The Upstream Center: Income Interventions to Address the Fundamental Causes of Cancer Inequities

上游中心：解决癌症不平等根本原因的收入干预措施

• 批准号: 10661407
• 负责人: MELISSA L. BONDY
• 金额: $ 209.5万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-26 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10661407
• 关键词: Address; Advanced Malignant Neoplasm; Affect; Area; Behavior; Behavioral; California; Cancer Burden; Cancer Control; Cancer Etiology; Cancer Science; Cancer health equity; Catchment Area; Cause of Death; Cessation of life; Collaborations; Communities; Complex; Data Scientist; Development; Diet; Environment; Food; Foundations; Health; Health Services Accessibility; Health behavior; Health system; Healthcare; Housing; Incidence; Income; Income Tax; Individual; Inequity; Intervention; Learning; Low income; Malignant Neoplasms; Mediating; Methodology; Outcome; Personal Satisfaction; Persons; Physical activity; Pilot Projects; Play; Policies; Policy Developments; Policy Maker; Population; Poverty; Poverty Areas; Process; Research; Research Personnel; Research Project Grants; Resources; Risk Factors; San Francisco; Science; Social Change; Social Sciences; Social Work; Supplementation; Testing; Training; Transportation; Universities; Wages; Work; cancer prevention; cancer risk; career; career development; deprivation; economic disparity; evidence base; improved; innovation; mathematical model; member; mortality; novel; poor communities; prevent; programs; research and development; screening; social; social determinants; social disparities; social health determinants; stress reduction; structural determinants

Overall Component: Project Summary/Abstract Persistent poverty environments impose particular challenges for cancer prevention, with complex and intersecting factors creating barriers at the individual, health system, and population level. Improving cancer outcomes in these areas requires transformational, multisector solutions targeting fundamental causes and social determinants of health, with research and policy development processes that are co-created with the impacted communities. To address this challenge, we will form the UPSTREAM Research Center, an innovative approach to the fundamental problem of income deprivation by leveraging state programs for Guaranteed Basic Income and the Earned Income Tax Credit (EITC). Our team science approach to this problem is supported by the unparalleled resources at Stanford University, the University of California, San Francisco and the University of California, Davis. Our work advances multiple conceptual and methodological innovations through two main research projects: 1) an ongoing partnership with the California Department of Social Services to access and evaluate a $35M intervention of Guaranteed Basic Income in persistent poverty areas with a focus on modifiable cancer risk factors and intermediate outcomes; 2) the impact of increases in income support through the EITC, which in California has a unique focus on lower income wage earners, as well as undocumented workers. Our Specific Aims are to: Aim 1. Build a collaborative community of residents in persistent poverty areas, policy makers, trainees, cancer and social science researchers and data scientists that co-create programs to address the fundamental impacts of income deprivation, Aim 2. Evaluate the impact of income-based interventions in demographically diverse persistent poverty areas in Northern CA, Aim 3. Develop a mathematical model, with community input, that can assist in predicting long-term impacts of income-focused interventions on cancer incidence, providing community members, policy makers, and researchers with guidance on how best to eliminate the increased burden of cancer in persistent poverty areas, Aim 4. Develop and implement a career enhancement program that will facilitate the training and career development of a diverse cadre of interdisciplinary early-career scholars who are committed to advancing cancer health equity through research and practice in persistent poverty areas, and Aim 5. Implement innovative and collaborative cancer prevention and control programs identified through the UPSTREAM Research Center research projects and our community partners to develop long-term sustainable strategies in our Northern CA Catchment Areas and across the Persistent Poverty Centers Network. Results from this novel groundbreaking work will lay the foundation for transformative approaches to address cancer prevention and control programs in the face of severe economic and social disadvantage through capacity building and sustainable partnerships with policymakers, state and local agencies and community partners.

总体组成部分：项目总结/摘要 持续的贫困环境给癌症预防带来了特殊的挑战， 交叉因素在个人、卫生系统和人口层面造成障碍。改善癌症 要在这些领域取得成果，就需要针对根本原因和 健康的社会决定因素，研究和政策制定进程， 影响社区。为了应对这一挑战，我们将成立上游研究中心， 通过利用国家方案， 保证基本收入和所得税抵免（EITC）。我们的团队科学方法 这个问题得到了斯坦福大学、加州大学旧金山分校无与伦比的资源的支持 弗朗西斯科和加州大学戴维斯分校。我们的工作推进了多个概念和方法 通过两个主要研究项目的创新：1）与加州教育部的持续合作， 社会服务部门将获得和评估一项3 500万美元的基本收入保障措施，以解决持续贫困问题 关注可改变的癌症风险因素和中间结果的领域; 2） 通过EITC提供收入支持，在加州，EITC特别关注低收入工薪阶层， 以及无证工人。我们的具体目标是：目标1。建立居民协作社区 在持续贫困地区，政策制定者、受训人员、癌症和社会科学研究人员以及数据科学家 共同创建项目，以解决收入剥夺的根本影响，目标2。评价 基于收入的干预措施对北方加利福尼亚州持续贫困地区的影响 3.开发一个数学模型，与社区的投入，可以帮助预测长期的影响， 以收入为重点的癌症发病率干预措施，为社区成员、决策者和 研究人员就如何最好地消除持续贫困地区日益增加的癌症负担提供指导， 目标4。制定并实施职业发展计划，以促进培训和职业发展 发展一个致力于推进跨学科的早期职业学者的多元化干部 通过在持续贫困地区的研究和实践实现癌症健康公平，以及目标5。实施 通过UPSTREAM确定的创新和协作癌症预防和控制计划 研究中心的研究项目和我们的社区合作伙伴，以制定长期的可持续发展战略， 我们的北方CA集水区和整个持续贫困中心网络。本小说的结果 开创性的工作将为解决癌症预防的变革性方法奠定基础， 通过能力建设，在面临严重的经济和社会劣势的情况下实施控制方案， 与决策者、州和地方机构以及社区伙伴建立可持续的伙伴关系。