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

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.

项目概要/摘要标题：加勒比癌症耻辱调查及其对宫颈癌筛查和 HPV 疫苗接种的影响本申请是为了响应标识为“NOT-CA-21-026 的特殊利益通知 (NOSI)”而提交的癌症耻辱感是寻求癌症治疗、早期诊断、筛查和其他预防的一个尚未充分研究的障碍特别是，必须优先考虑宫颈癌（CCA）的耻辱感，因为宫颈癌是最致命的癌症之一。但尽管有准确的筛查测试，CCA 仍是世界上第四大常见癌症。和预防性 HPV 疫苗 99% 的宫颈癌以及大部分肛门癌都是由人乳头状瘤病毒 (HPV) 引起的。阴茎癌和口腔癌的负担持续存在，黑人中的 CCA 发病率和死亡率甚至在增加。具体而言，全球资源匮乏国家的女性 CCA 发病率最高，并且是早产的主要原因。尽管 HPV 相关癌症的风险很大，而且容易获得，但成本低廉。筛查和 HPV 疫苗接种 (HPVV)，加勒比地区的 CCA 筛查和 HPV 疫苗接种情况我们之前的初步研究表明，CCA 耻辱与筛查不足有关，诊断时癌症已处于晚期，并且加勒比地区人群对 HPV 疫苗的使用率较低加勒比地区和美国（US）然而，我们的初步研究以及CCA相关的文献。耻辱，缺乏采用定性和定量方法严格量化的人口研究耻辱，并衡量耻辱对 CCA 筛查和 HPVV 的影响，以进一步了解耻辱。在加勒比地区，癌症耻辱对 CCA 筛查和 HPVV 的影响，我们的目标是 1) 在文化上改造现有经过验证的癌症耻辱量表 (CASS) 用于人群适宜性，2) 评估非患者的癌症耻辱感牙买加和格林纳达使用文化移植 CASS 的男性和女性人口，3) 评估关联 a) 女性宫颈癌筛查和 b) HPVV 知识和实践 --- 针对患有以下疾病的参与者对于本研究，社会规范理论形成了适合 HPVV 的理论，我们将使用混合方法。设计，植根于社区参与研究方法，这两个地区都将任命一个社区咨询委员会。牙买加和格林纳达，为 CASS 的创译和研究的整体文化响应能力提供信息。将与利益相关者一起使用定性方法来创制和修改 CASS 的研究调查。 CASS 将通过社交媒体和电子平台分发给人口样本（n=1,240）。使用纸质格式和基于研究电子数据采集系统 (REDCap) 完成调查。根据我们的初步调查结果和文献，我们在加勒比地区（格林纳达和牙买加）追求类似的耻辱分数，与其他国家相比，加勒比地区的耻辱分数会更高，并且更高的耻辱分数将与之相关癌症筛查较少，HPV 疫苗的知识、可接受性和使用率较低（对于年龄较大的人）加勒比地区由于靠近该地区，因此必须在全球癌症研究中得到重视。美国和加勒比海移民占美国黑人的 12%，因此，研究结果将为干预措施提供信息。减少耻辱感并加强癌症预防，例如加勒比海地区人口中的 CCA 筛查和 HPVV 加勒比地区和美国加勒比移民之间最终减少黑人癌症差异。