Patient Navigator Video Training for Cancer in Low-Income African Americans

项目摘要/摘要：非洲裔美国人的宫颈癌和结直肠癌死亡率高于任何其他种族或族裔群体。对于导致这些致命癌症发展的癌前病变，存在有效的筛查和治疗方法，但非裔美国人的依从性很低。公共卫生电视台（PHTV）与凯斯综合癌症中心合作，提议通过为患者导航员开发基于视频的培训来增加低收入非裔美国人对这两种癌症的癌前筛查和治疗依从性。病人导航是指利用社区的非专业成员来指导和支持服务不足的人群，通过获得慢性病的筛查和医疗保健的过程。NCI支持将患者导航作为一种手段，帮助服务不足的人群获得更及时的癌症治疗。PHTV将把病人导航的概念与其行之有效的文化特定健康交流过程结合起来，让低收入的非裔美国人参与结肠直肠癌和宫颈癌的二级预防。2个具体目标将实现这一目标。首先，PHTV计划制作系列视频/DVD，培训患者导航员，指导低收入非裔美国患者参与结直肠癌筛查并坚持癌前息肉的随访治疗。其次，PHTV将开发视频/DVD系列内容，培训患者导航员，帮助低收入非洲裔美国妇女了解宫颈癌筛查算法，并遵守与人乳头瘤病毒（HPV）相关的癌前宫颈病变的治疗。PHTV将识别并满足目标群体的信息需求，通过我们经过验证的文化特定生产流程，使用目标人群的成员来设计信息。将举办低收入非洲裔美国人焦点小组和由目前在城市环境中与少数民族患者合作的导航员组成的审查会议，以确定增加参与二级预防活动的障碍和解决办法。一个由综合癌症中心、公共卫生机构和美国癌症协会代表组成的咨询小组将利用基于网络的跟踪系统，在俄亥俄州和纽约哈莱姆区的病人导航员中验证制作和评估视频计划的可行性。这些努力将使PHTV在第二阶段成功启动并测试基于视频的导航员培训项目。低收入非洲裔美国人癌症患者导航员视频培训项目叙事相关性：公共卫生相关性在于开发一种可转让工具的潜力，该工具旨在增加对筛查程序和治疗的参与，以预防因这些疾病死亡率过高的人群中发生侵袭性宫颈癌和结直肠癌。这将降低整个社会的医疗保健费用。

DESCRIPTION (provided by applicant): Project Summary/Abstract: African Americans have the highest death rates from cervical and colorectal cancers than any other racial or ethnic group. Effective screening and treatment exist for the pre-cancerous conditions that lead to the development of these deadly cancers, but there is low adherence among African Americans. Public Health Television (PHTV), in partnership with the Case Comprehensive Cancer Center, proposes to increase screening and treatment adherence for pre-cancerous among low-income African Americans for these 2 cancers by developing video-based training for patient navigators. Patient navigation refers to using lay members of the community to guide and support underserved populations through the process of obtaining screening and medical care for chronic diseases. NCI endorses patient navigation as a means to help underserved populations obtain more timely cancer treatment. PHTV will combine the concept of patient navigation with its proven process of culturally specific health communication to engage low-income African Americans in the secondary prevention of colorectal and cervical cancers. 2 specific aims will accomplish this objective. First, PHTV plans to produce a video/DVD series to train patient navigators to guide low-income African American patients through participating in colorectal cancer screening and adhering to follow up treatment for pre-cancerous polyps. Second, PHTV will develop content for a video/DVD series to train patient navigators to assist low-income African American women with cervical cancer screening algorithms and compliance with treatment for human papillomavirus (HPV) associated pre-cancerous cervical lesions. PHTV will identify and meet target group information needs with our proven culturally specific production process that uses members of the target population to design messages. Focus groups of low-income African Americans and review meetings comprised of navigators currently working with minority patients in urban settings will be conducted to identify barriers and solutions for increasing participation in secondary prevention activities. An Advisory Panel comprised of representatives from comprehensive cancer centers, public health agencies, and the American Cancer Society will validate feasibility of plans to produce and evaluate the videos among patient navigators working across Ohio and in Harlem, New York, using a web-based tracking system. These efforts will enable PHTV to successfully launch and test a video based navigator-training program in Phase II. PATIENT NAVIGATOR VIDEO TRAINING FOR CANCER IN LOW-INCOME AFRICAN AMERICANS Project Narrative Relevance: Public health relevance lies in the potential to develop a transferable instrument designed to increase participation in screening procedures and treatments to prevent invasive cervical and colorectal cancers among a population dying from these diseases at disproportionate rates. This will result in reduced overall health care costs to society.