Full Project 2: Supporting High Risk African American Men in Research, Engagement & Decision Making (SHARED)

完整项目 2：支持高风险非裔美国男性进行研究和参与

• 批准号: 10082865
• 负责人: David D. Odell
• 金额: $ 2.55万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-24 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10082865
• 关键词: Address; Adult; Advisory Committees; African American; Area; Attitude; Awareness; Cancer Etiology; Chicago; Communities; Data; Decision Aid; Decision Making; Detection; Development; Diagnosis; Disadvantaged; Disease; Early Diagnosis; Evaluation; Evidence based practice; Federally Qualified Health Center; Guidelines; Health; Health Personnel; Health Sciences; Hospitals; Illinois; Incidence; Individual; Intention; Intervention Studies; Interview; Knowledge; Literature; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Medical Records; Medicare/Medicaid; Methods; Minority Groups; Morbidity - disease rate; Not Hispanic or Latino; Outcome; Outreach Research; Patients; Persons; Pilot Projects; Population; Population Heterogeneity; Preventive service; Process; Provider; Recommendation; Research; Research Design; Research Ethics; Research Project Grants; Risk; Scientist; Screening for Prostate Cancer; Screening for cancer; Smoker; Smoking History; Social Network; Survival Rate; System; Training; Trust; Underserved Population; United States; United States Agency for Healthcare Research and Quality; United States Centers for Medicare and Medicaid Services; Universities; aged; base; care providers; citizen science; clinical care; computed tomography screening; effectiveness evaluation; ethnic minority population; evidence base; health equity; high risk; high risk population; improved; improved outcome; innovation; low-dose spiral CT; lung cancer screening; men; mortality; mortality disparity; outcome forecast; outreach; primary outcome; programs; racial and ethnic; recruit; screening; screening guidelines; secondary outcome; shared decision making; standard care; uptake

ABSTRACT Supporting High Risk African American Men in Research & Engagement in Decision Making for Lung Cancer Screening is a ChicagoCHEC outreach research full project that aims to reduce lung cancer inequities across diverse populations of high-risk smokers. Racial/ethnic minorities carry the greatest burden of lung cancer morbidity and mortality, with African American men (AAM) carrying the greatest incidence and mortality rates. Low dose helical computed tomography (LDCT) lung cancer early detection screening is recommended by the US Preventive Services Task Force (USPSTF - B recommendation) among adults aged 55-80, with a history of smoking. However, few studies have addressed how to engage high risk AAM and their clinical care providers in LDCT. We propose an innovative outreach intervention research project engaging AAM as Citizen Scientists to improve uptake of lung cancer screening at Mile Square Health Centers (MSHC), a group of 13 Federally Qualified Health Centers associated with the University of Illinois Hospital and Health Sciences System at UIC. Citizen Scientists refer to lay persons who are not formally trained as scientists but who are trained to engage in research efforts responsive to community needs. Citizen Scientists have proven valuable in increasing communities’ knowledge and awareness of research, building trust in scientific research, and informing areas of research design and ethics. As the Centers for Medicare and Medicaid Services requires a shared decision- making process for Medicare and Medicaid recipients prior to LDCT screening, we focus our Citizen Scientists efforts in this study on leveraging their social networks to engage AAM and supporting and enhancing an Agency for Healthcare Research and Quality (AHRQ) evidence-based Decision Aid (DA) that promotes shared decision making and subsequent lung cancer screening. We propose the following aims 1): recruit and train 8 AAM as Citizen Scientists; 2) engage Citizen Scientists to examine knowledge, attitudes, barriers and facilitators related to LDCT lung cancer screening among AAM smokers and their providers; 3) using data obtained in Aim 2, engage Citizen Scientists to refine outreach strategies for engaging AAM in lung cancer screening with MSHC and adapt the AHRQ DA to co-create a culturally targeted lung cancer screening DA for AAM patients and their providers; and 4) engage Citizen Scientists in a pilot RCT comparing the relative efficacy of the culturally targeted Citizen-Scientist informed DA vs the standard care AHRQ DA on knowledge, decisional support, and lung cancer screening among AAM. We hypothesize that compared with AAM assigned to the standard care DA, those receiving the Citizen-Scientist informed DA will demonstrate greater intention to screen, greater utilization of LDCT screening per USPSTF guidelines, and greater knowledge and perceived decisional support. Engaging AAM as Citizen Scientists is expected to improve outreach and respond to the needs communities that may traditionally be “unengaged” in the research process and provides an opportunity for the group at the most increased risk for lung cancer, AAM, to directly drive uptake of evidence based screening.

抽象的 支持高风险的非洲裔美国男性研究和参与肺癌决策 筛查是一个芝加哥外展研究完整项目，旨在减少跨越肺癌的不平等 多样化的高风险吸烟者人群。种族/族裔少数群体带有最大的肺癌烧伤 发病率和死亡率，非裔美国人（AAM）的发病率和死亡率最高。 低剂量的螺旋计算机断层扫描（LDCT）肺癌早期检测筛查建议 美国预防服务工作组（USPSTF -B建议），年龄在55-80岁的成年人中 吸烟。但是，很少有研究解决了如何参与高风险AAM及其临床护理提供者 在LDCT。我们提出了一个创新的外展干预研究项目，使AAM担任公民科学家 为了改善在Mile Square Health Centers（MSHC）的肺癌筛查的摄取，这是一组联邦政府 与UIC的伊利诺伊大学医院和健康科学系统相关的合格卫生中心。 公民科学家指的是未经正式培训的科学家而受过训练的外行人 响应社区需求的研究工作。公民科学家已被证明对增加 社区的知识和对研究的认识，建立对科学研究的信任，并向领域告知 研究设计和道德。由于医疗保险和医疗补助服务中心需要共同的决定 - 在LDCT筛查之前，为Medicare和Medicaid接受者制定过程，我们集中于我们的公民科学家 在这项研究方面努力利用他们的社交网络与AAM互动并支持和增强代理商 用于医疗保健研究和质量（AHRQ）基于证据的决策援助（DA），以促进共同的决定 进行和随后的肺癌筛查。我们提出以下目的1）：招募和培训8 AAM作为 公民科学家； 2）让公民科学家检查知识，参与者，障碍和协助者相关的知识 在AAM吸烟者及其提供者中筛查LDCT肺癌； 3）使用在AIM 2中获得的数据， 让公民科学家们完善与MSHC一起参与肺癌筛查的外展策略 并适应AHRQ DA共同创建AAM患者及其其具有文化靶向的肺癌筛查DA 提供者； 4）与公民科学家进行试点RCT，比较了针对文化的针对性的相对有效性 公民科学家告知DA与标准护理AHRQ DA有关知识，决策和肺癌 筛选AAM。我们假设这是与分配给标准护理DA的AAM相比 接受公民科学家知情的DA将表现出更大的筛查意图，更大的利用 根据USPSTF指南的LDCT筛选，以及更大的知识和决定性支持。参与 AAM作为公民科学家有望改善外展活动，并应对可能的需求社区 传统上，在研究过程中“无关”，并为小组提供了一个机会 AAM肺癌的风险增加了直接推动基于证据筛查的吸收的风险。