PROJECT 1

在纽约市，年轻人(20-39岁)癌症发病率的上升速度目前超过了增长速度。 在美国其他地区(每10万人中有96.9人与89.5人)。然而，纽约的癌症负担并不相同 分布式的。在纽约市最贫穷的社区，宫颈癌等可预防癌症的发病率为73% 与最富裕的社区相比，这一比例更高。这种差距的大小超过了与之相关的 有黑人、西班牙裔或居住在农村县的人，在以前的基于人口的记录中 研究美国。相反，很可能是这些社区持续的贫困导致了癌症差异。 尽管有这些已知的事实，但关于多层次和多代人方法的研究仍然有限 解决持续贫困对青年和青年当前和未来癌症风险行为的影响。 在学校进行有效的癌症教育干预可以显著影响促进健康的意图和 年轻人的癌症危险行为。到目前为止，大多数基于学校的干预研究都是有限的。这个 在美国人口最多的城市纽约市，对这项研究的需求尤为突出，该市有近2 百万18岁以下的纽约人。回应RFA-CA-22-015持续贫困中的癌症控制研究 本申请分两波随机抽取纽约市共10所学校(n=906名学生)，超过2人 几年后，立即与延迟(等待名单对照)进行为期六周的癌症教育和社会正义干预 由训练有素的课堂科学教师授课。干预以自决和青年为导向 赋权理论，因此它将利用青年的自然愿望，成为有社会意识的、独立自主的 能够有效地推动社会变革的个人。干预的目的是：1)提高学生的学习意向 在下个月至少进行一项促进健康的行为(例如，少喝或不喝含糖饮料) 作为实际行为变化的预测指标；以及2)增加学生和学生之间的癌症风险沟通 一位家长。此外，我们还将探讨癌症风险沟通增加对健康促进的影响 家庭中至少有一位父母或成年照顾者的行为。将对学生进行评估 在基线、6周和24周。家长将在课程实施后6周进行评估，然后 同样是在24周的时候。如果有效，我们的务实方法为整合癌症提供了一个框架 以社会公正为视角的教育干预更广泛地进入纽约市公立学校，这是最大的公立学校 在这个国家的系统中。这一计划将产生深远的影响，使青少年获得知识 这不仅可以降低弱势青年未来的癌症发病率，还可以促进更健康的行为 在家庭内部。

The rise in cancer incidence among younger adults (ages 20-39) in NYC is currently outpacing the increase across the rest of the US (96.9 vs. 89.5 per 100,000). However, the burden of cancer in NYC is not equally distributed. In NYC's poorest neighborhoods, the rates of preventable cancers, such as cervical cancer, is 73% higher compared to the wealthiest neighborhoods. The magnitude of this disparity exceeds those associated with Black race, Hispanic ethnicity, or residence in a rural county documented in a previous population-based study of the US. Rather, it is likely the persistent poverty in these neighborhoods that drives cancer disparities. Despite these known facts, there remains limited research on multi-level and multi-generational approaches that address the impact of persistent poverty on youth and young adults' current and future cancer risk behaviors. Effective cancer education interventions in schools could significantly impact health-promoting intentions and cancer risk behaviors in younger adults. To date, most school-based intervention studies have been limited. The need for this research is especially salient in NYC, the most populous city in the United States, with nearly 2 million New Yorkers under 18. In response to RFA-CA-22-015 Cancer Control Research in Persistent Poverty Areas, this application in randomize a total of 10 new York City schools (n=906 students) in two waves, over 2 years, to an immediate vs delayed (wait list control) six-week cancer education and social justice intervention delivered by trained classroom science teachers. The intervention is guided by the Self-Determination and youth empowerment theory, thus it will leverage the natural desire of youth to be socially conscious, autonomous individuals who can be effective agents of social change. The intervention aims to: 1) increase students’ intention to engage in at least one health-promoting behavior (e.g., drink less or no sugary beverages) in the next month as a predictor of actual behavior change; and 2) increase cancer risk communication between the student and a parent. Additionally, we will explore the impact of increased cancer risk communication on the health-promoting behaviors of at least one parent or adult caregiver in the household. Assessments of students will be conducted at baseline, 6 and 24 weeks. Parents will be assessed 6 weeks after implementation of the curricula and then again at 24 weeks. If effective, our pragmatic approach provides a framework for integrating a cancer education intervention with a social justice lens more broadly into NYC public schools, the largest public school system in the country. This program will have far-reaching effects, empowering adolescents with knowledge that can not only mitigate future cancer incidence of vulnerable youth but also promote healthier behaviors within families.