Empowering Latinas to Obtain Guideline-Concordant Breast Cancer Screenings

帮助拉丁裔获得符合指南的乳腺癌筛查

• 批准号: 10700955
• 负责人: Yamile Molina
• 金额: $ 58.85万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-08 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700955
• 关键词: Address; Breast; Breast Cancer Detection; Caring; Chicago; Clinical; Collaborations; Communication; Communities; Community Health Aides; Community Health Education; Data; Education; Educational process of instructing; Enrollment; Equation; Family; Federally Qualified Health Center; Friends; Fright; Future; Goals; Guidelines; Health; Healthcare; Individual; Intervention; Knowledge; Latina; Latina Population; Latino; Learning; Long-Term Effects; Mammography; Measures; Mediating; Mediation; Modeling; Motivation; Pathway Analysis; Pilot Projects; Population; Process; Quality of life; Randomized, Controlled Trials; Reporting; Role; Services; Social Network; Solid; Testing; Translations; United States Preventative Services Task Force; Woman; acceptability and feasibility; arm; breast cancer diagnosis; cancer care; community based participatory research; community engagement; community intervention; community organizations; comparison intervention; cost; design; diagnosis quality; empowerment; experience; implementation science; improved; innovation; intervention effect; intervention participants; leadership development; malignant breast neoplasm; member; models and simulation; novel; peer; prospective; psychosocial; randomized, clinical trials; recruit; role model; screening; screening guidelines; skills; skills training; social observations; volunteer

ABSTRACT Latinas suffer disproportionately from late stage breast cancer (BC) diagnoses and worse post-diagnosis quality of life relative to non-Latina Whites (NLWs), in part due to lower guideline-concordant screening. Education+navigation (educate) approaches have offered Latinas community education to address psychosocial barriers (e.g., fear) and navigated Latinas to free/low-cost breast cancer care. Our transdisciplinary team has developed a promising empowerment+navigation (empower) approach that may lead to greater BC screening among Latino networks. In the empower approach, Latinas who are non-adherent to US Preventive Services Task Force (USPSTF) guidelines learn about BC; are navigated to free/low cost breast cancer care; and gain communication skills to promote BC screening throughout their networks. Our premise is that empowering non-adherent Latinas as breast health agents may lead to greater BC screening among non-adherent Latinas and their networks than treating non-adherent Latinas as passive recipients of education. The current proposal tests our premise and identifies “active ingredients” of the empower approach. In Aim 1, we will conduct an individual randomized controlled trial (RCT) in a federally qualified health center (FQHC). This trial will build on our team’s current service projects to provide free/low-cost BC screening in the FQHC, including leveraging its relationship with a community organization committed to leadership development among Latinas. Among non-adherent Latinas, we will compare the effects of empower and educate approaches on initial and repeat BC screening, in line with USPSTF guidelines. In Aim 2, we conduct an observational social network study. We will recruit network members through non- adherent Latinas enrolled in our RCT. Among network members, we will compare the effects of empower and educate approaches on initial and repeat BC screening across four years. In Aim 3, we will explore theoretical mechanisms of change that could contribute to intervention differences in BC screening. For non-adherent Latinas’ BC screening, we will examine the mediating roles of greater BC knowledge and motivation to be healthy role model. For network members’ BC screening, we will examine the mediating role of non-adherent Latinas’ enhanced capacity to promote BC screening. Specifically, we will test the independent effects of volunteerism in community BC initiatives, potential to “bridge” network members with formal change agents (e.g., community health workers, navigators), acceptability to promote BC, feasibility to promote BC, and BC promotion to network members. Our innovative, robust approach has direct implications for expediting the translation of promising community interventions into practice.

抽象的 拉丁裔因晚期乳腺癌（BC）诊断和诊断后较差而遭受不成比例的痛苦 相对于非拉丁裔白人（NLW）的生活质量，部分原因是指导方案筛查较低。 教育+导航（教育）方法提供了拉丁裔社区教育来解决 社会心理障碍（例如恐惧）和导航拉丁裔，以免费/低成本的乳腺癌护理。我们的 跨学科团队已经开发了一种有希望的授权+导航（授权）方法 导致拉丁裔网络之间的BC筛查更大。在授权方法中，不遵守的拉丁裔 对于我们的预防服务工作队（USPSTF）指南，了解BC；是免费/低成本的导航 乳腺癌护理；并获得沟通技巧，以促进整个网络的bc筛查。 我们的前提是，赋予非遵守拉丁裔作为乳房健康特工可能会导致更大的卑诗省的能力 在非遵守拉丁裔及其网络中筛选，而不是将非遵守拉丁裔视为被动 受教育的接受者。当前的提案测试了我们的信念，并确定了 授权方法。 在AIM 1中，我们将在联邦合格的健康中心进行单独的随机对照试验（RCT） （FQHC）。该试验将基于我们团队当前的服务项目，以提供免费/低成本的BC筛查 FQHC，包括利用其与致力于领导的社区组织的关系 拉丁裔之间的发展。在非遵循的拉丁裔中，我们将比较授权的影响 根据USPSTF指南，对初始和重复BC筛查的方法进行了教育。 在AIM 2中，我们进行了一项考试社交网络研究。我们将通过非 - 遵守拉丁裔参加了我们的RCT。在网络成员中，我们将比较授权的影响和 在四年中，对初始和重复BC筛查进行了教育方法。 在AIM 3中，我们将探索变化的理论机制，这可能导致干预差异 BC筛选。对于非遵守拉丁裔的BC筛查，我们将研究更大的BC的中介作用 成为健康榜样的知识和动力。对于网络成员的BC筛查，我们将检查 不遵守拉丁裔促进BC筛查的能力的介导作用。具体来说，我们将测试 志愿服务在社区卑诗省倡议中的独立影响，有可能“桥接”网络成员 具有正式变革代理（例如社区卫生工作者，导航员），可接受性，可行性 促进卑诗省，并向网络成员促进卑诗省。 我们创新，强大的方法对加快承诺社区的翻译具有直接的影响 干预措施实践。