Developing a Culturally Relevant Model of Smoking Cessation among Latinos

描述（由申请人提供）：Yessenia Castro，Ph.D.，是得克萨斯大学健康差异研究系的博士后研究员。安德森癌症中心（MDACC）。她正在通过国家癌症研究所的指导研究科学家发展奖寻求五年的资金，以促进多样性（K 01）。卡斯特罗博士在大卫维特博士的指导下进行研究，研究少数民族和服务不足人群戒烟的社会，人际，个人和文化决定因素。MDACC提供了一个异常丰富的培训环境，包括大量的讲习班，研讨会和课程;发展赠款写作，出版和项目管理技能的绝佳机会;以及协助年轻研究人员的一流资源。 博士卡斯特罗的长期职业目标是在大学环境中担任独立的，以研究为导向的教师，并制定一项研究计划，重点是了解癌症风险行为的文化相关影响，特别关注拉丁美洲人的吸烟问题。这样的计划可以改善针对拉丁美洲人的戒烟干预措施，并最终帮助消除这一人群的健康差距。 在目前的提案中，卡斯特罗博士描绘了四个短期目标，以实现整个奖励期间，旨在作为一个独立的研究生涯的基础。这些是：1）在社会，认知和情感机制和过程中积累了强大的知识基础，这些机制和过程涉及服务不足的成年人群的烟草依赖和戒烟; 2）将她目前对性别和种族/民族的研究知识扩展到癌症预防领域;特别是拉丁美洲人的戒烟; 3）从公共卫生的角度获得文化能力社区水平研究的知识和经验; 4）学习适当的统计方法和建模技术，以评估复杂的纵向数据。这些目标将通过以下方式实现：1）严格的正式课程和指导性阅读; 2）众多的专业发展经验; 3）众多的项目实施，数据分析和手稿写作/出版经验，以及; 4）由具有不同专业知识的高度成功的科学家团队进行密集指导，以便每个导师都可以在实现特定的短期目标方面提供宝贵的指导，但大多数人都能提出不止一个目标的建议。 拟议的研究计划旨在解决现有研究的缺乏，解决拉丁美洲人戒烟的潜在机制。成瘾和健康行为的研究已经确定了一些个人层面的因素，这些因素是戒烟的关键决定因素，包括社会/环境，人际/自我和认知/情感因素。新兴的研究表明，许多已知的戒烟决定因素对少数吸烟者可能同样重要，但在这一领域需要更多的研究，正如几个著名的出版物所指出的那样，包括外科医生报告和治疗烟草使用和依赖临床实践指南。此外，除了涉及文化适应对吸烟流行率影响的数据外，几乎不知道文化适应和其他文化相关变量的影响（例如，文化适应压力，感知歧视）对戒烟过程的影响。因此，拟议的项目将利用来自三个拉丁美洲吸烟者的纵向研究的数据，研究文化相关因素对戒烟机制的影响。该项目的最终目标是开发和评估一个全面的概念模型，将文化因素与戒烟机制联系起来，该模型由以前的工作提供信息，这些工作涉及文化对身心健康的影响，社会经济地位对健康的影响以及成瘾行为的理论。此外，该项目还将使用科学生态瞬时评估技术收集的数据来评估具体的细粒度假设。

DESCRIPTION (provided by applicant): Yessenia Castro, Ph.D., is a postdoctoral fellow in the Department of Health Disparities Research at the University of Texas M.D. Anderson Cancer Center (MDACC). She is seeking five years of funding through the National Cancer Institute's Mentored Research Scientist Development Award to Promote Diversity (K01). Dr. Castro conducts research examining social, interpersonal, intrapersonal, and cultural determinants of smoking cessation in minority and underserved populations under the mentorship of Dr. David Wetter. MDACC provides an unusually rich training environment that includes an extraordinary number of workshops, seminars, and courses; outstanding opportunities for developing skills in grant writing, publication, and project management; and superb resources for assisting young investigators. Dr. Castro's long term career goals are to serve as an independent, research-oriented faculty member in a university environment, and to develop a program of research focused on understanding culturally relevant influences of cancer risk behaviors, with a particular focus on smoking among Latinos. Such a program could improve smoking cessation interventions tailored for or targeted at Latinos, and ultimately aid in eliminating health disparities among this population. In the current proposal, Dr. Castro delineates four short term goals to be achieved throughout the award period that are intended to serve as the foundation for an independent research career. These are: 1) accumulate a strong knowledge base in the social, cognitive, and affective mechanisms and processes involved in tobacco dependence and cessation among underserved adult populations; 2)extend her current knowledge of research on gender and race/ethnicity into the area of cancer prevention; particularly, smoking cessation among Latinos; 3) gain knowledge and experience in culturally competent community level research from a public health perspective, and; 4) learn the appropriate statistical methods and modeling techniques for evaluating complex longitudinal data. These goals will be achieved through a combination of: 1) rigorous formal coursework and directed readings; 2) numerous professional development experiences; 3) numerous project implementation, data analysis, and manuscript writing/publication experiences, and; 4) intensive mentoring by a team of highly successful scientists with diverse expertise, such that each mentor can provide invaluable guidance in achieving a specific short term goal, but most can advise about more than one goal. The proposed research plan seeks to address the paucity of existing research addressing the mechanisms underlying smoking cessation among Latinos. Research in addictions and health behavior has identified a number of individual-level factors that are key determinants of smoking cessation including social/environmental, inter-/intrapersonal, and cognitive/affective factors. Emerging research suggests that many of the known determinants of smoking cessation may be of equal importance to minority smokers, but more research is needed in this area, as noted by several prominent publications including the Surgeon General's Report and the Treating Tobacco Use and Dependence Clinical Practice Guideline. Further, with the exception of data addressing the influence of acculturation on smoking prevalence, almost nothing is known about the effect of acculturation and other culturally relevant variables (e.g., acculturative stress, perceived discrimination) on the process of smoking cessation. Thus, the proposed project will utilize data from three longitudinal studies of Latino smokers to examine the impact of culturally relevant factors on mechanisms of smoking cessation. The ultimate goal of this project is to develop and evaluate a comprehensive conceptual model linking cultural factors to mechanisms of smoking cessation that is informed by previous work addressing the impact of culture on mental and physical health, socioeconomic status influences on health, and theories of addictive behaviors. Additionally, the project will evaluate specific, fine-grained hypotheses using data collected with state-of-the-science ecological momentary assessment techniques.