Pilot Project I: Intervention to Increase Cervical Cancer Screening among Pacific Islanders Living in Guam and Hawaii

试点项目一：加强居住在关岛和夏威夷的太平洋岛民宫颈癌筛查的干预措施

• 批准号: 9163116
• 负责人: LILNABETH SOMERA
• 金额: $ 3.34万
• 依托单位: UNIVERSITY OF GUAM
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9163116
• 关键词: 21 year old; Address; Advanced Malignant Neoplasm; Affect; Area; Attitude; Behavior; Belief; Biostatistics Shared Resource; Cancer Burden; Cancer Center; Car Phone; Cervical Cancer Screening; Communities; Community Outreach; Diagnosis; Disease; Economics; Effectiveness; English Language; Environment; Family; Federated States of Micronesia; Future; Goals; Guam; Hawaii; Health Care Costs; Health Promotion; Health Services; Health Status; Healthcare Systems; Healthy People 2020; Human Resources; Incidence; Indigenous; Information Technology; Intention; Intervention; Knowledge; Language; Lead; Life; Mainstreaming; Malignant neoplasm of cervix uteri; Marshall Islands; Methods; Micronesia; Mission; Morbidity - disease rate; Nomads; Outcome; Pacific Island Americans; Participant; Pilot Projects; Population; Populations at Risk; Prevalence; Randomized; Research Project Grants; Risk; Services; Social Welfare; Societies; Staging; Target Populations; Testing; Text; Textiles; Transportation; Treatment Efficacy; United States; Universities; Ursidae Family; Woman; Women' s Group; Work; abstracting; base; cancer health disparity; community based participatory research; cost; design; disorder prevention; experience; health care availability; health equity; health literacy; high risk; improved; mortality; neoplasm registry; peer; post intervention; programs; screening; secondary outcome

Project Summary/Abstract Pilot 1 is a 3 year hypothesis-driven research project aimed at decreasing cervical cancer screening disparities in Chuukese and Marshallese Pacific Islander women. This group of women has among the highest incidence rates of cervical cancer in the world (79.7 per 100,000 and 42.4 per 100,000 (2007-2011)) in the Republic of the Marshall Islands (RMI) and Pohnpei, Federated States of Micronesia (FSM) respectively, compared to 9.9 per 100,000 women in the US(1). Therefore, identifying culturally appropriate methods to increase screening for this preventable disease is essential for these women and the welfare of their family. Prior work has persuaded us that text messaging on mobile phones is an effective method for reaching this population of Pacific Islanders. Pilot Project 1 has three objectives: 1) to understand the knowledge, attitudes, and beliefs of Micronesian Pacific Islander migrant populations that affect cervical cancer screening behavior; 2) to develop SMS (Short Message Service) strategies that will lead to increased screening rates in the target populations; 3) to support an environment for community-based participatory research and engagement for this study. Target Population: The intervention will focus on women ages 21-65 (inclusive) from two migrant groups of Pacific Islanders who bear a disproportionate burden of cervical cancer morbidity and mortality: 1) the indigenous Chuukese women of the Federated States of Micronesia (FSM) who recently migrated to GU and 2) women from the RMI who recently migrated to HI. The overarching goal of the project is to evaluate the effectiveness of community-based SMS strategies to increase cervical cancer screening rates in underserved Pacific Islander populations who have migrated to GU and HI within the last 5 years. Specific Aim 1 Evaluate the effectiveness of community-based SMS strategies to increase cervical cancer screening rates in underserved indigenous Chuukese and Marshallese populations who have migrated to GU and HI within the last 5 years Aim 1.1: Develop SMS messaging materials encouraging cervical cancer screening in three languages: English, Chuukese and Marshallese. Aim 1.2: Implement a randomized delayed control intervention to assess the effectiveness of SMS to increase completion of cervical cancer screening among Marshallese in HI and Chuukese in GU. Hypothesis: Cervical cancer screening completion will be higher for recently migrated (2007-2014) Chuukese and Marshallese women, ages 21-65, who received the peer-led, SMS-based intervention compared to those who did not receive the intervention. The efficacy of the intervention will be assessed by comparing the prevalence of completion of cervical cancer screening between the two randomized groups in an intention-to-treat analysis at 9 months post- randomization; we will also compare the change in these outcomes before and after intervention in women across both randomized groups. As a secondary outcome, intent to screen will be tracked; the study participants who intend to obtain cervical cancer screening following the intervention but ultimately do not receive cervical cancer screening to understand what other factors, such as transportation, cultural barriers, or a low priority of screening, influence their completion of cervical cancer screening. Knowledge these barriers will be used to develop and design a more robust cervical cancer screening program in the future. SMS health messages directed to this population may be an effective method to reach these culturally isolated and vulnerable Pacific Islander populations. The pilot project will support the overall goals of the Comprehensive Partnership to Advance Cancer Health Equity (CPACHE) by focusing on decreasing the disparity in cancer burden in under-served Pacific Islanders in HI and GU. The pilot will draw support from the Community Outreach Core (COC) and Shared Resources (Biostatistics, Information Technology and Cancer Registry). Pilot project personnel are well-versed in working with Pacific Islander community coalitions, and with the implementation of CBPR within these communities. This design is consistent with the mission and overarching goals of Healthy People 2020 and its Community-Based Objectives to expand culturally relevant approaches to health promotion and disease prevention (www.healthypeople.gov). Most importantly, this project addresses an urgent need to act to reduce the extremely high risk for cervical cancer, which is a preventable disease, in at-risk under-served Pacific Islander women.

