Reducing Oral Health Disparities: Early Detection of Oral Cancer

美国卫生局局长最近的报告记录了健康差距人口经历了 口腔和咽癌的负担不成比例。这些癌症的预后特别差。 在黑人/非裔美国人男性5年存活率最低的晚期被发现 这一比例仅为21%。尽管如此，关于以社区为基础的干预的有效性的研究很少 用于早期检测口腔恶性和癌前病变或有关成分的特定信息 在这样的晋升中所需要的。这个翻译项目的第一个目标将测试 促进口腔和咽癌筛查的社区媒体干预的组成部分， 基于城市黑人/非裔美国成年人的视角开发的，将推广到农村环境。 活动信息和媒介将使用细化的原则进行提炼和测试 使用针对更多农村黑人/非裔美国人居民的一系列焦点小组的似然性模型 佛罗里达州中北部的各县。一旦完成，我们将测试这种量身定做的干预措施的效果 采用对照组职前设计。在具体目标2中，我们将检验这样的假设，即这种干预将 增加口腔和咽部癌症及其主要危险因素的知识，提高对口腔和咽部的认识 癌症筛查、感知易感性，并在干预中减少感知的护理障碍 社区与对照社区相比。我们还将测试这些变量的变化是否会 在黑人/非裔美国人中更大，这是为其制定干预措施的群体。特定目标 3将测试干预前后的情况，以增加两人之间口腔和咽癌的接受率 对2000名受试者进行长达3年的跟踪调查。此外，我们还将推广和提供 在干预社区和对照社区进行一系列免费口腔和咽癌筛查 衡量参加免费筛查的目标人群比例的差异 干预后。这项研究将有效的干预扩展到一个特定的健康差距人群，农村 黑人/非裔美国人，并致力于促进对恶性肿瘤和癌前病变的早期诊断 口腔损伤。本课题的研究将为今后的口试设计提供有益的参考。 促进咽癌筛查或其他预防性或早期干预相关行为 最终目标是改善口腔健康，减少或消除健康差距。

The recent U.S. Surgeon General's Report documented that health disparity populations experience a disproportionate burden of oral and pharyngeal cancer. The prognosis of these cancers is particularly poor when they are detected at a late stage with Black/African American males having the lowest 5-year survival rate of only 21%. Despite this, there is little research on the effectiveness of community-based interventions for early detection of malignant and pre-malignant oral lesions or specific information about components needed in such a promotion. The first aim of this translational project will test the extent to which components of a community-based media intervention promoting oral and pharyngeal cancer screening, developed based on perspectives of urban Black/African American adults, will generalize to a rural setting. The campaign messages and medium will be refined and tested using the principles of the Elaboration Likelihood Model using a series of focus groups targeting Black/African American residents of more rural counties of North Central Florida. Once this is completed, we will test the efficacy of this tailored intervention using a control group pre-post design. In specific aim 2, we will test the hypothesis that this intervention will increase knowledge of oral and pharyngeal cancer, its major risk factors, awareness of oral and pharyngeal cancer screenings, perceived susceptibility, and also reduce perceived barriers to care in an intervention community compared to the control community. We will also test whether the change in these variables will be greater among Black/African Americans, the group for which the intervention was developed. Specific aim 3 will test for a pre- to post-intervention to increase the receipt of an oral and pharyngeal cancer among two samples of 2000 subjects who will be followed for up to 3 years. In addition we will promote and offer a series of free oral and pharyngeal cancer screening at both intervention and control communities and measure differences in the proportion of the target population that participates in a free screening pre- and post-intervention. This study extends an efficacious intervention to a specific health disparity population, rural Black/African American men, and addresses the promotion of early diagnosis of malignant and premalignant oral lesions. This project will provide useful information for the design of future oral and pharyngeal cancer screening promotions or other preventive- or early intervention-related behaviors with the ultimate goal of improving oral health and reducing or eliminating health disparities.