Building Bridges, Breaking Barriers: An Academic-Community Partnership to Address Disparities in Uterine Fibroids

 描述（由申请人提供）：一个学术-社区伙伴关系，以解决子宫肌瘤的差异，旨在消除非洲裔美国妇女（AAW）和拉丁美洲妇女之间的子宫肌瘤的重大健康差距。子宫平滑肌瘤或“肌瘤”是明确的，良性平滑肌肿瘤的子宫。纤维瘤存在于30%-50%的育龄妇女中，并且到50岁时估计累积发病率为70%。子宫肌瘤与月经过多、贫血、不孕、盆腔疼痛和复发性流产有关，是美国子宫切除术的主要原因。最近的分析估计，在美国，肌瘤的成本每年高达340亿美元。我们知道肌瘤不成比例地影响AAW，流行病学研究显示，到50岁时累积发病率接近90%。虽然拉丁裔的数据较少，但现有的研究表明，拉丁裔妇女的患病率也高于白人妇女。该提案的总体目标是促进社区组织和利益相关者与AAW和拉丁美洲人以及学术医疗中心之间的伙伴关系，该中心将被授权创造性地和有机地研究如何使用基于社区的参与性研究（CBPR）方法来解决子宫肌瘤中的健康差异。这项工作的结果将具有临床意义，因为我们目前对当前挑战和最有效的干预措施的数据有限，以减少受影响最严重的女性-AAW和拉丁裔妇女的子宫肌瘤负担。我们的建议是创新的，因为它提出了最初的社区参与，最终CBPR方法，以创建一个社区驱动的，因此高度相关的，解决子宫肌瘤的议程。据我们所知，迄今尚未尝试这样做。我们建议在三年的资助期内实现以下具体目标：对于目标1，我们将建立一个社区-学术伙伴关系，以发展对子宫肌瘤健康差异进行CBPR的能力。在目标2中，我们将确定社区对子宫肌瘤和相关健康差异的了解和兴趣领域。目标3将侧重于向社区利益攸关方提供关于子宫肌瘤和健康差距的健康教育和伙伴关系信息，并将为学术利益攸关方提供关于适当社区参与的教育。在目标4中，我们将制定一个合作议程，旨在维持伙伴关系，并通过CBPR研究确定，量化并最终减少子宫肌瘤的健康差异。第三届国立卫生研究院国际子宫肌瘤研究进展大会的会议记录呼吁研究人员使子宫肌瘤患者的研究人群多样化。从拟议的伙伴关系的输出将提供初步了解的因素，促进子宫肌瘤的健康差距之间的非洲裔美国人和西班牙裔妇女，并设置一个议程，为未来的CBPR，以解决这些因素。

 DESCRIPTION (provided by applicant): An Academic-Community Partnership to Address Disparities in Uterine Fibroids seeks to eradicate the significant health disparities in uterine fibroids amongst African- American women (AAW) and Latinas. Uterine leiomyomas or "fibroids" are well-defined, benign smooth muscle tumors of the uterus. Fibroids are present in 30%-50% of reproductive-age women and have an estimated cumulative incidence of 70% by age 50 years. Fibroids are associated with menorrhagia, anemia, infertility, pelvic pain, and recurrent pregnancy loss, and are the leading cause of hysterectomy in the United States. Recent analyses estimate the cost of fibroids in the U.S. to be as high as $34 billion annually. We know that fibroids disproportionately affect AAW, with epidemiological studies showing cumulative incidence approaching 90% by the age of 50 years. While there are fewer data on Latinas, the available studies show an increased prevalence in Latinas versus Caucasian women as well. The overall objective of this proposal is to facilitate a partnership between community organizations and stakeholders with ties to AAW and Latinas and an academic medical center that will be empowered to creatively and organically study ways to address health disparities in uterine fibroids using a community-based participatory research (CBPR) approach. The results of this work will be clinically significant, as we currently have limited data on the current challenges and most effective interventions to reduce the burden of uterine fibroids in women who are most affected-AAW and Latinas. Our proposal is innovative in that it proposes initially community-engaged and ultimately CBPR approaches to create a community-driven, and therefore highly relevant, agenda for addressing uterine fibroids. To our knowledge, this has not been attempted to date. We propose the following specific aims to be pursued over a three-year grant period: For Aim 1, we will establish a community-academic partnership that will develop the capacity to conduct CBPR on health disparities in uterine fibroids. In Aim 2, we will identify the communities' knowledge of and areas of interests regarding uterine fibroids and related health disparities. Aim 3 will focus on the provision of health education and partnership information to community stakeholders on both uterine fibroids and health disparities and will provide education for academic stakeholders on appropriate community engagement. In Aim 4, we will develop a collaborative agenda that will be designed to sustain the partnership as well as identify, quantify, and ultimately reduce health disparities in uterine fibroids via CBPR research. The Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research called on researchers to diversify study populations of fibroid patients. The output from the proposed partnership will provide initial insight into the factors that promote uterine fibroid health disparities amongst African-American and Hispanic women and set an agenda for future CBPR to address these factors.