PSYCHOSOCIAL VARIABLES ASSOCIATED WITH COLORECTAL CANCER SCREENING IN MAS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 目的：本研究的总体目标是检查在VA医院，南德克萨斯退伍军人医疗保健系统奥迪L。墨菲司（STVHCS-AMD）在圣安东尼奥，得克萨斯州。 研究计划：具体目标是： 1. 估计社会心理变量之间的关联程度，包括社会经济弱势地位和参与结直肠癌筛查。 2. 确定特定的社会心理变量、社会经济劣势变量和参与结直肠癌筛查之间是否存在协同和/或独立关系。 本研究将调查在德克萨斯州圣安东尼奥退伍军人管理局（VA）门诊部登记的墨西哥裔美国退伍军人的各种心理社会变量、特定SES变量与参与结直肠癌筛查之间的关联强度。 还将通过回归分析检查这些变量，以确定是否存在交互和/或独立关联。 本研究将采用横断面调查设计。 便利抽样将用于招募年龄在50至80岁之间的墨西哥裔美国人参与者。 方法：在获得每位参与者的书面知情同意后，该项目训练有素的研究员（Pasko博士）将对受试者进行结构化验证调查。 受试者从在圣安东尼奥，TX的STVHCS-AMD医院的门诊部就诊的患者招募。 受试者将从该诊所的初级保健提供者的患者小组中抽取。 本研究的入选标准是西班牙裔（墨西哥裔美国人或其他指定的西班牙裔/拉丁裔），年龄50至80岁。 排除标准为非西班牙裔（自我报告），年龄小于50岁，有结直肠癌病史和/或目前诊断为任何癌症。 将在诊所设置中指定的日期，通过计算机化门诊患者样本组文件中的性别和出生日期识别受试者。 将使用便利采样，因为连续接近每例患者可能不可行。 将使用斯皮尔曼相关系数分析三个月内收集的数据。 预计负0.20的估计适度相关性（r）。 效应量（r）等于[-0.20] = 0.20。 alpha是双侧的，等于0.05。 beta是0.10。 本描述性研究的样本量计算为259。 将使用初步多变量逻辑回归模型确定变量之间的潜在相互作用效应。 置信区间水平设定为95%。 临床相关性：单一或简单的原因可能无法解释癌症负担与社会经济劣势和种族之间的差异。 研究表明，各种障碍阻碍了预防工作。 早期筛查和早期发现已被证明可以增加许多癌症的存活率并降低死亡率，包括结肠直肠癌。 因此，少数民族之间筛查率的差异较低可能是调查的一个重要因素，因为少数民族之间结直肠癌结果的健康差异。 缺乏关于获得护理的具体方面和其他心理社会因素的数据，这些因素可能导致西班牙裔人口利用不足。 拟议的调查结果可能表明，哪些具体因素，以进一步研究的障碍，结直肠癌筛查中的西班牙裔墨西哥裔美国人提取。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: The overall aim of this research is to examine barriers to colorectal cancer screening participation in a convenience sample of Mexican Americans in a VA Hospital, the South Texas Veterans Health Care System-Audie L. Murphy Division (STVHCS-AMD) in San Antonio, Texas. RESEARCH PLAN: The specific aims are: 1. To estimate the magnitude of the associations between psychosocial variables, including socioeconomic disadvantaged status and participation in colorectal cancer screening. 2. To determine if a synergistic and/or independent relationship exists between specific psychosocial variables, the socioeconomic disadvantage variables and participation in colorectal cancer screening. This study will investigate the strength of the association between various psychosocial variables, specific SES variables and participation in colorectal cancer screening by Mexican American veterans enrolled in an outpatient Veterans Administration (VA) clinic in San Antonio, TX. These variables will also be examined by regression analysis to determine if interactive and/or independent associations exist. This study will utilize a cross-sectional survey design. Convenience sampling will be used to accrue Mexican American participants, ages 50 to 80. METHODS: After obtaining written informed consent from each participant, the trained investigator for this project (Dr. Pasko) will administer structured validated surveys to subjects. Subjects are recruited from patients seen in the outpatient clinic at the STVHCS-AMD Hospital in San Antonio, TX. Subjects will be drawn from the patient panels of primary care providers in this clinic. The criteria for inclusion into this study are Hispanic (Mexican American or other specified Hispanic/Latino origin) by self-report, ages 50 to 80. The criteria for exclusion are non-Hispanic ethnicity (self-report), age less than 50, and a history of colorectal cancer and/or current diagnosis of any cancer. Subjects will be identified by gender and birth date from the computerized outpatient clinic patient panel files on the days designated in the clinic setting. Convenience sampling will be used since it may not be feasible to approach each patient consecutively. Spearman's coefficient correlation will be used to analyze the data collected for a time period of three months. An estimated modest correlation (r) of a negative 0.20 is anticipated. The effect size (r) is equal to [-0.20] = 0.20. The alpha is two-sided and equal to 0.05. The beta is 0.10. The sample size for this descriptive study was calculated to be 259. A preliminary multivariate logistic regression model will be used to determine the potential interaction effects between the variables. The confidence interval level is set at 95%. CLINICAL RELEVANCE: Single or simple reasons probably do not explain the disparities in the cancer burden with respect to socioeconomic disadvantage and ethnicity. Research suggests that a variety of barriers impede prevention. Early screening and early detection have been shown to increase survival and reduce mortality rates for many cancers, including colorectal cancer. Differentially lower rates of screening among minorities, therefore, is a likely candidate for investigation as a significant contributor to health disparities with respect to colorectal cancer outcomes among minorities. There is a lack of data on specific aspects of access to care and other psychosocial factors that may contribute to underutilization in the Hispanic population. The results of the proposed investigation could suggest which specific factors to further examine as impediments to colorectal screening among Hispanics of Mexican American extraction.