Multidimensional structural racism and moderating role of psychosocial resources on cancer-control behaviors in African Americans

项目摘要 影响非裔美国人的癌症差异深深植根于历史上的社会不公正， 结构性种族主义，住房歧视和歧视，挣扎的教育系统， 贫困众所周知，一个人所居住的社区会对他的生活产生相当大的影响。 他们的健康和健康行为这包括癌症控制行为，癌症发病率的主要驱动因素 and mortality.我们的初步数据表明，社区特征对癌症有独特的影响， 控制非裔美国人个体因素之外的行为。然而，人们对多层次和 结构性种族主义和歧视在预测癌症控制行为方面的纵向影响，以及 保护性社会心理资源的潜在作用。这在非洲裔美国人中尤其如此， 承受着不成比例的癌症负担。该研究将定量测量SRD，评估其 纵向作用的癌症控制行为，并检查调节作用的心理社会资源， 非裔美国成年人在目标1中，我们将构建一个结构性种族主义和歧视指数， 目标2和目标3分析中使用的公开数据。在目标2中，我们将评估相对贡献 历史、长期和当前基于地点的结构性种族主义和歧视的影响 关于癌症控制行为（例如，饮食，吸烟，体力活动，筛查）在非洲的概率样本 美国人从四个焦点国家（N=5000）通过多层次分析。在目标3中，我们将测试调节作用 暴露于SRD和癌症控制行为之间关系的心理社会资源， 非裔美国人研究结果将对政策和社区干预措施产生重要影响， 消除对非裔美国人造成不成比例影响的持续癌症差异。

Project Summary Cancer disparities impacting African Americans are deeply rooted in historical social injustices such as structural racism, housing discrimination and redlining, struggling educational systems, and concentrated poverty. It is well-established that the neighborhood where a person lives can have a considerable impact on their health and health behaviors. This includes cancer control behaviors, a primary driver of cancer incidence and mortality. Our preliminary data suggests that neighborhood characteristics contribute uniquely to cancer control behaviors beyond individual factors in African Americans. However, little is known about multi-level and longitudinal influences of structural racism and discrimination in predicting cancer control behaviors, and the potential role of protective psychosocial resources. This is particularly true among African Americans, who suffer a disproportionate cancer burden. The proposed study will quantitatively measure SRD, evaluate its longitudinal role in cancer control behaviors, and examine the moderating role of psychosocial resources in African American adults. In Aim 1, we will construct an index of structural racism and discrimination from publicly available data for use in the Aims 2 and 3 analysis. In Aim 2, we will evaluate the relative contributions of the impact of historical, long-term, and current place-based exposure to structural racism and discrimination on cancer control behaviors (e.g., diet, smoking, physical activity, screening) in probability samples of African Americans from four focal states (N=5000) via a multilevel analysis. In Aim 3, we will test the moderating role of psychosocial resources in the relationship between exposure to SRD and cancer control behaviors in African Americans. Study findings will have important implications for policy and community interventions to eliminate persistent cancer disparities that disproportionately impact African Americans.