项目总结/摘要 试点1是一个为期3年的假设驱动的研究项目，旨在减少宫颈癌筛查的差异 在楚科奇和马绍尔群岛的太平洋岛民妇女中。这组妇女的发病率最高， 2007-2011年世界宫颈癌发病率（每10万人79.7例和每10万人42.4例） 马歇尔群岛（马绍尔群岛）和波恩佩、密克罗尼西亚联邦（密克罗尼西亚联邦）分别为9.9 在美国，每10万名妇女（1）。因此，确定文化上适当的方法来增加筛查， 因为这种可预防的疾病对这些妇女及其家庭的福利至关重要。以前的工作有 说服我们，在移动的手机上发短信是一种有效的方法， 太平洋岛民。试点项目1有三个目标：1）了解知识，态度和信念， 太平洋岛民移民人口影响宫颈癌筛查行为; 2）发展 SMS（短信息服务）战略，将导致目标人群的筛查率增加; 3） 支持以社区为基础的参与性研究和参与这项研究的环境。目标 人口：干预措施将侧重于来自太平洋岛屿两个移民群体的21-65岁（含21-65岁）妇女。 在宫颈癌发病率和死亡率方面承受不成比例负担的岛民：1）土著居民 最近移民到关岛的密克罗尼西亚联邦楚克族妇女和2）妇女 刚移民到夏威夷的马绍尔人 该项目的首要目标是评估以社区为基础的短信服务战略的有效性， 提高移民到关岛的得不到充分服务的太平洋岛民的宫颈癌筛查率 在过去的五年里， 具体目标1评估以社区为基础的SMS策略对增加宫颈癌的有效性 移民到关岛的得不到充分服务的楚克人和马绍尔人的筛查率 在过去的5年里， 目标1.1：以三种语文编写鼓励宫颈癌筛查的短信材料： 英语、楚克语和马绍尔语。 目的1.2：实施随机延迟对照干预，以评估SMS增加 在HI完成对马绍尔人和在GU完成对Chuukese人的宫颈癌筛查。 假设：最近移民的楚克人（2007-2014年）完成宫颈癌筛查的比例较高 年龄在21-65岁之间的马绍尔妇女，与那些接受同伴领导的，基于短信的干预的妇女相比， 他们没有接受干预。 干预措施的有效性将通过比较完成宫颈癌的患病率进行评估 在治疗后9个月的意向治疗分析中，两个随机化组之间的筛选 随机分组;我们还将比较女性干预前后这些结果的变化 在两个随机组中。作为次要结局，将跟踪筛选意图;研究 参与者打算在干预后接受宫颈癌筛查，但最终没有 接受宫颈癌筛查，了解其他因素，如交通，文化障碍，或 筛查优先级低，影响其完成宫颈癌筛查。了解这些障碍 将用于制定和设计一个更强大的宫颈癌筛查计划在未来。 针对这一人群的短信健康信息可能是一种有效的方法，以达到这些文化隔离 脆弱的太平洋岛民该试点项目将支持联合国的总体目标， 全面伙伴关系，以促进癌症健康公平（CPACHE），重点是减少 在HI和GU中，服务不足的太平洋岛民的癌症负担存在差异。飞行员将得到 社区外展核心（COC）和共享资源（生物统计学，信息技术和癌症 登记处）。试点项目人员精通与太平洋岛民社区联盟的合作， 在这些社区内实施CBPR。这种设计符合使命， 《2020年健康人》的总体目标及其基于社区的目标， 促进健康和预防疾病的方法（www.healthypeople.gov）。最重要的是这 该项目解决了采取行动降低宫颈癌极高风险的迫切需要， 可预防的疾病，在面临风险的服务不足的太平洋岛民妇女。