Geographic and Racial Disparities in Mammography Screening and Barriers to Receiving Care

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PROJECT SUMMARY This K01 proposal entitled “Geographic and Racial Disparities in Mammography Screening and Barriers to Receiving Care” describes the career development and research plan that will be instrumental in the development of Dr. Justin Xavier Moore’s transition into an independent investigator in the field of breast cancer disparity and community-based participatory research. Dr. Moore has a background in epidemiology and cancer prevention and control that includes training in quantitative methods, research design, geospatial analysis, and social epidemiology. However, this grant will provide Dr. Moore with additional needed training in Bayesian methodology and inference, qualitative and mixed-methods, health communication, participant recruitment, and community-participatory research through a combination of courses, independent studies with hands on focus, and mentoring. Dr. Moore’s interdisciplinary mentors include researchers with achievements in breast cancer disparities research, cancer health communication through community-based participatory research, qualitative and mixed methods approaches as indicated through their multiply funded NIH awards. Further, their expertise will provide the necessary support for the career development and research activities of the study proposed in this application by Dr. Moore. The proposed research will provide valuable insight to the field of breast cancer disparities and address key public health questions of relevance to racial and geographic disparities in breast cancer using innovative analytical methods. It will combine Dr. Moore’s expertise in spatial and cancer epidemiology with the mentors’ expertise in large intervention studies on breast cancer, health communication and community-based participatory research, and mixed-methods analysis to understand the individual, interpersonal, community facilitators of mammography screening among minority (Hispanic and Black) women living in the highest risk communities of the United States. The research includes specific aims that be will achieved using interdisciplinary research methods including Bayesian methodology for small-area estimates of mammography screening, semi-structured interviews, and survey research among those recruited within the pilot study. The aims include: (1) identifying areas of low mammography screening among Black and Hispanic women using novel small-area estimation; 2) quantifying a novel index of high-risk counties for breast cancer among Blacks and Hispanics, and 3) performing a pilot study among Black and Hispanic women, stratified among the novel index, to understand the personal, interpersonal, and community barriers on intentions to receiving mammography screening. Through the proposed research the investigator will understand culturally specific barriers and develop a strong rapport within high-risk communities using a community-based approach that will provide a foundation to develop a larger longitudinal study with sustainable interventions.