CRC Screening in Primary Care Settings: Factors for Low Income Urban Hispanics

初级保健机构中的 CRC 筛查：低收入城市西班牙裔人的因素

• 批准号: 7200862
• 负责人: KATHERINE N DUHAMEL
• 金额: $ 17.88万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7200862
• 关键词: Acculturation; Address; Adherence; Age; Area; Behavioral; Behavioral Model; Behavioral Research; Belief; Cancer Control; Cancer Etiology; Caring; Categories; Cessation of life; Clinical Research; Collection; Colonoscopy; Colorectal Cancer; Communication; Country; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Development Plans; Diagnostic; Disease; Dominican; Evaluation; Flexible fiberoptic sigmoidoscopy; Focus Groups; Gatekeeping; Goals; Grant; Health; Health Promotion; Health Promotion and Care; Health Services Accessibility; Health Services Research; Healthcare; Hispanics; Indigenous; Individual; Internet; Intervention; Knowledge; Lead; Length; Location; Low income; Malignant Neoplasms; Malignant neoplasm of prostate; Medical; Methodology; Methods; Mexican; Minority; Minority Groups; Modality; Modeling; Motivation; Nature; New York; Numbers; Operative Surgical Procedures; Patients; Persons; Phase; Physicians; Polyps; Population; Prevention; Primary Care Physician; Primary Health Care; Printing; Progress Review Group; Puerto Rican; Race; Rate; Readiness; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Research Priority; Risk; Screening procedure; Staging; Standards of Weights and Measures; Surveys; System; Testing; Theoretical model; Time; Underserved Population; United States; Woman; base; behavioral health; cancer prevention; colorectal cancer prevention; colorectal cancer screening; cultural values; design; health belief; innovation; men; mortality; preference; prevent; programs; social; therapy development

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the 3rd leading cause of cancer death among Hispanic women and ties with prostate cancer as the 2nd deadliest cancer among Hispanic men. A key and modifiable way to decrease mortality from CRC among Hispanics is to increase their rates of CRC screening and early detection of CRC. Unfortunately, the majority of Hispanics do not get screened. All the more troubling is that CRC screening rates are even low for individuals who seek routine medical care. Prior to developing interventions to increase CRC screening in Hispanics, the factors that are barriers and facilitators to screening among Hispanics need to be identified. To that end, the proposed R21 will identify barriers and facilitators to CRC screening among urban Hispanics treated in three primary practice settings, involving over 35 full-time physicians, located in East Harlem, New York. This proposal directly addresses the priorities identified by NCI for social, behavioral, and health services research in colorectal cancer. The proposal focuses on behavioral models that can guide interventions to increase the use of CRC screening in urban Hispanics, cultural considerations are a theme throughout, and the research team is interdisciplinary. The specific aims are: 1) To identify barriers and facilitators to endoscopic CRC screening in urban Hispanics (Dominicans, Mexicans and Puerto Ricans) treated in a primary care practice and 2) To investigate health care, health promotion, and cultural factors associated with Hispanics': a) stage of readiness to undergo endoscopic CRC screening; and b) endoscopic CRC screening adherence. The study will also explore if there are intra-Hispanic differences (i.e., differences among Dominicans, Mexicans, and Puerto Ricans), for the factors associated with stage of readiness to undergo endoscopic CRC screening and endoscopic CRC screening adherence. There will be two phases to the study. Each of the two study phases will use a different approach to data collection and analysis. The first phase will use focus group methodology with six focus groups comprised of up to 10 Hispanics in each group. Qualitative analyses of the data from the focus groups will identify barriers and facilitators of CRC screening among Hispanics and suggest revisions to the survey that will be used for the 2nd study approach. The second phase will use a cross-sectional survey of 300 Hispanics men and women), over the age of 50 at average risk for CRC. The results of the quantitative analyses with the data from the study's cross-sectional survey will indicate health care, health promotion, and cultural factors associated with Hispanics' stage of readiness to undergo endoscopic CRC screening and endoscopic CRC screening adherence. The results from this second study approach will also suggest if there are intra-Hispanic differences in the factors identified as barriers and facilitators to CRC screening. Lay Summary: The proposed study seeks to investigate the barriers and facilitators of CRC screening among Hispanics. The study results will lead to the development of intervention materials to increase CRC screening among diverse Hispanics based on the factors that are most relevant to them. Interventions to increase CRC screening in this rapidly growing minority group could increase their rates of CRC screening and thereby decreased their mortality from CRC.

描述（由申请人提供）：结直肠癌（CRC）是西班牙裔女性癌症死亡的第三大原因，与前列腺癌并列为西班牙裔男性第二大致命癌症。降低西班牙裔CRC死亡率的一个关键和可修改的方法是提高CRC筛查和CRC早期发现率。不幸的是，大多数西班牙裔人没有得到筛选。更令人不安的是，对于寻求常规医疗护理的个人来说，CRC筛查率甚至很低。在制定干预措施以增加西班牙裔CRC筛查之前，需要确定西班牙裔筛查的障碍和促进因素。为此，拟议的R21将确定在三个主要实践环境中治疗的城市西班牙裔CRC筛查的障碍和促进因素，涉及位于纽约东哈莱姆的35名全职医生。该提案直接解决了NCI确定的结直肠癌社会，行为和卫生服务研究的优先事项。该提案的重点是行为模型，可以指导干预措施，以增加CRC筛查在城市西班牙裔的使用，文化因素是贯穿始终的主题，研究团队是跨学科的。具体目标是：1）确定在初级保健实践中治疗的城市西班牙裔（多米尼加人，墨西哥人和波多黎各人）内镜CRC筛查的障碍和促进因素; 2）调查与西班牙裔相关的医疗保健，健康促进和文化因素：a）接受内镜CRC筛查的准备阶段;和B）内镜CRC筛查依从性。该研究还将探讨西班牙裔之间是否存在差异（即，多米尼加人，墨西哥人和波多黎各人之间的差异），与接受内镜CRC筛查的准备阶段和内镜CRC筛查依从性相关的因素。研究将分两个阶段进行。两个研究阶段中的每个阶段将使用不同的数据收集和分析方法。第一阶段将采用焦点小组方法，由六个焦点小组组成，每组最多10名西班牙裔。对焦点小组数据的定性分析将确定西班牙裔CRC筛查的障碍和促进因素，并对将用于第二种研究方法的调查提出修订建议。第二阶段将对300名年龄在50岁以上的西班牙裔男性和女性进行横断面调查，平均风险为CRC。本研究的横断面调查数据的定量分析结果将表明与西班牙裔准备接受内镜CRC筛查和内镜CRC筛查依从性相关的医疗保健，健康促进和文化因素。第二种研究方法的结果也将表明，在确定为CRC筛查障碍和促进因素的因素中，是否存在西班牙裔之间的差异。概述：拟议的研究旨在调查西班牙裔CRC筛查的障碍和促进因素。研究结果将导致干预材料的开发，以增加基于与他们最相关的因素的不同西班牙裔之间的CRC筛查。在这个快速增长的少数群体中增加CRC筛查的干预措施可以提高他们的CRC筛查率，从而降低CRC的死亡率。