Improved Cancer Screening: Life Skills Training in S Texas Hispanic Communities

改进癌症筛查：德克萨斯州南部西班牙裔社区的生活技能培训

• 批准号: 7668492
• 负责人: THELMA C HURD
• 金额: $ 15.28万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-04 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7668492
• 关键词: Acculturation; Address; Affect; Attitude; Behavior; Behavior Therapy; Belief; Body of uterus; Breast; Breast Cancer Detection; Cancer Control; Cancer Intervention; Cardiovascular Diseases; Caucasians; Caucasoid Race; Cervical; Cervical Cancer Education; Colorectal; Colorectal Cancer; Communities; Community Health; Community Surveys; Complement; Consumption; Country; County; Diabetes Mellitus; Diagnosis; Diagnostic Neoplasm Staging; Disease; Early Diagnosis; Early treatment; Education; Educational Curriculum; Educational Materials; English Language; Enrollment; Face; Family; Female; Focus Groups; Goals; Health; Health Resources; Health Services Accessibility; Health behavior; Health behavior change; Health education; Healthcare; Healthcare Systems; Hispanics; Hour; Husband; Incidence; Intervention; Interview; Knowledge; Lead; Life; Linguistics; Link; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Mexican; Mexico; Modification; Morbidity - disease rate; Obesity; Outcome; Outcome Measure; Pilot Projects; Population; Prevention; Prevention education; Preventive Health Services; Prostate; Public Health; Randomized; Relative (related person); Reporting; Research; Rural; Screening for cancer; Screening procedure; Social support; Socioeconomic Factors; South Texas; Staging; Testing; Texas; Training; Treatment Cost; Ursidae Family; Woman; Women' s Role; base; cancer diagnosis; experience; family structure; health care service utilization; improved; informant; malignant breast neoplasm; meetings; men; mortality; novel; primary outcome; programs; public health relevance; skills training

DESCRIPTION (provided by applicant): Mexican women with breast or cervical cancer in South Texas are diagnosed at later stages. The higher mortality rates are due in large part to low screening rates. Tailored, culturally relevant cancer interventions that change health behaviors are urgently needed. This project's long term objective is to decrease late stage diagnosis of breast and cervical cancer among Hispanic women in South Texas and the Texas border region. The central hypothesis is that culturally relevant community based breast and cervical cancer intervention, education and screening programs combined with life skills training will synergistically increase breast and cervical cancer knowledge and improve screening rates. Aim 1 will survey community attitudes toward female-centered, faith based cancer initiatives targeting Mexican men and women living in four South Texas communities. Aim 2 will pilot a South Texas Hispanic version of Esperanza y Vida, a novel, culturally tailored, community based breast and cervical cancer education program in diverse South Texas Hispanic communities. Aim 3 will evaluate the effect of life skills training on health behaviors among Mexicans who have completed a breast and cervical cancer education program. This project will be conducted in four distinct, underserved Mexican populations (2 rural, 2 urban) in Webb, Hidalgo and Nueces Counties. Focus groups and key informant interviews will be conducted to assess breast and cervical cancer knowledge, attitudes, beliefs and practices among Hispanic women and men in each community. A novel, community based breast and cervical cancer education and screening program (Esperanza y Vida) has been modified to meet the needs of South Texas Hispanic women and men. This study will randomize 240 women and 100 of their husbands to 1 of 4 study groups: Group 1 will attend a 2 hour Esperanza y Vida program, Group 2 will attend the 2 hour program Esperanza y Vida program followed by expanded Esperanza y Vida education program (12 sessions that cover each topic presented in the initial program), Group 3 will attend the 2 hour Esperanza y Vida program followed by life skills training (10 sessions), and Group 4 will attend the 2 hour Esperanza y Vida program followed by the expanded Esperanza y Vida education program and life skills training. Screening practices, barriers and breast and cervical cancer knowledge will be assessed at the end of the initial 2 hour program. Breast and cervical cancer knowledge will be assessed following each intervention in study groups 2-4. The primary outcomes measured are a) change in breast and cervical cancer knowledge and b) the number of completed screening exams. Parametric and non-parametric statistical analyses will be used to compare screening practices, barriers, breast and cervical cancer knowledge and number of completed screening exams between groups. PUBLIC HEALTH RELEVANCE: Effective cancer control and prevention public health strategies are needed in Texas where health resources are increasingly limited in the face of rapidly expanding population needs. Forty} 60% of breast and cervical cancers are diagnosed at advanced stages when treatment costs are high. The current health care system can not bear this burden. Education, screening and prevention combined with changes in health behaviors will result in a greater proportion of early stage cancer at diagnosis which in turn will lead to lower health resource consumption and most importantly, a healthier population. This project represents the start of a 10-year plan to increase cancer preventive health services utilization and modify health behaviors among Mexican men and women living in South Texas and the US-Mexico border region. The overarching goal is to decrease breast and cervical cancer incidence and mortality. Durable community partnerships have been developed that will enable a multi-tiered, community based approach to cancer control and prevention that respects and complements Hispanic sub-populations' culture.

