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 支持高危非裔美国男性进行肺癌研究和参与决策 筛查是芝加哥CHEC 的一项外展研究完整项目，旨在减少肺癌的不平等现象 不同的高危吸烟者人群。少数种族/族裔承受着肺癌的最大负担 发病率和死亡率，其中非洲裔美国男性 (AAM) 的发病率和死亡率最高。 低剂量螺旋计算机断层扫描 (LDCT) 肺癌早期检测筛查是由 美国预防服务工作组（USPSTF - B 级推荐）针对 55-80 岁、有以下病史的成年人 吸烟。然而，很少有研究探讨如何让高风险 AAM 及其临床护理提供者参与进来 在LDCT中。我们提出一项创新的外展干预研究项目，让 AAM 作为公民科学家参与其中 提高 Mile Square 健康中心 (MSHC) 对肺癌筛查的接受率，该中心由 13 个联邦机构组成 与伊利诺伊大学医院和 UIC 健康科学系统相关的合格健康中心。 公民科学家是指未受过正式科学家培训但接受过从事科学研究的非专业人士 响应社区需求的研究工作。公民科学家已被证明在增加 communities’ knowledge and awareness of research, building trust in scientific research, and informing areas of 研究设计和伦理。由于医疗保险和医疗补助服务中心需要共同决定 - 在 LDCT 筛查之前为 Medicare 和 Medicaid 受益人制定流程，我们重点关注我们的公民科学家 本研究中关于利用社交网络参与 AAM 以及支持和加强机构的努力 用于促进共同决策的医疗保健研究和质量 (AHRQ) 循证决策援助 (DA) 进行和随后的肺癌筛查。我们提出以下目标 1)：招募和培训 8 名 AAM 作为 公民科学家； 2）让公民科学家研究相关的知识、态度、障碍和促进因素 对 AAM 吸烟者及其提供者进行 LDCT 肺癌筛查； 3) 使用目标 2 中获得的数据， 让公民科学家完善推广策略，让 AAM 与 MSHC 一起参与肺癌筛查 并调整 AHRQ DA，为 AAM 患者及其患者共同创建具有文化针对性的肺癌筛查 DA 提供商； 4) 让公民科学家参与试点随机对照试验，比较文化目标的相对功效 公民科学家知情 DA 与标准护理 AHRQ DA 在知识、决策支持和肺癌方面的比较 AAM 之间的筛选。 We hypothesize that compared with AAM assigned to the standard care DA, those 收到公民科学家通知的 DA 将表现出更大的筛选意图、更多地利用 根据 USPSTF 指南进行 LDCT 筛查，以及更多知识和感知决策支持。引人入胜 AAM 作为公民科学家预计将改善外展活动并响应社区的需求 传统上“不参与”研究过程，最多为团队提供机会 肺癌风险增加，AAM，直接推动基于证据的筛查的采用。