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

 描述(由申请人提供)：一项旨在解决子宫肌瘤差异的学术-社区合作伙伴关系寻求消除非裔美国妇女(AAW)和拉丁裔妇女在子宫肌瘤方面的显著健康差异。子宫肌瘤或“肌瘤”是一种定义明确的良性子宫平滑肌瘤。肌瘤存在于30%-50%的育龄妇女中，估计到50岁时累积发病率为70%。子宫肌瘤与月经过多、贫血、不孕不育、盆腔疼痛和反复妊娠丢失有关，是美国子宫切除术的主要原因。最近的分析估计，美国每年的子宫肌瘤成本高达340亿美元。我们知道，肌瘤对AAW的影响不成比例，流行病学研究显示，到50岁时，累积发病率接近90%。虽然关于拉丁裔的数据较少，但现有研究表明，拉丁裔女性的患病率也高于高加索女性。这项建议的总体目标是促进社区组织和与AAW和拉丁美洲有联系的利益相关者之间的伙伴关系，以及一个学术医疗中心，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的健康差距。这项工作的结果将具有临床意义，因为我们目前关于当前挑战和最有效的干预措施的数据有限，以减轻受影响最严重的妇女--AAW和拉丁裔妇女的子宫肌瘤负担。我们的建议是创新的，因为它最初提出了社区参与的方法，最终提出了CBPR方法，以创建社区驱动的、因此高度相关的解决子宫肌瘤的议程。据我们所知，到目前为止还没有人试图这样做。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，我们将建立社区-学术合作伙伴关系，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距的知识和感兴趣的领域。目标3将侧重于向社区利益攸关方提供有关子宫肌瘤和健康差距的健康教育和伙伴关系信息，并将向学术利益攸关方提供有关社区适当参与的教育。在目标4中，我们将制定一项合作议程，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距。第三届美国国立卫生研究院关于子宫肌瘤研究进展的国际会议论文集呼吁研究人员使子宫肌瘤患者的研究人群多样化。拟议伙伴关系的成果将为促进非裔美国人和西班牙裔妇女子宫肌瘤健康差异的因素提供初步见解，并为未来的CBPR制定解决这些因素的议程。

 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.