Social determinants of health associated to the cervical cancer-related care across the cancer control continuum among women living with HIV in Puerto Rico

波多黎各艾滋病毒感染者整个癌症控制过程中与宫颈癌相关护理相关的健康社会决定因素

• 批准号: 10557582
• 负责人: Marievelisse Soto-Salgado
• 金额: $ 28.01万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10557582
• 关键词: Acquired Immunodeficiency Syndrome; Affect; Cancer Control; Cancer Etiology; Cancer Patient; Cancer health equity; Caring; Cervical; Cervical Cancer Screening; Clinic; Colon; Colposcopy; Communities; Consensus; Continuity of Patient Care; Data; Development; Diagnosis; Discrimination; Disparity; Enrollment; Ensure; Equity; Ethnic Population; Evaluation; Evidence based intervention; Focus Groups; Funding; General Population; Goals; HIV; HIV/AIDS; Health; Health Personnel; Health Services Accessibility; Healthcare; Hispanic; Human Papilloma Virus Vaccination; Human Papillomavirus; Incidence; Insurance Coverage; Intervention; Interview; Investigation; Lesion; Low income; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Medical Staff; Methods; Monitor; Morbidity - disease rate; Oncogenic; Oncology; Outcome; Pap smear; Persons; Population; Prevalence; Prevention approach; Principal Investigator; Privatization; Public Health; Puerto Rican; Puerto Rico; Recording of previous events; Recurrence; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Risk; Surveillance Program; Survival Analysis; Time; Training; United States; Woman; barrier to care; cancer care; cancer diagnosis; cancer invasiveness; cancer therapy; care providers; career; chronic infection; clinical care; experience; follow-up; health care availability; health disparity; health equity; high risk; improved; informant; insurance claims; mortality; neoplasm registry; optimal treatments; premalignant; programs; racial population; research study; screening; social; social health determinants; social stigma; treatment comparison; vaccine acceptance

Program Director/Principal Investigator (Last, First, Middle): Colón-López, Vivian PROJECT SUMMARY/ABSTRACT: RESEARCH PROJECT 1 Cervical cancer is the leading cause of cancer among women living with HIV (WLWH). Although cervical cancer screening is part of routine clinical care for WLWH, this population lacks regular screening, appropriate follow- up and/or treatment for precancerous lesions and/or cervical cancer. There is no consensus on the most important social determinants of health (SDoH) associated with access to care across the cervical cancer care continuum (screening, diagnosis, and treatment) among WLWH. The overall goal of this investigation is to employ a mixed-methods approach to identify multi-level factors within the SDoH that affect timely access to cervical cancer care across the cancer care continuum (screening, diagnosis, and treatment) among WLWH in Puerto Rico (PR). PR is one of the jurisdictions within the United States (US) with a high incidence and prevalence of HIV/AIDS, and a recent significant increase in the incidence of cervical cancer (2001-2017). Our specific aims are: (1) To examine the impact of HIV status on the extent and determinants of delay in cervical cancer care (screening, diagnosis and treatment) among cervical cancer patients diagnosed in PR during the period 2013-2020; (2) Establish multi-level factors within the SDoH that affect timely cervical cancer care (screening, diagnosis and treatment) among women with high-grade cervical lesions (HSIL) or cervical cancer in PR; and (3) Estimate the use of effective primary (HPV vaccination) and secondary (screening for, and treating HSIL) prevention approaches among women diagnosed with HIV or AIDS in PR for 2023 and 2024. Our ultimate goal is that all WLWH have equitable health access to cervical cancer care, while reducing morbidity and mortality associated to this malignancy. This proposal supports a 3-year research and training plan to allow Dr. Soto to make substantial progress toward a career as an independent investigator and leader in the field of SDoH, cancer control and HIV. Results from this project will identify intervention opportunities within the SDoH along the cervical cancer care continuum. Moreover, findings will guide the development and evaluation of these interventions to reduce barriers to care and ensure health equity among WLWH in a subsequent R01 application. This information could also potentially be adapted to Hispanic WLWH in the US and in other populations. OMB No. 0925-0001/0002 (Rev. 03/2020 Approved Through 02/28/2023) Page Continuation Format Page

项目总监/首席研究员（最后一个，中间）：VivianColón-López 项目摘要/摘要：研究项目1 宫颈癌是艾滋病毒（WLWH）女性癌症的主要原因。虽然宫颈癌 筛查是WLWH常规临床护理的一部分，该人群缺乏定期筛查，适当的跟进 - UP和/或治疗癌前病变和/或宫颈癌。最多没有共识 重要的社会决定者（SDOH）与整个宫颈癌护理的访问有关 WLWH中的连续体（筛查，诊断和治疗）。调查的总体目标是 员工一种混合方法方法来识别SDOH中多层因素，以影响及时访问 WLWH中的癌症护理连续体（筛查，诊断和治疗）的宫颈癌护理 波多黎各（PR）。公关是美国境内的司法管辖区之一（美国） 艾滋病毒/艾滋病的患病率以及最近的宫颈癌发病率显着增加（2001-2017）。我们的 具体目的是：（1）检查艾滋病毒状况对颈椎延迟的程度和确定的影响 癌症护理（筛查，诊断和治疗）在PR中诊断为宫颈癌患者 2013 - 2020年期； （2）在SDOH内建立多层次因素，以影响及时的宫颈癌护理 （筛查，诊断和治疗）高级宫颈病变（HSIL）或宫颈癌的女性 在PR中； （3）估计使用有效初级（HPV疫苗接种）和次要的使用（筛查和处理 HSIL）在2023年和2024年被诊断出患有艾滋病毒或艾滋病的妇女中的预防方法。我们的最终 目标是所有WLWH都能公平地获得宫颈癌护理，同时降低发病率和 与这种恶性肿瘤有关的死亡率。该建议支持一项为期3年的研究和培训计划，以允许博士。 索托（Soto SDOH，癌症控制和艾滋病毒。该项目的结果将确定SDOH内的干预机会 沿着宫颈癌护理连续体。此外，调查结果将指导对这些的发展和评估 在随后的R01申请中，采取干预措施，以减少护理障碍并确保WLWH之间的健康公平。 这些信息也可能适应美国和其他人群中的西班牙裔WLWH。 OMB No. 0925-0001/0002（Rev. 03/2020通过02/28/2023批准）页面延续格式页面