Validating Area-Level Behavioral Profiles for Cancer Disparities Research

说明(申请人提供)：人口普查得出的社会经济指标在社会科学研究人员中得到广泛接受，既是直接测量不可行时个人层面信息的小范围代理，也是调查社会环境和背景资源对健康影响的具体生态模型中的重要结构。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”，即根据人口统计和消费者行为对小地理区域进行细分和定义。然而，商业准备的地区级行为数据对健康研究的效用在很大程度上是未知的。这项探索性的R21调查的目的是测试地区层面的行为消费者概况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地区层面的行为数据方法。具体地说，这个项目将：1)使用商业准备的地区级消费者概况数据，建立马里兰州特定癌症相关行为的地理覆盖范围和综合癌症风险概况，并通过统计建模这些措施与华盛顿县21岁及以上居民线索研究中高质量的单独报告数据的相似性，来测试这些措施的结构有效性；2)使用2000年向马里兰州癌症登记中心报告的病例，检查这些措施的预测有效性，当添加到社会经济和医疗保健准入措施时，关于四个主要癌症地点(乳腺癌、结直肠、前列腺癌和肺癌)的超额癌症负担，以及3)促进了解社会和行为对癌症和其他疾病差异空间格局的影响的方法和理论，长期目标是改进监测在解决这些健康不平等方面的进展情况的工具。这项研究呼吁在行为和社会科学方法论中提出建议，为多方法、多层次的研究建立方法，并开发在不同和高度优先的人群中可靠和有效的方法。这一创新的方法如果被拟议的工作验证，将为从高度保密和反应性的行为监测方法转向成本更低、适用范围更广的方法提供一个潜在的工具。这项拟议的探索性研究向马里兰州通报了一个或多个人口亚群的地理区域，总体上超过了非地理特征可能预期的风险，在临床上，它可能建议特定类型的服务所需的人口亚群、地理区域或社区，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个可能的工具，并可能向关注癌症差异的研究人员提供更具体的调查领域。

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.