描述（由申请人提供）：德克萨斯州南部患有乳腺癌或宫颈癌的墨西哥妇女在晚期才被诊断出来。较高的死亡率在很大程度上是由于筛查率较低。迫切需要定制的、与文化相关的癌症干预措施来改变健康行为。该项目的长期目标是减少德克萨斯州南部和德克萨斯州边境地区的西班牙裔妇女乳腺癌和宫颈癌的晚期诊断。中心假设是，基于文化的相关社区乳腺癌和宫颈癌干预、教育和筛查计划与生活技能培训相结合，将协同增加乳腺癌和宫颈癌知识并提高筛查率。目标 1 将调查社区对以女性为中心、基于信仰的癌症倡议的态度，该倡议针对居住在德克萨斯州南部四个社区的墨西哥男性和女性。 Aim 2 将在德克萨斯州南部的西班牙裔社区试行 Esperanza y Vida 的版本，这是一项新颖的、针对文化定制的、以社区为基础的乳腺癌和宫颈癌教育计划，在德克萨斯州南部的多个西班牙裔社区中进行。目标 3 将评估生活技能培训对完成乳腺癌和宫颈癌教育计划的墨西哥人健康行为的影响。该项目将在韦伯县、伊达尔戈县和纽埃塞斯县的四个不同的、服务不足的墨西哥人口（2 个农村人口，2 个城市人口）中开展。将进行焦点小组和关键知情人访谈，以评估每个社区的西班牙裔女性和男性对乳腺癌和宫颈癌的知识、态度、信仰和实践。一项新颖的、基于社区的乳腺癌和宫颈癌教育和筛查计划 (Esperanza y Vida) 已经过修改，以满足南德克萨斯州西班牙裔女性和男性的需求。本研究将 240 名女性及其 100 名丈夫随机分为 4 个研究组中的 1 个：第 1 组将参加 2 小时的 Esperanza y Vida 计划，第 2 组将参加 2 小时的 Esperanza y Vida 计划，随后是扩展的 Esperanza y Vida 教育计划（涵盖初始计划中提出的每个主题的 12 节课程），第 3 组将参加 2 小时的 Esperanza y Vida 计划，然后是通过生活技能培训（10 次），第 4 组将 参加 2 小时的 Esperanza y Vida 课程，然后是扩展的 Esperanza y Vida 教育课程和生活技能培训。筛查实践、障碍以及乳腺癌和宫颈癌知识将在最初的 2 小时计划结束时进行评估。乳腺癌和宫颈癌知识将在研究组 2-4 的每次干预后进行评估。测量的主要结果是 a) 乳腺癌和宫颈癌知识的变化以及 b) 完成的筛查检查的数量。参数和非参数统计分析将用于比较各组之间的筛查实践、障碍、乳腺癌和宫颈癌知识以及已完成筛查检查的数量。公共卫生相关性：德克萨斯州需要有效的癌症控制和预防公共卫生战略，面对迅速增长的人口需求，该州的卫生资源日益有限。 40} 60% 的乳腺癌和宫颈癌是在晚期才被诊断出来的，此时治疗费用很高。目前的医疗保健系统无法承担这个负担。教育、筛查和预防与健康行为的改变相结合，将导致诊断时早期癌症的比例增加，从而降低卫生资源消耗，最重要的是，使人口更加健康。该项目代表了一项为期十年的计划的开始，该计划旨在提高癌症预防保健服务的利用率并改变居住在德克萨斯州南部和美墨边境地区的墨西哥男女的健康行为。总体目标是降低乳腺癌和宫颈癌的发病率和死亡率。持久的社区伙伴关系已经建立，这将能够采用多层次、基于社区的方法来控制和预防癌症，尊重和补充西班牙裔亚群的文化。