与癌症筛查。事实上，LEP可能是造成宫颈癌患者差异的原因之一。 华裔美国女性的筛查率(65.8%)低于非西班牙裔白人 女性(82.8%)。来自国家健康访谈调查(NHIS)的估计也注意到类似的差异 筛查，与黑人/非裔美国人相比，中国女性报告的巴氏试验使用率较低(68.7%) 女性(84.3%)和AI/AN女性(81.2%)，并与菲律宾等其他亚洲亚群进行比较 (82.7%)。重要的是，在新移民中，中国女性使用巴氏测试的比例最低。 多个因素导致华裔美国女性患有LEP而没有进行筛查，包括缺乏 保险或常规医疗服务提供者，缺乏时间，语言困难，以及尴尬。新兴 支持用于人类乳头瘤病毒(HPV)检测的自我采样的技术可以提供有价值的， 为筛查不足和医疗服务不足的华裔美国妇女赋权的循证战略 能够与LEP一起参与宫颈癌筛查。尽管之前的研究已经证明 在低资源社区环境中提供HPV自我采样是可行的，没有一项研究关注于 华裔美国女性，尽管这一群体的宫颈癌筛查水平最低 费率。因此，本行政副刊的目的是检查社区中的HPV自我采样。 150例患有LEP的美籍华裔女性样本。在这项随机研究中，75名女性将接受我们的 以前测试过的关于宫颈癌筛查和导航的社区教育计划，以及HPV 自我抽样工具包；75名妇女将接受我们之前测试过的社区教育计划以及 导航到基于临床的筛查。拟议补编的目的是：(1)比较提供 150名华裔美国人的自我采集样本与临床宫颈癌筛查结果比较 患有轻瘫的女性。参与自我抽样或基于诊所的筛查将在6个月的随访中进行评估。它 假设在HPV自我采样计划中提供 自我采集的样本将高于以临床为基础的计划中获得临床治疗的妇女的比例- 基于筛查。本附录中提出的研究将是第一个评估HPV的随机研究 在服务不足的患有LEP的华裔美国妇女中进行自我抽样。我们的发现将为未来的证据提供信息- 以计划为基础，加强对这一研究不足的人群的筛查。