Individual, cultural, and area-based factors associated with survivorship care among Asian/Asian American childhood cancer survivors

与亚裔/亚裔美国儿童癌症幸存者的生存护理相关的个人、文化和地区因素

• 批准号: 10482384
• 负责人: Joel E Milam
• 金额: $ 62.61万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-06 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10482384
• 关键词: Acculturation; Address; Adult; Aftercare; Age; Area; Asian; Asian Americans; Asian Pacific Islander; Asian population; Attitude; Belief; California; Caring; Characteristics; Childhood; Childhood Cancer Survivor Study; Chinese; Chronic; Consensus; Country; County; Data; Development; Diagnosis; Ethnic group; Family; Filipino; Fostering; Guidelines; Health; Health Services Accessibility; Healthcare; Immigrant; Incidence; Individual; Insurance; Intervention; Interview; Knowledge; Koreans; Late Effects; Lead; Life; Longterm Follow-up; Los Angeles; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of brain; Medical; Medical center; Methods; Modeling; Morbidity - disease rate; Neighborhoods; Not Hispanic or Latino; Oranges; Outcome; Parents; Patients; Pediatric Oncology Group; Population; Race; Research; Risk; Self Efficacy; Seminal; Socioeconomic Status; Stress; Subgroup; Survey Methodology; Survivors; Time; United States; barrier to care; base; cancer prevention; cancer therapy; childhood cancer survivor; clinically significant; cohort; ethnic minority; experience; follow-up; health disparity; mortality; neoplasm registry; outreach; patient population; population based; prevent; psychosocial; racial minority; recruit; residence; socioeconomics; survivorship; young adult

Abstract With treatment advances for childhood cancer, over 80% of patients achieve long-term survival. However, cancer treatments often lead to other serious issues, including chronic health problems and early mortality. These health problems are referred to as “late effects,” defined as any adverse medical or psychosocial outcome that develops or persists after treatment. By 25 years following treatment, over two-thirds of childhood cancer survivors (CSS) have developed at least one clinically significant late effect, with over one-third developing one or more severe or life-threatening late effect. As a result, life-long cancer-focused long-term follow-up care (LTFU) is essential for CCS to screen for, prevent, and treat late effects. Our current understanding of among CCS comes primarily from a cohort of adult CCS diagnosed between 1970 and 1986 (The Childhood Cancer Survivor Study-CCSS) which is comprised of predominantly non-Hispanic white survivors. However, studies have shown that CCS from racial and ethnic minority backgrounds experience significant health disparities and thus more research is required among CCS of diverse backgrounds to understand disparities to address and reverse them. Rates of LTFU and factors influencing cancer-focused care among Asian American (AA) CCS are unknown. AA populations represent the fastest growing ethnic group in the United States and the largest group of new immigrants, with 59% of the US Asian population born in another country. This group is culturally and socioeconomically heterogenous and has grown 72% between 2000 and 2015 is projected to grow to more than 10% of the US population by 2050. Thus, the number of AA CCS is expected to increase, and a greater focus on facilitators and barriers to LTFU is needed in this underresearched population. Further, many Asian immigrants live in ethnically concentrated neighborhoods (ethnic enclaves) which may influence engagement in LTFU for AA CCS. We propose to recruit a population- based cohort of roughly 330 young adult AA CCS and their parents (N=100) in Los Angeles and Orange Counties to examine factors related to survivorship care utilization. Our aims are: Aim 1: We will characterize on a population basis the utilization of cancer-focused survivorship care among Asian CCS. Aim 2: We will examine through qualitative interviews and survey methods individual- and family-level factors associated with the utilization of cancer-focused survivorship care among AA CCS and their parents. Aim 3: We will investigate the effect of residing in an ethnically concentrated neighborhood on the utilization of LTFU. The proposed research will provide guidance to identify and address needs among AA CCS for survivorship care utilization to increase culturally congruent outreach and intervention strategies to engage and retain these CCS in care.

抽象的 随着儿童癌症治疗的进步，超过 80% 的患者实现了长期生存。 癌症治疗通常会导致其他严重问题，包括慢性健康问题和过早死亡。 这些健康问题被称为“后期影响”，定义为任何不利的医疗或心理社会问题 治疗后出现或持续的结果到治疗后 25 年，超过三分之二的儿童期。 癌症幸存者 (CSS) 已出现至少一种具有临床意义的晚期效应，超过三分之一 从而产生一种或多种严重或危及生命的晚期效应，导致终生癌症。 后续护理 (LTFU) 对于 CCS 筛查、预防和治疗我们当前的迟发效应至关重要。 对 CCS 的了解主要来自 1970 年至 1986 年间诊断的一组成人 CCS （儿童癌症幸存者研究 - CCSS）主要由非西班牙裔白人组成 然而，研究表明，少数种族和族裔背景的幸存者会经历CCS。 显着的健康差异，因此需要在不同背景的 CCS 之间进行更多研究 了解解决和扭转这些问题的差异以及影响癌症重点的因素。 亚裔美国人 (AA) CCS 人群的护理情况尚不清楚，AA 人群是增长最快的种族。 美国最大的新移民群体，占美国亚裔人口的59% 在另一个国家，这个群体在文化和社会经济上具有异质性，并且增长了 72%。 2000 年和 2015 年，预计到 2050 年，AA 的数量将增长到占美国人口的 10% 以上。 CCS 预计会增加，在此过程中需要更加关注 LTFU 的促进因素和障碍 此外，许多亚洲移民居住在种族集中的社区。 （种族飞地）可能会影响 AA CCS 的 LTFU 参与度。 基于洛杉矶和奥兰治的约 330 名年轻人 AA CCS 及其父母 (N=100) 的队列 各县检查与幸存者护理利用相关的因素。我们的目标是： 目标 1：我们将描述特征。 以人口为基础，在亚洲 CCS 中利用以癌症为重点的生存护理 目标 2：我们将。 通过定性访谈和调查方法检查与相关的个人和家庭层面的因素 AA CCS 及其父母对以癌症为中心的生存护理的利用情况 目标 3：我们将进行调查。 居住在种族集中的社区对 LTFU 利用率的影响。 研究将为确定和解决 AA CCS 对幸存者护理利用的需求提供指导 增加文化上一致的外展和干预策略，以吸引和保留这些 CCS 的护理。