Multidimensional structural racism and moderating role of psychosocial resources on cancer-control behaviors in African Americans

项目摘要 影响非裔美国人的癌症差异深深植根于历史上的社会不公正，例如 结构性种族主义，住房歧视和红线，挣扎的教育系统，以及集中 贫穷。众所周知，一个人所居住的社区会对 他们的健康和健康行为。这包括癌症控制行为，这是癌症发病率的主要驱动力 和死亡率。我们的初步数据表明，社区特征对癌症有独特的影响 控制非裔美国人超越个人因素的行为。然而，人们对多层次和 结构性种族主义和歧视对预测癌症控制行为的纵向影响，以及 保护性心理社会资源的潜在作用。这在非洲裔美国人中尤其如此，他们 承受着不成比例的癌症负担。拟议的研究将定量测量SRD，评估其 在癌症控制行为中的纵向作用，并检验心理社会资源在癌症控制中的调节作用 非裔美国成年人。在目标1中，我们将构建结构性种族主义和歧视的索引 AIMS 2和AIMS 3分析中可公开使用的数据。在目标2中，我们将评估相对贡献 历史上、长期和当前在地方暴露于结构性种族主义和歧视的影响 关于非洲人癌症控制行为(如饮食、吸烟、体力活动、筛查)的概率样本 来自四个重点州(N=5000)的美国人通过多水平分析。在目标3中，我们将测试调节作用 心理社会资源在暴露于SRD与癌症控制行为关系中的作用 非裔美国人。研究结果将对政策和社区干预具有重要意义 消除长期存在的癌症差异，这些差异对非裔美国人的影响不成比例。

Project Summary Cancer disparities impacting African Americans are deeply rooted in historical social injustices such as structural racism, housing discrimination and redlining, struggling educational systems, and concentrated poverty. It is well-established that the neighborhood where a person lives can have a considerable impact on their health and health behaviors. This includes cancer control behaviors, a primary driver of cancer incidence and mortality. Our preliminary data suggests that neighborhood characteristics contribute uniquely to cancer control behaviors beyond individual factors in African Americans. However, little is known about multi-level and longitudinal influences of structural racism and discrimination in predicting cancer control behaviors, and the potential role of protective psychosocial resources. This is particularly true among African Americans, who suffer a disproportionate cancer burden. The proposed study will quantitatively measure SRD, evaluate its longitudinal role in cancer control behaviors, and examine the moderating role of psychosocial resources in African American adults. In Aim 1, we will construct an index of structural racism and discrimination from publicly available data for use in the Aims 2 and 3 analysis. In Aim 2, we will evaluate the relative contributions of the impact of historical, long-term, and current place-based exposure to structural racism and discrimination on cancer control behaviors (e.g., diet, smoking, physical activity, screening) in probability samples of African Americans from four focal states (N=5000) via a multilevel analysis. In Aim 3, we will test the moderating role of psychosocial resources in the relationship between exposure to SRD and cancer control behaviors in African Americans. Study findings will have important implications for policy and community interventions to eliminate persistent cancer disparities that disproportionately impact African Americans.