Developing measurements to evaluate intersectional stigma related to cancer and HIV

开发测量方法来评估与癌症和艾滋病毒相关的交叉耻辱

• 批准号: 10844755
• 负责人: Andrew Ddungu Kambugu
• 金额: $ 20.24万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-13 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10844755
• 关键词: AIDS related cancer; Accounting; Address; Adherence; Administrative Supplement; Affect; Africa; Africa South of the Sahara; Area; Attitude to Health; Award; Behavior; Behavioral; Caring; Cessation of life; Characteristics; Cognitive; Complex; Comprehension; Data; Development; Dimensions; Discrimination; Early Diagnosis; Enrollment; Ensure; Epidemiology; Ethnic Origin; Exposure to; Factor Analysis; Funding; Gender Identity; General Population; Goals; HIV; HIV diagnosis; Health; Health behavior; Healthcare; Incidence; Individual; Infection; Intervention; Interview; Investigation; Kenya; Label; Laboratories; Link; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Measures; Mental Depression; Mental Health; Methods; Morbidity - disease rate; Outcome; Outcome Measure; Parents; Participant; Patients; Persons; Population; Prevention; Process; Quality of life; Race; Reporting; Research; Resource-limited setting; Risk; Sampling; Screening for cancer; Self Efficacy; Social support; Stigmatization; Structure; Target Populations; Techniques; United States; Validation; Work; adherence rate; cancer diagnosis; career development; community involvement; design; experience; follow-up; improved; interest; intersectionality; member; mortality; multidisciplinary; parent grant; patient population; patient subsets; response; screening services; social exclusion; social stigma; sociodemographics; tool; treatment adherence; treatment services; virus related cancer

PROJECT SUMMARY This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA-23-036.” Sub-Saharan Africa (SSA) bears a disproportional burden of HIV globally. Additionally, the risk for malignancy in this population far exceeds the general population with higher associated morbidity and mortality. As the dual burden of HIV and cancer in the global population increases, investigation of the impact of stigma on this population is crucial for improving health outcomes. Stigma is a well-studied construct that occurs when individuals are recognized and labeled as “other” due to various sociodemographic, behavioral, or health-related characteristics, and has been linked to poor quality of life and health-related outcomes. Stigma associated with HIV and cancer diagnoses in particular have been associated to poor mental health, low treatment adherence rates, and decreased healthcare engagement. When an individual has multiple, co-occurring stigmatizing characteristics, they have the potential for a more complex stigma experience, termed intersectional stigma. Individuals living with HIV and cancer may experience stigma more prominently due to one dominant stigmatizing condition or may experience a synergistic or multiplicative effect. Intersectional stigma has been measured via validated scales for constructs such as race, ethnicity, gender identity, and behavior, but no scale exists to measure the intersectionality of HIV and cancer stigma. The ability to measure the stigma experience in people living with HIV and cancer is crucial for assessing its influence on health-related behaviors and for designing more targeted interventions. As an administrative supplement to U54 CA254571, our overall goal is to initiate the development of a scale that effectively measures intersectional stigma in patients with concurrent HIV and cancer diagnoses. Our specific aims are: 1) To develop a preliminary pool of scale questions that capture key dimension of HIV and cancer intersectional stigma. We will use both pre-existing and de-novo qualitative interviews and quantitative data to develop this initial pool. 2) To involve community stakeholders and participants with HIV and cancer in further refinement of the pool of scale questions. We will use techniques including member checking and cognitive debriefing. 3) To complete preliminary item validation on a population subset of patients living with both HIV and cancer. To achieve these aims, we leverage a multidisciplinary team of leaders in stigma, scale development, HIV-associated cancers, and epidemiology. We will develop an intersectional stigma scale for HIV and cancer supported by our already existing laboratory for HIV and malignancies in the AMPATH network in western Kenya, funded by parent grant U54 CA254571. Findings from this work are expected to lead to the development of an intersectional stigma scale that will help to better characterize co-occuring, potentially synergistic HIV and cancer stigma and ultimately allow us to develop more informed health interventions.

项目摘要 本申请是为了响应特别利益通知（NOSI）而提交的，该通知被确定为 “NOT-CA-23-036.”撒哈拉以南非洲（SSA）在全球范围内承担着不成比例的艾滋病毒负担。另夕h 该人群的恶性肿瘤风险远远超过一般人群，相关发病率更高， mortality.随着全球人口中艾滋病毒和癌症的双重负担增加， 消除对这一群体的污名化对改善健康结果至关重要。 污名是一个被广泛研究的概念，它发生在个体被识别和标记为“他者”的时候 由于各种社会人口、行为或健康相关特征， 生活质量和健康相关结果。与艾滋病毒和癌症诊断相关的耻辱，特别是 与心理健康状况差、治疗依从率低和医疗保健减少有关 订婚当一个人有多种共同出现的污名化特征时，他们有可能 一个更复杂的污名体验，称为交叉污名。艾滋病毒感染者和癌症患者 可能由于一种显性污名化条件而更显著地经历污名化，或者可能经历 协同或倍增效应。交叉柱头已经通过有效的结构尺度进行了测量 如种族，民族，性别认同和行为，但没有规模存在衡量的交叉性， 艾滋病毒和癌症的耻辱。衡量艾滋病毒感染者和癌症患者的耻辱经历的能力是 这对于评估其对健康相关行为的影响和设计更有针对性的干预措施至关重要。 作为U 54 CA 254571的管理补充，我们的总体目标是启动 该量表有效测量了同时诊断为艾滋病毒和癌症的患者的交叉耻辱。 我们的具体目标是：1）开发一个初步的规模问题库，捕捉艾滋病毒的关键方面 和癌症交叉污名。我们将使用既有和从头定性访谈， 定量数据来开发这个初始池。2)让社区利益攸关方和艾滋病毒感染者参与进来 和癌症在进一步完善池规模的问题。我们将使用包括成员在内的技术 检查和认知汇报。3)完成对患者人群子集的初步项目确认 同时感染艾滋病和癌症 为了实现这些目标，我们利用一个多学科的领导团队在耻辱，规模发展， 艾滋病相关癌症和流行病学。我们将制定一个艾滋病毒和癌症的交叉耻辱量表 由我们现有的艾滋病毒和恶性肿瘤实验室在西部的AMPATH网络的支持， 肯尼亚，由母基金U 54 CA 254571资助。这项工作的结果预计将导致 发展一个交叉的耻辱规模，这将有助于更好地表征共同发生，潜在的 艾滋病毒和癌症耻辱的协同作用，并最终使我们能够制定更知情的健康干预措施。