Validating Area-Level Behavioral Profiles for Cancer Disparities Research

描述（由申请人提供）：人口普查衍生的社会经济措施在社会科学研究人员中被广泛接受，当直接测量不可行时，它们可以作为个人层面信息的小区域代理，同时也可以作为研究社会环境和背景资源对健康影响的特定生态模型的重要构建。人口统计数据的许多扩展被成功地应用于商业领域，如市场营销，包括“地理人口统计”，即基于人口统计和消费者行为对小地理区域进行分割和定义。然而，商业准备的区域行为数据对健康研究的效用在很大程度上是未知的。这项探索性R21调查的目的是测试区域级行为消费者资料数据在解释癌症负担的地理差异方面的效用，并为未来的研究完善区域级行为数据方法。具体而言，该项目将：1)利用商业准备的区域级消费者资料数据建立马里兰州特定癌症相关行为和综合癌症风险概况的地理覆盖，并通过统计建模将这些措施与华盛顿县21岁及以上居民的CLUE研究的高质量单独报告数据的相似性来检验这些措施的构建有效性；当加入社会经济和医疗保健获取措施时，关于四个主要癌症部位（乳腺癌、结肠直肠癌、前列腺癌和肺癌）的过度癌症负担，使用2000年向马里兰州癌症登记处报告的病例，以及3)有助于了解癌症和其他疾病差异空间格局的社会和行为影响的方法和理论，其长期目标是改进监测这些健康不平等问题进展的工具。本研究旨在呼吁行为科学和社会科学方法论的建议，以建立多方法，多层次的研究方法，并开发在不同和高优先级人群中可靠和有效的方法。这种创新的方法，如果被提议的工作所证实，将为从高度保密和反应性的行为监测方法转向成本更低、广泛适用的方法提供潜在的工具。这项探索性研究向马里兰州通报了一个或几个人口亚群的地理区域风险过高，总体上超过了非地理特征可能预期的风险，并且在临床上，它可能建议人口、地理区域或社区的亚群需要特定类型的服务，以解决高风险或高需求。对于健康领域的社会科学研究人员来说，它也为调查和理解社区层面的健康行为提供了一种可能的工具，它可能为关注癌症差异的研究人员提供更具体的研究领域。

DESCRIPTION (provided by applicant): Census-derived socioeconomic measures have wide acceptance among social science researchers both as small-area proxies for individual-level information when direct measurement is not feasible, as well as important constructs in their own right in specifically ecological models investigating the effect of the social environment and contextual resources on health. Many extensions of demographic data are utilized successfully in commercial areas such as marketing, including "geodemographics," the segmentation and definition of small geographic areas based on both demographics and consumer behavior. However, the utility of commercially prepared area-level behavioral data for health research is largely unknown. The aims of this exploratory R21 investigation are to test the utility of area-level behavioral consumer profile data in explaining geographic disparities in cancer burden, and to refine area-level behavioral data methodologies for future studies. Specifically, this project will: 1) use commercially prepared area-level consumer profile data to build a geographic coverage for Maryland on specific cancer-related behaviors and a composite cancer risk profile, and test the construct validity of these measures by statistically modeling their similarity to high-quality individually reported data from the CLUE studies of Washington County residents age 21 and older, 2) examine the predictive validity of these measures, when added to socioeconomic and healthcare access measures, on excess cancer burden for four major cancer sites (breast, colorectal, prostate, and lung), using cases reported in 2000 to the Maryland Cancer Registry, and 3) contribute to the methods and theory for understanding social and behavioral influences on spatial patterns of disparities in cancer and other diseases, with the long-term goal of improving tools for monitoring progress in addressing these health inequities. This research addresses the call for proposals in behavioral and social science methodology to build methods for multi-method, multi-level research, and to develop methods which are reliable and valid in diverse and high priority populations. The innovative methodology, if validated by the proposed work, offers a potential tool for moving from highly confidential and reactive methods of behavioral surveillance to less costly, widely applicable methodologies. This proposed exploratory research informs the State of Maryland of geographic areas with excess risk for one or several population subgroups, overall and above what might be anticipated by non-geographic characteristics, and clinically, it may suggest subgroups of the population, geographic areas, or communities for whom specific types of services warranted, to address high risk or high need. For social science researchers in health, it also offers a possible tool for investigating and understanding community-level health behaviors, and it may suggest areas for more specific inquiry to researchers focusing on cancer disparities.