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Tri-City Cervical Cancer Prevention Study among Women in the Justice System

三城市司法系统中女性宫颈癌预防研究

基本信息

批准号：
10738325
负责人：
Megha Ramaswamy
金额：
$ 3.85万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-12-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10738325
关键词：
Accounting Address Affect Behavior Behavior Therapy Behavioral Model Caring Cervical Cervical Cancer Screening Cities Climate Clinical Communities Community Health Complex Coupled Criminal Justice Development Disparity Environment Geography Goals Health Health Insurance Health system High Risk Woman Housing Imprisonment Intervention Interview Investigation Jail Justice Kansas Learning Life Longitudinal Surveys Longterm Follow-up Malignant Neoplasms Malignant neoplasm of cervix uteri Mental Health Methods Modeling Motivation Natural History Outcome Pap smear Patients Pharmaceutical Preparations Policies Population Prevention Provider Public Health Recommendation Recording of previous events Research Resources Risk Risk Behaviors Sampling Service setting Services Sexual Health Shapes Site Structure Supervision System Time Trauma Trust Variant Victimization Vulnerable Populations Woman Women&apos s Group barrier to care cancer prevention cancer risk cervical cancer prevention cost effective design experience follow-up health belief health care availability health care delivery health determinants health disparity health literacy high risk population probation recruit screening screening guidelines sociodemographics therapy design

项目摘要

ABSTRACT Women with criminal justice histories persist as one of the groups most affected by cervical cancer, with 4- 5 times the rates of cancer compared to other women. Our research team has spent the last 8 years investigating the factors that account for this disparity. We have found that abnormal Pap tests are high, with sexual health risk, trauma, women's life circumstances, and low cervical health literacy as facilitators of risk and barriers to care. But questions remain about justice-involved women's screening trajectories over time given complex cervical screening recommendations and the difficulty of interfacing with health systems and navigating complex health insurance environments. Thus, there is insufficient information available to inform interventions that address justice-involved women's cervical cancer prevention needs in the community. The specific objective of this study is to develop a better understanding of the natural history of cervical cancer risk and prevention behaviors among community-based justice-involved women. The long-term goal of this study is to identify strategies for where and how to intervene to change the factors and environments that structure women's cervical health risk. We have a unique opportunity to conduct a natural history study of cervical health risk and screening among community-based justice-involved women in three geographically and demographically diverse cities. We plan to leverage three existing samples of community-based, justice-involved women – in Kansas City, MO, Birmingham, AL, and Oakland, CA – to become one of the first long-term cancer prevention studies of high-risk women across cities in the U.S. By studying three geographically and demographically diverse cities, we can draw conclusions about factors at each level of inquiry across study sites, accounting for variation in cities and increasing our ability to generalize findings. By leveraging samples generated by our ongoing projects in each city, we also offer a cost-effective and feasible way to engage in long-term follow-up of hard to reach women, with whom we've already established trust and rapport. In our first aim, we use the Behavioral Model for Vulnerable Populations (BMVP) to explain the natural history of cervical health risk behaviors, screening, and treatment among community-based justice-involved women (N~600) over a 5-year period in three cities. In the second aim, we use a mixed methods approach to unpack the ways in which significant domains of the BMVP operate in the daily lives of a subsample of women (N~60) recruited from the larger sample. Public health significance of this study centers on two products: 1) Development of a multi-level conceptual framework that explains the environment in which justice-involved women engage in cervical cancer prevention. 2) Creation of intervention models that address “upstream” determinants of health in clinical and service settings, while addressing justice-involved women's unique needs.

抽象的有刑事司法历史的女性仍然是受宫颈癌影响最严重的群体之一，其中 4- 与其他女性相比，癌症发病率高出 5 倍。我们的研究团队花费了过去8年的时间调查造成这种差异的因素。我们发现巴氏试验异常率很高，性健康风险、创伤、妇女的生活环境和宫颈健康素养较低是风险的促进因素和护理障碍。但随着时间的推移，涉及正义的女性筛查轨迹仍然存在疑问鉴于复杂的宫颈筛查建议以及与卫生系统对接的困难，应对复杂的健康保险环境。因此，没有足够的信息可以告知解决社区中涉及正义的妇女宫颈癌预防需求的干预措施。本研究的具体目的是更好地了解宫颈癌的自然史社区司法参与妇女的癌症风险和预防行为。长期目标是这项研究的目的是确定在何处以及如何进行干预以改变影响因素和环境的策略。结构女性宫颈健康风险。我们有一个独特的机会进行宫颈健康风险和筛查的自然史研究三个地理和人口不同城市的社区司法参与妇女。我们计划利用三个现有的基于社区、参与正义的女性样本——堪萨斯城、密苏里州、阿拉巴马州伯明翰和加利福尼亚州奥克兰——成为首批长期癌症预防研究之一美国各个城市的高风险女性通过研究三个地理和人口不同的城市，我们可以对跨研究地点的每个调查级别的因素得出结论，并考虑到差异城市并提高我们概括研究结果的能力。通过利用我们正在进行的生成的样本针对各个城市的项目，我们还提供了一种经济高效、可行的方式，对难以解决的问题进行长期跟踪。接触女性，我们已经与她们建立了信任和融洽关系。在我们的第一个目标中，我们使用弱势群体行为模型（BMVP）来解释自然现象社区司法参与人员的宫颈健康风险行为史、筛查和治疗五年内三个城市的女性（N~600）。在第二个目标中，我们使用混合方法来揭示 BMVP 重要领域在女性子样本日常生活中的运作方式 (N~60)从较大样本中招募。这项研究的公共卫生意义集中在两个产品上：1) 开发多层次的产品解释参与正义的妇女参与宫颈癌的环境的概念框架癌症预防。 2) 创建解决健康“上游”决定因素的干预模型临床和服务环境，同时解决涉及司法的妇女的独特需求。

项目成果

期刊论文数量（13）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Sources of Information and Health Care Experiences Related to COVID-19 among Women Involved in Criminal Legal System in Three U.S. Cities.

DOI：
10.31038/awhc.2020351
发表时间：
2020-12
期刊：
Archives of women health and care
影响因子：
0
作者：
Lorvick J;Hemberg J;Cropsey K;Wickliffe J;Faust A;Comfort M;Ramswamy M
通讯作者：
Ramswamy M

Health and Health Service Needs: Comparison of Older and Younger Women with Criminal-Legal Involvement in Three Cities.

卫生和卫生服务需求：比较三个城市的年龄较大和年轻妇女与法律犯罪的参与。

DOI：
10.1177/08982643211025443
发表时间：
2022-01
期刊：
JOURNAL OF AGING AND HEALTH
影响因子：
2.8
作者：
Emerson, Amanda;Lipnicky, Ashlyn;Comfort, Megan;Lorvick, Jennifer;Cropsey, Karen;Smith, Sharla;Ramaswamy, Megha
通讯作者：
Ramaswamy, Megha

Validating self-reported cervical cancer screening among women leaving jails.

验证出狱妇女自我报告的宫颈癌筛查情况。