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A Paradigm to Examine Cancer Disparities: Limited English Proficient Chinese Patients with Thyroid Nodules

检查癌症差异的范例：英语水平有限的中国甲状腺结节患者

基本信息

批准号：
10661137
负责人：
Debbie Wan Hua Chen
金额：
$ 18.25万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-09 至 2028-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10661137
关键词：
Address Administrator Area Asian Asian Americans Asian population California Cancer Patient Caring Cause of Death Cessation of life Chinese Chinese American Chinese population Clinical Trials Cohort Studies Communication Continuity of Patient Care Data Decision Making Detection Development Diagnosis Disparity Effectiveness of Interventions English Language Equity Ethnic Origin Ethnic Population Evaluation Fine needle aspiration biopsy Focus Groups Funding Goals Health Personnel Health Services Individual Information Resources International Intervention K-Series Research Career Programs Language Learning Limited English Proficiency Linguistics Link Literature Malignant Neoplasms Malignant neoplasm of thyroid Medical Mentors Michigan Modeling Nodule Outcome Pacific Islander Patient Recruitments Patient Self-Report Patients Physicians Pilot Projects Policy Maker Population Preparation Public Health Quality of Care Race Reporting Research Research Personnel Research Proposals Resources Sampling San Francisco Site Surgical complication Surveys Thyroid Gland Thyroid Nodule Training United States Universities Variant Woman Work acceptability and feasibility advanced disease arm barrier to care burden of illness cancer care cancer diagnosis cancer health disparity cancer therapy care delivery design ethnic minority population experience improved innovation mortality nonEnglish language patient population prototype racial population recruit sex skill acquisition therapy development tool virtual

项目摘要

PROJECT SUMMARY Asian Americans and Pacific Islanders are the only racial/ethnic group in the United States (US) for whom cancer is the leading cause of death for both sexes. Thus, there is an urgent need for research focused on understanding the mechanisms by which cancer disparities occur in this vulnerable patient population. Across the thyroid cancer care continuum, which starts prior to diagnosis and treatment of cancer, Asians experience a disproportionate burden of disease and death. Among Asian women, in particular, thyroid cancer is the second most common cancer and thyroid cancer mortality is the highest of any racial/ethnic group in the US. Differential management of thyroid nodules, a precursor of thyroid cancer, likely contributes to observed downstream disparities in the thyroid cancer continuum. However, Asians continue to be underrepresented in both the cancer disparities and thyroid literature, potentially exacerbated by the high rates of limited English proficiency in this population. Thus, granular data on the quality of medical care received by Asian Americans across the thyroid cancer care continuum is lacking. We propose using the paradigm of limited English proficient (LEP) Chinese patients with thyroid nodules to improve our understanding of linguistic disparities across the thyroid cancer care continuum and to inform the development of interventions that promote equitable care for LEP patients. In Aim 1, we will survey a national sample of physicians to examine variation in medical care delivery to LEP patients with thyroid nodules and thyroid cancer. In Aim 2, we will recruit patients from two sites, the University of Michigan (U-M) and the University of California, San Francisco (UCSF), to conduct virtual focus groups of LEP and English- proficient Chinese patients with thyroid nodules to explore their experiences with thyroid nodule evaluation and treatment. In Aim 3, we will use study findings from Aims 1 and 2 to inform the development and evaluation of a thyroid nodule decision preparation tool prototype for LEP Chinese patients. Data from the subsequent pilot clinical trial to evaluate the feasibility, acceptability, and preliminary effectiveness of this intervention will inform a R01 application to develop and evaluate a more comprehensive, multilevel, personalized thyroid nodule decision preparation tool that is accessible in multiple languages. By tailoring this intervention to the LEP patient population and targeting disparities more upstream of the cancer continuum, we hope to improve downstream cancer outcomes for LEP patients with thyroid cancer. This innovative research proposal fulfills a critically important unmet public health need while serving as a vehicle for Dr. Debbie Chen’s development into an independent health services researcher in the fields of cancer disparities and thyroidology. In addition to didactic learning, she will receive mentoring from her team of committed mentors and advisors who have complementary expertise and are internationally recognized experts in their field. Upon completion of this carefully designed project linking skill acquisition to research aims, Dr. Chen will emerge as an expert in linguistic disparities across the cancer care continuum.

项目摘要亚裔美国人和太平洋岛民是美国唯一的种族/族裔群体，是导致男女死亡的主要原因因此，迫切需要进行研究，癌症差异在这一脆弱患者群体中发生的机制。穿过甲状腺癌护理连续体，开始之前的诊断和治疗癌症，亚洲人经历了不成比例的疾病和死亡的负担。特别是在亚洲女性中，甲状腺癌是第二常见的癌症和甲状腺癌死亡率是美国任何种族/民族群体中最高的。差异化管理甲状腺结节，甲状腺癌的前兆，可能有助于观察到的下游差异，甲状腺癌连续体然而，亚洲人在癌症差异和甲状腺文献，可能加剧了这一人群的英语水平有限的高比率。因此，在本发明中，关于亚裔美国人在甲状腺癌治疗中接受的医疗护理质量的颗粒数据缺乏连续性。我们建议使用有限英语熟练（LEP）的中国患者的范例，甲状腺结节，以提高我们对甲状腺癌护理连续体中语言差异的理解并为制定促进LEP患者公平护理的干预措施提供信息。在目标1中，我们对全国范围内的医生进行抽样调查，以检查对患有甲状腺疾病的LEP患者提供医疗服务的差异结节和甲状腺癌。在目标2中，我们将从密歇根大学（U-M）和加州大学弗朗西斯科分校（UCSF），进行LEP和英语的虚拟焦点小组- 熟练的中国甲状腺结节患者，探讨他们对甲状腺结节评估的经验，治疗在目标3中，我们将利用目标1和目标2的研究结果，针对LEP中国患者的甲状腺结节决策准备工具原型。后续试点数据评估这种干预措施的可行性、可接受性和初步有效性的临床试验将提供信息， R 01应用程序，用于开发和评估更全面、多层次、个性化的甲状腺结节决策准备工具，可使用多种语言。通过为LEP患者量身定制这种干预，人口和针对癌症连续体上游的差异，我们希望改善下游 LEP患者甲状腺癌的预后。这一创新的研究方案实现了一个关键的重要的未满足的公共卫生需求，同时作为一个工具，陈黛比博士的发展成为一个癌症差异和甲状腺学领域的独立卫生服务研究员。除了说教学习，她将从她的团队的承诺导师和顾问谁有互补的指导专业知识，并在其领域的国际公认的专家。在完成这个精心设计的通过将技能获取与研究目标联系起来的项目，陈博士将成为跨语言差异方面的专家。癌症护理的连续性。