Cancer screening among Latinas

描述(申请人提供)：针对PAR-07-380《行为和社会科学关于了解和减少健康差距的研究》，拟议的研究重点是确定拉美裔(拉美裔)女性在乳腺癌筛查和癌症相关行为方面存在差异的潜在原因。虽然这项研究的重点是单一人群，但拟议的重点是医疗保健、文化因素和规范以及其他变量，这将有助于阐明可能导致乳腺癌差异的环境和机制。这项拟议研究的主要目标是阐明与各种癌症相关行为和风险因素(吸烟、锻炼和体重指数)以及乳腺癌筛查(乳房X光检查)的近期情况相关的心理社会和文化因素，并检查可能预测这些行为的社会、社区水平和获得医疗保健因素。该模型旨在考察社会资本、邻里因素、癌症筛查与癌症相关健康行为之间的关系；测试家族主义、关于吸烟和肥胖的健康行为规范以及关于癌症的宿命论信念在多大程度上调节文化适应、癌症筛查和健康行为结果之间的关系；分析获得医疗保健是否在社区资源、社会阶层和筛查之间起中介作用；以及检验社会资本是否通过社会支持预测筛查。总共将从纽约的社区环境(特别是华盛顿高地/因伍德和南布朗克斯的部分地区)招募402名拉丁裔。数据将通过面对面的访谈收集。有关社区特征的数据将来自自我报告、公开的人口普查数据以及街道层面的观察。采用横断面设计，用结构方程模型统计技术对理论模型进行检验。公共卫生相关性：该研究将确定在拉丁裔中促进和阻碍乳腺癌筛查和癌症相关健康行为的因素。健康教育工作者可以使用数据来设计有效的、符合文化的教育计划，其他健康专业人员也可以使用这些数据来提供符合文化的健康服务。因此，这项研究将为文化相关项目的发展提供基础，提出政策和环境层面的干预点，并导致未来对高危人群健康行为的个人和结构性决定因素的流行病学研究。

DESCRIPTION (provided by applicant): In response to PAR-07-380 Behavioral and Social Science Research on Understanding and Reducing Health Disparities, the proposed study focuses on identifying potential causes of disparities in breast cancer screening and cancer-related behaviors among Latina (Hispanic) women. Although the study focuses on a single population, the proposed focus on health care, cultural factors and norms, and other variables will help to elucidate the circumstances and mechanisms that may contribute to disparities in breast cancer. The primary goals of the proposed study are to elucidate psychosocial and cultural factors that are associated with a variety of cancer-related behaviors and risk factors (smoking, exercise, and body mass index), and recency of breast cancer screening (mammography), as well as to examine social, neighborhood-level, and access health care factors that may predict these behaviors. The model aims to examine the relationship between social capital, neighborhood factors, cancer screening, and cancer-related health behaviors; to test the extent to which familism, health-behavior norms concerning smoking and obesity, and fatalistic beliefs about cancer mediate the relationship between acculturation, cancer screening, and health behavior outcomes; to analyze whether access to health care mediates the relationship between neighborhood resources, social class, and screening; and to examine whether social capital predicts screening via social support. A total of 402 Latinas will be recruited from community-based settings in New York (specifically, Washington Heights/Inwood and sections of the South Bronx). Data will be collected via face-to-face interviews. Data on neighborhood characteristics will be derived from self-report, publicly-available Census data, as well as street-level observations. Employing a cross-sectional design, the theoretical model will be tested with Structural Equation Modeling statistical techniques. PUBLIC HEALTH RELEVANCE: The study will identify factors that promote and present barriers to breast cancer screening and cancer-related health behaviors among Latinas. Data can be used by health educators to design effective, culturally-competent educational programs, and by other health professionals to provide culturally-appropriate health services. Therefore, the research will provide a basis for the development of culturally-relevant programs, suggest points of intervention at the policy and environmental levels, and lead to future epidemiologic studies of individual and structural determinants of health behaviors in a high risk group.