A Collectivist Approach to Cervical Cancer Screening Among Latinos

拉丁裔和其他少数民族对宫颈癌的筛查不足，并分担不成比例的宫颈癌负担 因这一原因引起的疾病和死亡。有迹象表明，社会支持可以提高筛查率， 但是，提供这种支持的最佳方式以及它所依据的机制并不是 显然是经过研究的。这项K奖将提供进行癌症行为试验所需技能的培训 在服务不足的人群中进行筛查。培训目标是：1)获得必要的技能，以 设计和分析行为干预试验；2)进一步开展与文化相关的社会培训 指导干预设计的生态学和行为学理论；以及3)磨练整合 定性和定量的数据分析。培训目标将通过课程、学院、 研讨会，并指导研究。关于这些目标，研究部分将作为培训。 获得统计技能的基础(纵向、调解和调节分析)，创建 基于定性数据的量化量表，并定性地研究不寻常(“偏差”)的结果 纵向分析。拟议的研究议程将确立集体主义方法的可行性 对同龄人招募的94名拉丁裔妇女进行筛查(“团体访问”)。最终的目标是提炼 在拉丁裔和非洲人中测试这一方法的随机行为试验中使用的程序 我猜测，美国人将更多地遵守筛查指南。具体目标为1) 评估在“新增长领域”(快速增长但仍孤立)的拉丁裔群体访问的可行性 拉丁裔社区)；2)评估团体访问对癌症筛查相关结果的影响 拉丁美洲人使用纵向调查来比较结果并得出点估计，衡量 变异性和影响大小对这些结果的影响；3)探索集体主义者的心理社会基础 通过分析妇女参加集体访问的经历，了解巴氏试验对癌症筛查的指导作用) 开发和试行基于文化的集体主义筛选和社会调查问题 支持，以及b)在纵向分析中阐明主要结果变量中的“异常值”结果。 相关性(请参阅说明)： 如果成功，团体访问方法有可能提供符合文化能力的护理，因此 改善对筛查准则的遵从性，从而预防疾病和死亡，并导致 医疗成本节约。它还将促进自然社会网络和 参加癌症筛查的家庭。

Latinas and other minorities are underscreened for cervical cancer and share a disproportionate burden of disease and death due to this cause. There are indications that social support can improve screening rates, but the best way to deliver such support and the mechanism through which it acts upon have not been clearly studied. This K award will provide training in skills needed to conduct behavioral trials on cancer screening among underserved populations. The training goals are: 1) To acquire the necessary skills to design and analyze behavioral intervention trials; 2) To further develop training in culturally relevant social ecological and behavioral theories to guide intervention designs; and 3) To hone skills in the integration of qualitative and quantitative data analysis. The training goals will be achieved via courses, institutes, workshops, and directed studies. In relation to these goals, the research component will serve as training ground for acquiring statistical skills (longitudinal, mediation and moderation analyses), creating of quantitative scales based on qualitative data, and qualitatively studying unusual ("deviant") results in longitudinal analysis. The proposed research agenda will establish the feasibility of a collectivist approach to screening ("group visits") among 94 Latina women recruited by peers. The ultimate goal is to refine procedures to be used in a randomized behavioral trial to test this approach among Latinas and African Americans, which I hypothesize, will increase adherence to screening guidelines. The Specific Aims are to 1) Assess the feasibility of group visits among Latinas in "new growth areas" (fast growing but still isolated Latino communities); 2) Assess the effect of group visits on cancer screening related outcomes among Latinas using longitudinal surveys to compare outcomes and to derive point estimates, measures of variability and effect sizes on these outcomes; and 3) Explore the psychosocial basis for a collectivist orientation to cancer screening using Pap tests by analyzing women's experiences with group visits to a) develop and pilot test culturally-grounded survey questions regarding collectivist screening and social support, and b) shed light on "outlier" results in main outcome variables in longitudinal analysis. RELEVANCE (See instructions): If successful,the group visit approach has the potential to deliver culturally competent care and therefore improve compliance with screening guidelines, thus preventing disease and deaths and also resulting in healthcare cost savings. It will also advance knowledge in the integration natural social networks and the family in cancer screening.