Partners in Action: A UM/ Little Haiti Collaborative United Against Breast Cancer

描述（由申请人提供）：“行动伙伴”，或Patne an Aksyon在海地克里奥尔语，代表了迈阿密西尔维斯特综合癌症中心（UM SCCC）和主要的海地美国社区组织在迈阿密，佛罗里达大学之间的校园社区伙伴关系。这一伙伴关系旨在减轻生活在迈阿密大都市地区的海地裔美国妇女在乳腺癌发病率和死亡率方面的过重负担。与迈阿密的其他种族/少数民族和移民人口相比，海地妇女更有可能因乳腺癌而致残和死亡，这在很大程度上取决于她们诊断时的疾病阶段。海地妇女通常被诊断为晚期乳腺癌（III期和IV期），预后很差。以前的研究没有研究为什么海地美国妇女出现晚期乳腺癌，尽管这个人口亚组在南佛罗里达越来越重要。因此，Patne an Aksyon社区咨询委员会（CAB）决定为此进行研究。我们建议进行一项为期两年的研究，以确定可能导致海地美国妇女乳腺癌晚期表现夸大的决定因素。我们将使用三种互补的方法来确定这些决定因素。民族志是第一种方法，将用于绘制“小海地”的社会和地理边界，“小海地”是迈阿密的一个主要海地社区。我们将利用这些信息为拟议研究中采用的另外两种方法-快速评估调查和深入访谈-制定抽样框架。快速评估调查将用于记录小海地使用乳房X光检查的普遍程度，并确定一生中从未接受过筛查或筛查频率低于国家准则建议的每一至两年一次的妇女的特征。深入访谈，反过来，将提供有关障碍的信息，以筛查和后续行动的乳房异常在南佛罗里达海地社区。所有数据都将由社区卫生工作者（CHW）收集，他们是小海地的土著，能说流利的海地克里奥尔语，并接受过进行民族志社区绘图、快速评估调查和深入访谈的培训。使用CHW收集数据将有助于确保研究的成功。这些人对小海地、社区习俗和文化规范有着深入的了解。我们的主要目标是了解为什么海地妇女经历过多的乳腺癌死亡率，并利用这种理解来指导未来的研究和干预措施，以缩小这种差距。

DESCRIPTION (provided by applicant): "Partners in Action," or Patne an Aksyon in Haitian Creole, represents a campus-community partnership between the University of Miami Sylvester Comprehensive Cancer Center (UM SCCC) and key Haitian American community-based organizations in Miami, Florida. This partnership aims to alleviate the excess burden of breast cancer morbidity and mortality experienced by Haitian American women living in the Miami metropolitan area. When compared to other racial/ethnic minorities and immigrant populations in Miami, Haitian women are more likely to suffer disability and death from breast cancer, largely as a function of their stage of disease at diagnosis. Haitian women are typically diagnosed with late-stage breast cancer (Stages III and IV) when the prognosis for survival is poor. Previous research has not examined why Haitian American women present with late-stage breast cancer, despite the growing importance of this population sub-group within South Florida. Thus, the Community Advisory Board (CAB) for Patne an Aksyon decided to undertake research toward this end. We propose a two-year study to identify the determinants that may account for the exaggerated late-stage presentation of breast cancer among Haitian American women. We will identify such determinants using three complementary methodologies. Ethnography, the first methodology, will be used to map the social and geographic boundaries of "Little Haiti," a predominately Haitian neighborhood in Miami. We will use this information to develop sampling frames for the rapid assessment surveys and in-depth interviews, the other two methodologies to be employed in the proposed study. The rapid assessment surveys will be used to document the prevalence of mammography use within Little Haiti, as well as to identify characteristics of women who have never been screened in their lifetime or are screened less frequently than every one to two years as is recommended by national guidelines. The in- depth interviews, in turn, will provide information about barriers to screening and follow-up for breast abnormalities within the South Florida Haitian community. All data will be collected by Community Health Workers (CHWs) who are indigenous to Little Haiti, fluent in Haitian Creole, and trained to perform ethnographic community mapping, rapid assessment surveys and in-depth interviews. Using CHWs to collect data will help ensure the study's success. These individuals have intimate knowledge of Little Haiti, community customs, and cultural norms. Our primary objective is to inform understanding of why Haitian women experience excess breast cancer mortality, and to use such understanding to direct future research and intervention initiatives to attenuate this disparity.