Using mHealth to investigate intersectionality and health behaviors: Implications for conceptual models and cancer prevention interventions for marginalized populations

使用移动医疗研究交叉性和健康行为：对边缘化人群的概念模型和癌症预防干预措施的影响

• 批准号: 10216028
• 负责人: Lindsey Potter
• 金额: $ 13.83万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10216028
• 关键词: Address; Affect; Behavior; Behavioral; Behavioral Mechanisms; Cancer Prevention Intervention; Cognition; Complex; Data; Development; Discrimination; Disease; Ecological momentary assessment; Emotions; Ethnic Origin; Exposure to; Female; Gender; Goals; Health; Health Technology; Health behavior; Health behavior change; Heterogeneity; Individual; Institutes; Intervention; Knowledge; Link; Longitudinal Studies; Low income; Malignant Neoplasms; Mediating; Mentors; Methodology; Methods; Mission; Modeling; Motivation; Names; Persons; Phase; Population; Population Intervention; Process; Race; Research; Research Design; Risk; Scientific Advances and Accomplishments; Self Efficacy; Shapes; Smoker; Smoking; Social Environment; Socioeconomic Status; Stress; Technology; Time; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Training; Work; adaptive intervention; anticancer research; base; behavior change; cancer risk; comparative efficacy; contextual factors; design; ethnic minority population; experience; health inequalities; improved; innovation; insight; intersectionality; lens; low socioeconomic status; mHealth; marginalized population; negative affect; novel; preventable death; preventive intervention; psychosocial; racial and ethnic; social; social factors; sociodemographics; statistics; stressor; theories; trend

PROJECT SUMMARY/ABSTRACT Tobacco is the leading cause of preventable death and disease and is linked to approximately 20 cancers. The rate of decline of tobacco use has been lower for marginalized populations compared to more privileged groups. Most research on tobacco inequities has examined differences based on a single attribute like race/ethnicity, yet this ignores heterogeneity within groups and how multiple aspects of a person’s identity like their race/ethnicity, socioeconomic status (SES), or gender may interact to shape lived experiences and health behaviors. Intersectionality posits that interconnections among multiple aspects of identity and their interaction with social, and contextual factors can contribute to inequities. This framework is useful for shifting focus from broad sectors of the population to groups with disproportionate health risk. Mobile health methodology (mHealth), such as AutoSense and ecological momentary assessment (EMA), provide real-time objective and subjective assessments of how and when emotions and behaviors change depending on time and context and can inform just-in-time adaptive interventions for populations disproportionately affected by tobacco use. The objective of this proposal is to advance methodological and content knowledge of the utility of intersectionality for examining psychosocial, behavioral, and contextual factors that contribute to tobacco use and cancer inequities. Training goals incorporate tobacco use and health inequities, mHealth methodology, advanced statistics, and professional development. The K99 phase will take place at the Huntsman Cancer Institute and focuses on tobacco use and mechanisms of behavior change (e.g., stress, affect, self-efficacy) in intersectional groups using the existing EMA and AutoSense data of the primary mentor, Dr. David Wetter, who is an expert in mHealth, health inequities, and interventions targeting tobacco behavior change. Training with co-mentors Benjamin Haaland in advanced statistics, Dr. Inbal ‘Billie’ Nahum-Shani in behavioral theory and the development of adaptive interventions, and Dr. Nicole Else-Quest in quantitative intersectionality research will contribute to training goals. The R00 phase will consist of a novel intersectionality study using AutoSense and EMA to investigate the real-time dynamics of intersectional identities with stress, negative affect, self-efficacy, and tobacco use in real-time. This work is innovative because no studies to-date have examined tobacco use inequities using an intersectionality framework, nor have any studies combined this framework with the use of cutting-edge technology like AutoSense and EMA to investigate tobacco use inequities in real-time. This work can directly inform tailored interventions targeting tobacco use behaviors among populations at specific sociodemographic intersections that confer inequitable cancer risk and directly addresses the NCI’s mission to conduct and support cancer research to advance scientific knowledge and help all people live longer, healthier lives.

项目摘要/摘要 烟草是可预防死亡和疾病的主要原因，与大约20种癌症有关。 与更特权的人群相比 组。大多数关于烟草不平等的研究都根据单个属性检查了差异 种族/种族，但这忽略了群体内部的异质性以及一个人身份的多个方面 他们的种族/种族，社会经济地位（SES）或性别可能会互动以塑造现场体验和健康 行为。交叉性认为身份的多个方面之间的互连及 与社会和上下文因素的互动可能导致不平等。该框架对于转移很有用 从广泛的人口部门的关注到具有不成比例的健康风险的群体。移动健康 方法（MHealth），例如自动理和生态瞬时评估（EMA），提供实时 客观和主题评估情感和行为如何以及何时会根据时间而变化 上下文，可以告知及时的自适应干预措施，对人群的影响不成比例 烟草使用。该提案的目的是提高效用的方法论和内容知识 检查有助于烟草的社会心理，行为和上下文因素的交叉性 使用和癌症不平等。培训目标包括烟草使用和健康不平等，MHealth 方法论，高级统计和专业发展。 K99阶段将在Huntsman Cancer Institute举行，重点是烟草使用和 使用现有的相交组的行为改变机制（例如，压力，情感，自我效能感） 主要导师的EMA和AutoSense Data，David Wetter博士，他是MHealth，Health的专家 摄入量和针对烟草行为改变的干预措施。与联合官员本杰明·海拉兰（Benjamin Haaland）培训 在高级统计中，行为理论中的Inbal“ Billie” Nahum-Shani博士和自适应的发展 干预措施和定量交叉性研究中的Nicole Else-Quest将有助于培训 目标。 R00阶段将包括使用AutoSense和EMA进行研究的新型相互作用研究 在压力，负面影响，自我效果和烟草中使用的交叉认同的实时动力学 即时的。这项工作具有创新性 交叉性框架，也没有任何研究将此框架与尖端的使用相结合 像AutoSense和EMA这样的技术可实时研究烟草使用不平等。这项工作可以直接 在特定社会人口统计学的人群中，旨在针对烟草使用行为的量身定制干预措施 涉及不平等癌症风险的交叉点，直接解决了NCI的行为任务和 支持癌症研究以促进科学知识，并帮助所有人生活更长，更健康的生活。