Caribbean Investigation of Cancer Stigma and its effect on Cervical Cancer Screening and HPV Vaccination

加勒比癌症耻辱调查及其对宫颈癌筛查和 HPV 疫苗接种的影响

基本信息

批准号：
10406126
负责人：
STEVEN Terry ROSEN
金额：
$ 21.96万
依托单位：
BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2021-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10406126
关键词：
Address Administrative Supplement Adolescent Advanced Malignant Neoplasm Advocate African Caribbean Age Cancer Research Project Caribbean region Catchment Area Cervical Cervical Cancer Screening Child Cities Communities Country Data Developing Countries Dimensions Disease Distress Early Diagnosis Ensure Face General Population Goals Grenada Guidelines Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Human papilloma virus infection Immigrant Immigration Incidence Income Intervention Investigation Jamaica Knowledge Lesion Literature Malignant Neoplasms Malignant neoplasm of anus Malignant neoplasm of cervix uteri Malignant neoplasm of penis Measurement Measures Methods Morbidity - disease rate Outcome Pap smear Paper Participant Pathway interactions Patient Self-Report Patient-Focused Outcomes Pattern Plant Roots Population Population Study Premature Mortality Prevalence Prevention Prevention program Preventive Punishment Qualitative Methods Recording of previous events Research Resources Risk Sampling Scientist Screening for cancer Sexual Transmission Stage at Diagnosis Stigmatization Surveys Testing United States Vaccination Woman anticancer research base black women cancer health disparity cancer prevention cancer risk cancer therapy cervical cancer prevention community engaged research cost demographics design electronic data capture system epidemiologic data high risk innovation interest low and middle-income countries malignant mouth neoplasm men mortality parent grant premalignant prevent ranpirnase response screening social media social norm social stigma sociodemographics stem success theories uptake vaccine acceptance

Address Administrative Supplement Adolescent Advanced Malignant Neoplasm Advocate African Caribbean Age Cancer Research Project Caribbean region Catchment Area Cervical Cervical Cancer Screening Child Cities Communities Country Data Developing Countries Dimensions Disease Distress Early Diagnosis Ensure Face General Population Goals Grenada Guidelines Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Human papilloma virus infection Immigrant Immigration Incidence Income Intervention Investigation Jamaica Knowledge Lesion Literature Malignant Neoplasms Malignant neoplasm of anus Malignant neoplasm of cervix uteri Malignant neoplasm of penis Measurement Measures Methods Morbidity - disease rate Outcome Pap smear Paper Participant Pathway interactions Patient Self-Report Patient-Focused Outcomes Pattern Plant Roots Population Population Study Premature Mortality Prevalence Prevention Prevention program Preventive Punishment Qualitative Methods Recording of previous events Research Resources Risk Sampling Scientist Screening for cancer Sexual Transmission Stage at Diagnosis Stigmatization Surveys Testing United States Vaccination Woman anticancer research base black women cancer health disparity cancer prevention cancer risk cancer therapy cervical cancer prevention community engaged research cost demographics design electronic data capture system epidemiologic data high risk innovation interest low and middle-income countries malignant mouth neoplasm men mortality parent grant premalignant prevent ranpirnase response screening social media social norm social stigma sociodemographics stem success theories uptake vaccine acceptance

