Modelling Community Disparity in Breast Cancer Screening

乳腺癌筛查中的社区差异建模

• 批准号: 6734349
• 负责人: Mario Schootman
• 金额: $ 10万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6734349
• 关键词: behavioral /social science research tag; breast neoplasm /cancer diagnosis; breast neoplasms; cancer risk; community; community health services; female; health behavior; health care model; health care service utilization; health disparity; health services research tag; human data; human middle age (35-64); human subject; mass screening; model design /development; personality; social model; socioeconomics; urban poverty area; women' s health

DESCRIPTION (Provided by Applicant): Although breast cancer screening has been proven to reduce the risk of mortality, low-income, disenfranchised communities have lower screening utilization. Much of the work examining these disparities has focused on understanding the association of individual and social characteristics with screening behavior (e.g., knowledge, social support). However, characteristics of the community in which women reside have been ignored despite the fact that such characteristics influence health and related behaviors. In order to address community disparities, it is critical to press beyond the current boundaries of our perspectives and develop a new, multilevel model. Multilevel approaches include characteristics of individuals as well as broader community level factors on individual-level outcomes. This new paradigm has the potential to increase our understanding of disparities in breast cancer screening among communities, point to new areas for interventions to increase screening, and thus have the potential to reduce the risk of mortality. Despite its great potential, there are currently no studies that have developed a multilevel model aimed at examining community variation of breast cancer screening. The proposed project will construct a conceptual model by testing the different pathways (medical infrastructure, general community infrastructure, social capital) by which women age 40 or older from metropolitan areas with adverse material and social conditions are less likely to be screened for breast cancer after controlling for individual-level barriers. Examination of these three potential pathways will lead to the development of more specific hypotheses about the mechanisms by which area adverse material and social conditions influence screening for breast cancer. We will conduct analyses of existing public use data (1999-2000 National Health Interview Survey) of more 10,000 women from 58 metropolitan areas throughout the United States, merged with community data from various existing sources to construct this model (e.g. US Census, Area Resource File). By focusing on specific pathways of the constructed multilevel model, the findings of this novel study will serve as the basis for future cancer control research grant applications. Such applications will focus on the evaluation of specific hypotheses using population-based surveys and in-depth data collection methods not available by using existing data sources.

描述(由申请人提供)：虽然乳腺癌筛查已被证明可以降低死亡风险，但低收入、被剥夺公民权的社区的筛查利用率较低。研究这些差异的大部分工作都集中在了解个人和社会特征与筛查行为(例如，知识、社会支持)的关联。然而，妇女所居住的社区的特征被忽视了，尽管这些特征会影响健康和相关行为。为了解决社区差异，至关重要的是超越我们目前的视角界限，发展一种新的、多层次的模式。多层次办法包括个人的特点以及影响个人一级成果的更广泛的社区一级因素。这一新的范式有可能增加我们对社区间乳腺癌筛查差异的了解，指出新的干预领域以增加筛查，从而有可能降低死亡率风险。尽管乳腺癌筛查具有巨大的潜力，但目前还没有研究开发出旨在检测乳腺癌筛查社区差异的多水平模型。 拟议的项目将通过测试不同的途径(医疗基础设施、一般社区基础设施、社会资本)来构建一个概念模型，通过这些途径，来自物质和社会条件不利的大都市地区的40岁或40岁以上的妇女在控制了个人层面的障碍后，不太可能被筛查为乳腺癌。对这三个潜在途径的研究将导致关于地区、不利的物质和社会条件影响乳腺癌筛查的机制的更具体的假设的发展。我们将对现有的公共使用数据(1999-2000年全国健康访谈调查)进行分析，这些数据来自全美58个大都会地区的10,000多名妇女，并与来自各种现有来源的社区数据相结合，以构建这个模型(例如，美国人口普查、地区资源文件)。通过专注于所构建的多水平模型的具体途径，这项新颖的研究结果将作为未来癌症控制研究拨款申请的基础。这类应用将侧重于使用基于人口的调查和使用现有数据来源无法获得的深入数据收集方法对具体假设进行评估。