A mixed methods study examining early onset anal cancer and current screening practices, attitudes, and perceived risk among people living with and without HIV in the Deep South

项目摘要/摘要 拟议的F31申请的目的是支持Anna Junkins女士(PI)进行研究、培训和 在她的流行病学博士培训期间，她在成为独立癌症的轨迹上的发展 研究员。这项拟议研究的主要目标是1)确定早发性肛门癌的预测因素 (&lt；确诊时50岁)，以及2)利用混合方法研究(MMR)方法来识别和解释 年男性HIV感染者及其提供者接受肛门癌筛查的相关因素 南方腹地。第一个目标是确定早发性肛门癌的预测因素，这些人在 阿拉巴马大学伯明翰分校(UAB)医院。UAB的电子健康记录(EHR)提供了详细的 人口统计、临床和社会行为数据，将在统计分析中使用，以预测早期 罹患癌症。接下来，使用MMR方法，目标2和目标3将识别和解释障碍和促进者 进行肛门癌筛查，了解MLHIV感染者及其家属对筛查和感知风险的态度 医疗保健提供者。中期监测方法的量化部分(目标2)将包括对调查数据的分析。 从UAB 1917年的临床队列数据库中确定筛查的预测因素。在目标2中的数据分析之后， 将开发一份深入访谈(IDI)指南，以解释目标3中筛查摄取的预测因素。 定性目标将包括数据在目标2中进行分析的患者亚群中的IDI，以及 UAB 1917诊所的医疗保健提供者(医生和护士从业者)。国际开发机构将致力于进一步 了解对筛查的态度、筛查的历史、筛查的障碍和促进者以及感知的风险。 拟议研究的长期目标是改善艾滋病毒携带者(PLHIV)和那些 通过1)通知国家肛门癌筛查指南，最有可能患早发性肛门癌 确定早发性肛门癌的风险因素；以及2)确定和解释患者水平和提供者- 在南方腹地对艾滋病毒感染者进行筛查的促进者和障碍。 主要培训目标包括：1)增加利用电子病历的知识和经验，以 回答有关早发性肛门癌的复杂研究问题；2)获得应用MMR认证 在南方艾滋病毒感染者中早期发现和筛查肛门癌；以及3)增加专门知识和 独立从事癌症预防和控制研究。拟议培训的总体目标是准备 Anna Junkins女士在PLHIV癌症早期检测方面的独立研究有很强的基础。 。

PROJECT SUMMARY/ABSTRACT The purpose of the proposed F31 application is to support Ms. Anna Junkins (PI) in research training and development during her PhD training in Epidemiology on her trajectory to becoming an independent cancer researcher. The primary goals of the proposed research are 1) to identify predictors of early onset anal cancer (<50 years of age at diagnosis), and 2) utilize a mixed methods research (MMR) approach to identify and explain factors associated with anal cancer screening uptake among men living with HIV (MLHIV) and their providers in the Deep South. The first Aim will identify predictors of early onset anal cancer who have received care at the University of Alabama at Birmingham (UAB) Hospital. Electronic health records (EHR) at UAB provide detailed demographic, clinical, and socio-behavioral data which will be used in the statistical analyses to predict early onset cancer. Next, using a MMR approach, Aim 2 and Aim 3 will identify and explain barriers and facilitators to anal cancer screening, and explore attitudes about screening and perceived risk among MLHIV and their healthcare providers. The quantitative part of the MMR approach (Aim 2) will include analysis of survey data from UAB’s 1917 Clinic cohort database to identify predictors of screening. Following the data analysis in Aim 2, an in-depth interview (IDI) guide will be developed to explain predictors of screening uptake in Aim 3. This qualitative Aim will include IDI among a subpopulation of patients whose data was analyzed in Aim 2, and healthcare providers (physicians and nurse practitioners) at the UAB 1917 Clinic. The IDIs will aim to further explore attitudes about screening, history of screening, barriers and facilitators to screening, and perceived risk. The long-term goal of the proposed research is to improve the lives of people living with HIV (PLHIV) and those most at risk for early onset anal cancer by informing national anal cancer screening guidelines through 1) identifying risk factors of early onset anal cancer; and 2) identifying and explaining patient-level and provider- level facilitators and barriers to screening among PLHIV in the Deep South. The primary training goals include: 1) increase knowledge and experience in the utilization of EHR to answer complex research questions regarding early onset anal cancer; 2) gain certification in applied MMR in early detection and screening of anal cancer among PLHIV in the South; and 3) increase expertise and independence in cancer prevention and control research. The overall goal of the proposed training is to prepare Ms. Anna Junkins with a strong foundation for independent research in early detection of cancer among PLHIV. .