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项目摘要

Project Summary/Abstract Title: Caribbean Investigation of Cancer Stigma and its effect on Cervical Cancer Screening and HPV Vaccination This application is being submitted in response to the Notice of Special Interest (NOSI) identified as "NOT-CA-21-026 Cancer stigma is an understudied barrier to cancer treatment seeking, early diagnosis, screening and other prevention practices. In particular, cervical cancer (CCA) stigma must be prioritized for research as CCA is among the most deadly but highly preventable cancers. CCA is the fourth most common cancer in the world despite an accurate screening test and a preventive HPV vaccine. The Human papilloma Virus (HPV) causes 99% of cervical, as well as much of anal, penile and oral cancers. The burden of CCA persists, and CCA incidence and mortality are even increasing among Black women in low resourced countries globally. Specifically, CCA incidence is highest, and is the leading cause of premature mortality among Caribbean women. Despite heightened risk for HPV-related cancer, and readily available, low cost screening and HPV vaccination (HPVV), both CCA screening and HPV vaccine uptake in the Caribbean region is perilously low. Our prior, preliminary research suggest that CCA stigma is associated with inadequate screening, advanced cancer stage at diagnosis, and low uptake of the HPV vaccine among Caribbean populations, both in the Caribbean region and United States (US). However, both our preliminary studies as well as the literature on CCA-related stigma, suffer from a lack of population studies that employs qualitative and quantitative methods to rigorously quantify stigma, and measure stigma’s impact on CCA screening and HPVV. Therefore in an effort to further understand the impact of cancer stigma on CCA screening and HPVV for the Caribbean context, we aim to 1) culturally transcreate the existing validated Cancer Stigma Scale (CASS) for population appropriateness, 2) assess cancer stigma in a non-patient population of men and women using the culturally transcreated CASS in Jamaica and Grenada, 3) assess the association of stigma and a) cervical cancer screening among women and b) HPVV knowledge and practice --- for participants with HPVV eligible adolescents. For this study, social norms theory formed the theory, and we will use a mixed-methods design, rooted in the community engaged research approach. A community advisory council will be appointed in both Jamaica and Grenada, to inform the transcreation of CASS and overall cultural responsiveness of the study. The study will use qualitative methods with stakeholders to transcreate and modify CASS. The study survey with the modified CASS will be distributed via social media and electronic platforms to a population sample (n=1,240). Participants will complete the survey using a paper-based format and the Research Electronic Data Capture System (REDCap). Based on our preliminary findings and the lierature, we hypothesize similar stigma scores in the Caribbean (Grenada and Jamaica), and that Caribbean stigma scores will be higher compared to other countries, and higher stigma scores will be associated with less cancer screening and lower knowledge, acceptability, and uptake of the HPV vaccine (for those with age eligible children). The Caribbean region must be emphasized in global cancer research because of its close proximity to the US and Caribbean immigrants account for 12% of US Blacks. Therefore, the results will inform interventions to reduce stigma and increase cancer prevention e.g., CCA screening and HPVV among Caribbean populations both in the Caribbean region and among US Caribbean immigrants to ultimately reduce Black cancer disparities.

项目摘要/摘要标题：加勒比海癌污名及其对宫颈癌筛查和HPV疫苗接种的影响该申请是为了响应特殊利益通知（NOSI）而提交癌症污名是癌症治疗，早期诊断，筛查和其他预防的障碍实践。特别是，必须将宫颈癌（CCA）污名作为研究优先级，因为CCA是最致命的但是高度可预防的癌症。 CCA是世界目的地的第四个最常见的癌症和预防性HPV疫苗。人类乳头状瘤病毒（HPV）导致99％的宫颈以及肛门的大部分阴茎和口服癌。 CCA的Burnen持续存在，CCA的发病率和死亡率甚至在黑色中增加全球低资源国家的妇女。具体而言，CCA事件最高，是过早的主要原因加勒比妇女的死亡率。尽管患有HPV相关癌症的风险较高，并且容易获得，但成本较低筛查和HPV疫苗（HPVV），CCA筛查和加勒比地区的HPV疫苗摄取均为危险低。我们先前的初步研究表明，CCA污名与筛查不足有关，诊断时的晚期癌症阶段，加勒比海人群中HPV疫苗的摄取量低加勒比地区和美国（美国）。但是，我们的初步研究以及有关CCA相关的文献污名，缺乏人口研究，该研究采用定性和定量方法来严格量化污名，并衡量污名对CCA筛查和HPVV的影响。因此，为了进一步了解癌症污名对加勒比海环境中CCA筛查和HPVV的影响，我们的目标是1）文化创造现有的经过验证的癌症污名量表（CASS）用于人口适当性，2）评估非患者的癌症污名使用牙买加和格林纳达的文化转录Cass的男性和女性人口，3）评估该关联妇女和a）女性宫颈癌筛查的污名和b）HPVV知识和实践 - HPVV合格的青少年。在这项研究中，社会规范理论形成了理论，我们将使用混合方法设计，植根于社区参与研究方法。两者都将任命社区咨询委员会牙买加和格林纳达，以告知CASS的转录和研究的整体文化反应能力。研究将使用利益相关者使用定性方法来转造和修改CASS。修改后的研究调查 CASS将通过社交媒体和电子平台分发给人群样本（n = 1,240）。参与者会使用基于纸张的格式和研究电子数据捕获系统（REDCAP）完成调查。基于我们的初步发现和谎言，我们假设在加勒比海（格林纳达和牙买加）中的类似污名得分，与其他国家相比癌症筛查较少，知识较低，可接受性和HPV疫苗的吸收（对于患有年龄的人合格的孩子）。加勒比地区必须在全球癌症研究中强调，因为它与美国和加勒比移民占美国黑人的12％。因此，结果将为干预提供信息降低污名并增加预防癌症，例如，加勒比海人群中的CCA筛查和HPVV都在加勒比地区以及美国加勒比海移民最终减少黑人癌症分布。