Increasing African-Immigrants Breast Cancer Screening

纽约市（NYC）是一个庞大而多样化的移民人口的家园。其中许多团体面临 预防性卫生保健方面的重大障碍，包括缺乏保险、难以获得卫生保健， 语言困难。大多数非洲移民妇女可能生活在贫困线以下， 健康知识普及程度低的人不太可能有健康保险和去看医生，特别是初级/预防性的 在乎由于无法获得初级保健，许多预防性服务，如乳腺癌筛查， 无人看管。乳腺癌筛查的障碍和促进因素为其他少数群体从服务不足 研究对象包括非裔美国人和拉丁裔妇女。对这些知之甚少， 非洲移民妇女以及如何最有效地让她们参与定期筛查。 我们对居住在纽约市的2,000多名非洲出生的移民的数据显示，77%的人报告说， 75%的人没有初级保健医生; 57%的人受过高中以下教育。至于 癌症筛查，当年龄校正时，44%的人从未做过乳房X光检查。通过我们独特 与非洲服务委员会和布朗克斯非洲咨询理事会合作，两个非 政府社区为基础的服务组织，我们准备对这些产生重大影响， 移民妇女，她们来自非洲20多个国家。这是一个人口众多， 需要增加对乳腺癌的了解，获得乳腺癌筛查和基本医疗保健。 健康信念模型（HBM）提供了一个框架，通过假设 做出参与健康行为的决定是通过权衡感知到的威胁与 效益使用HBM结构开发的健康教育计划是减少 导致癌症健康差异的障碍。此外，通过叙述来呈现健康信息 通信（即，讲故事;个人推荐）是教育参与者的有效方法， 癌症预防和筛查。我们在少数民族和移民社区的工作表明， 叙事通信和导航辅助可以增加乳腺癌筛查的参与。 然而，这些干预措施的有效性尚未在非洲出生的移民中得到实证检验。 拟议项目的长期目标是进行一项随机临床试验， 提高非洲出生移民的乳腺癌筛查率。在短期内，我们计划 追求以下具体目标：（1）确定乳腺癌筛查的障碍和促进因素， 非洲出生的移民和（2）文化适应和试点测试见证项目乳腺癌教育 为非洲出生的女性提供服务。因此，我们将在文化上采取有效的创新干预措施， 这种在非洲出生的移民社区中的显著健康差异。一旦我们进行了可行性试验 和干预的可接受性，我们将申请R 01资金。

New York City (NYC) is home to a large and diverse immigrant population. Many of these groups face significant barriers to preventive health care, including lack of insurance, poor health care access and language difficulties. Most African immigrant women are likely to live below the poverty line and have low health literacy, are less likely to have health insurance and visit a doctor, particularly for primary/preventive care. Without access to primary care, many preventive services, such as breast cancer screenings go unattended. The barriers and facilitators to breast cancer screening for other minority groups from underserved populations, such as African Americans and Latina women have been studied. Less is known about these for African immigrant women and how to most effectively engage their participation in regular screening. Our data of over 2,000 African-born immigrants living in NYC show that 77% report not having health insurance; 75% do not have a primary care physician; and 57% have less than a high school education. As for cancer screening, when corrected for age, 44% have never had a mammogram. Through our unique collaboration with the African Services Committee and the African Advisory Council of the Bronx, two non- governmental community-based service organizations, we are poised to have a significant impact on these immigrant women, who have emigrated from more than 20 countries in Africa. This is a population with great need for increased breast cancer knowledge, access to breast cancer screening, and basic medical care. The Health Belief Model (HBM) provides a framework for addressing cultural health barriers by positing that making a decision to engage in a health behavior is determined by weighing perceived threats versus benefits. Health education programs developed using HBM constructs are effective tools towards reducing barriers that lead to health disparities in cancer. Further, the presentation of health information via narrative communication (i.e., storytelling; personal testimonials) is an effective method of educating participants about cancer prevention and screening. Our work in minority and immigrant communities has shown that combining narrative communication and navigation assistance can increase participation in breast cancer screening. However, the efficacy of these interventions has not been empirically tested among African-born immigrants. The long term goal of the proposed project is to conduct a randomized clinical trial that tests the adapted intervention to increase breast cancer screening rates for African-born immigrants. In the short term, we plan to pursue the following specific aims: (1) Identify barriers and facilitators to breast cancer screening among African-born immigrants and (2) Culturally adapt and pilot test the Witness Project breast cancer education program for African-born women. Thus, we will culturally adapt an effective, innovative intervention to address this significant health disparity in African-born immigrant communities. Once we have pilot tested the feasibility and acceptability of the intervention, we will apply for R01 funding.