Increasing Breast Cancer Screening in Chinese Immigrants

增加中国移民的乳腺癌筛查

基本信息

批准号：
10316255
负责人：
Lina Jandorf
金额：
$ 23.23万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-12-09 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10316255
关键词：
Address Adherence Adoption Behavior Belief Breast Cancer Detection Breast Cancer Early Detection Breast Cancer Education Breast Cancer Risk Factor Caring China Chinese Chinese American Chinese population Communication Communities Complex Country Dissemination and Implementation Economics Education English Language Ethnic group Familiarity Feedback Focus Groups Funding Future Gatekeeping Goals Guidelines Health behavior Health education Healthcare Systems Healthy People 2020 Human Immigrant Immigrant community Immigration Individual Insurance Intervention Interview Knowledge Language Linguistics Malignant Neoplasms Mammographic screening Mammography Medical Modeling New York City Participant Plague Play Population Poverty Pre-Post Tests Preventive healthcare Province Randomized Clinical Trials Randomized Controlled Trials Reporting Research Residencies Resource-limited setting Review Literature Risk Role Screening for cancer Source Symptoms Testing Time Treatment Efficacy Underserved Population Woman Work acceptability and feasibility base cancer diagnosis cancer prevention community barrier cultural health design evidence base experience follow-up health belief health care availability health disparity high school improved innovation malignant breast neoplasm minority communities mortality novel pilot test predictive modeling programs screening screening guidelines social stem success tv watching uptake

项目摘要

In New York City (NYC), persons of Chinese descent experience the highest cancer mortality rate of any ethnic group. Breast cancer is the most commonly diagnosed cancer in Chinese immigrant women, who experience substantial increases in breast cancer risk after spending a decade or more in the US. Regular mammography screening and timely follow up are crucial for early detection of breast cancer and increased survival. However, Chinese immigrant women in NYC report low utilization of screening mammography and are less likely to complete follow up in a timely manner compared to non-Latina white women. Chinese immigrants in NYC are more likely to live below the poverty line, to lack insurance, and to be without a usual source of care. Over 50% have less than a high school education, cannot speak or understand English, and would not see a western doctor as a first course even if they had symptoms. Research within this community has revealed that only 23% of Chinese immigrant women in NYC had ever had a mammogram in their lifetime. This is a population with great need for basic medical care, increased breast cancer knowledge, and access to breast cancer screening. Health disparities plague the health care system and arise from a complex interplay of economic, social, and cultural factors. The Health Belief Model (HBM) provides a framework for addressing cultural health disparities related to preventive health care and cancer screening by positing that making a decision to engage in a health behavior is determined by weighing perceived threats versus benefits. Guided by the HBM, the Witness Project uses narrative communication (e.g., storytelling, personal testimonials) to educate, persuade, and engage target communities about cancer prevention and screening. Our work in minority and immigrant communities has demonstrated that narrative communication can increase participation in breast cancer screening. However, the efficacy of these interventions has not been empirically tested among Chinese immigrants. The long-term goal of the proposed line of research is to increase breast cancer screening rates for NYC Chinese immigrants. We plan to accomplish this objective by pursuing the following specific aims: AIM 1. Culturally and linguistically adapt the Witness Project, a narrative breast cancer education program, for Chinese immigrant women. Focus groups and qualitative interviews will be conducted with community gatekeepers and stakeholders to obtain feedback on intervention content. AIM 2. Pilot test feasibility and acceptability of WP for Chinese immigrant women. Feasibility and acceptability of the pilot intervention will be assessed to determine effect sizes for a future large scale trial. Screening mammogram receipt and intentions to undergo mammography, as well as other HBM constructs will be compared in a pre-post design stratified by language. Successful completion of the study aims will make a novel and transformative contribution to the field of cancer screening, especially for this underserved population.

在纽约市 (NYC)，华裔的癌症死亡率是所有种族中最高的团体。乳腺癌是中国移民女性中最常诊断出的癌症，在美国生活十年或更长时间后，患乳腺癌的风险大幅增加。定期乳房X光检查筛查和及时随访对于早期发现乳腺癌和提高生存率至关重要。然而，纽约市的中国移民女性表示，筛查性乳房 X 光检查的利用率较低，并且不太可能与非拉丁裔白人女性相比，及时完成随访。纽约市的华人移民是更有可能生活在贫困线以下，缺乏保险，并且没有通常的护理来源。超过50% 高中以下学历，不会说或听不懂英语，也不会看西方电影即使他们出现症状，也应将医生作为第一疗程。该社区内的研究表明，只有纽约市 23% 的中国移民女性一生中曾接受过乳房 X 光检查。这是一个人口非常需要基本医疗保健、增加乳腺癌知识和获得乳腺癌的机会筛选。健康差距困扰着医疗保健系统，并且是由经济、社会和文化因素。健康信念模型 (HBM) 提供了解决文化健康问题的框架与预防性医疗保健和癌症筛查相关的差异，假设做出参与的决定健康行为的影响是通过权衡感知到的威胁与收益来确定的。在 HBM 的指导下，见证项目使用叙事交流（例如讲故事、个人感言）来教育、说服、并让目标社区参与癌症预防和筛查。我们在少数族裔和移民方面的工作社区已经证明叙事沟通可以增加乳腺癌患者的参与度筛选。然而，这些干预措施的有效性尚未在中国人中得到实证检验。移民。拟议研究的长期目标是提高乳腺癌筛查率对于纽约市的中国移民来说。我们计划通过追求以下具体目标来实现这一目标：AIM 1. 在文化和语言上调整见证项目，这是一个叙述性乳腺癌教育计划，对于中国移民女性来说。将与社区进行焦点小组和定性访谈把关人和利益相关者获取有关干预内容的反馈。目标 2. 中试可行性和中国移民女性对WP的接受程度。试点干预的可行性和可接受性将进行评估以确定未来大规模试验的效应大小。筛查乳房X光检查收据和进行乳房 X 光检查的意图以及其他 HBM 构造将在前后设计中进行比较按语言分层。成功完成研究目标将产生新颖且变革性的成果对癌症筛查领域的贡献，特别是对于服务不足的人群。