Empowering Latinas to Obtain Guideline-Concordant Breast Cancer Screenings

帮助拉丁裔获得符合指南的乳腺癌筛查

• 批准号: 10518742
• 负责人: Yamile Molina
• 金额: $ 65.56万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-08 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10518742
• 关键词: Address; Advisory Committees; Breast; Breast Cancer Detection; Caring; Chicago; Clinical; Collaborations; Communication; Communities; Community Health Aides; Community Health Education; Data; Education; Enrollment; Equation; Family; Federally Qualified Health Center; Friends; Fright; Future; Goals; Guidelines; Health; Healthcare; Individual; Intervention; Knowledge; Latina; Latina Population; Latino; Lead; Learning; Long-Term Effects; Mammography; Measures; Mediating; Mediation; Modeling; Motivation; Pathway Analysis; Pilot Projects; Population; Preventive service; Process; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Role; Services; Social Network; Solid; Testing; Time; Translations; Woman; arm; base; breast cancer diagnosis; cancer care; community based participatory research; community engagement; community intervention; community organizations; comparison intervention; cost; design; diagnosis quality; empowered; empowerment; experience; implementation science; improved; innovation; intervention effect; intervention participants; leadership development; malignant breast neoplasm; member; models and simulation; novel; peer; prospective; psychosocial; recruit; role model; screening; screening guidelines; skills; skills training; social observations; volunteer

ABSTRACT Latinas suffer disproportionately from late stage breast cancer (BC) diagnoses and worse post-diagnosis quality of life relative to non-Latina Whites (NLWs), in part due to lower guideline-concordant screening. Education+navigation (educate) approaches have offered Latinas community education to address psychosocial barriers (e.g., fear) and navigated Latinas to free/low-cost breast cancer care. Our transdisciplinary team has developed a promising empowerment+navigation (empower) approach that may lead to greater BC screening among Latino networks. In the empower approach, Latinas who are non-adherent to US Preventive Services Task Force (USPSTF) guidelines learn about BC; are navigated to free/low cost breast cancer care; and gain communication skills to promote BC screening throughout their networks. Our premise is that empowering non-adherent Latinas as breast health agents may lead to greater BC screening among non-adherent Latinas and their networks than treating non-adherent Latinas as passive recipients of education. The current proposal tests our premise and identifies “active ingredients” of the empower approach. In Aim 1, we will conduct an individual randomized controlled trial (RCT) in a federally qualified health center (FQHC). This trial will build on our team’s current service projects to provide free/low-cost BC screening in the FQHC, including leveraging its relationship with a community organization committed to leadership development among Latinas. Among non-adherent Latinas, we will compare the effects of empower and educate approaches on initial and repeat BC screening, in line with USPSTF guidelines. In Aim 2, we conduct an observational social network study. We will recruit network members through non- adherent Latinas enrolled in our RCT. Among network members, we will compare the effects of empower and educate approaches on initial and repeat BC screening across four years. In Aim 3, we will explore theoretical mechanisms of change that could contribute to intervention differences in BC screening. For non-adherent Latinas’ BC screening, we will examine the mediating roles of greater BC knowledge and motivation to be healthy role model. For network members’ BC screening, we will examine the mediating role of non-adherent Latinas’ enhanced capacity to promote BC screening. Specifically, we will test the independent effects of volunteerism in community BC initiatives, potential to “bridge” network members with formal change agents (e.g., community health workers, navigators), acceptability to promote BC, feasibility to promote BC, and BC promotion to network members. Our innovative, robust approach has direct implications for expediting the translation of promising community interventions into practice.

抽象的 拉丁美洲人患晚期乳腺癌 (BC) 的比例不成比例，而且诊断后情况更糟 相对于非拉丁裔白人 (NLW) 的生活质量较高，部分原因是与指南一致的筛查较低。 教育+导航（教育）方法为拉丁裔社区提供了教育来解决 心理社会障碍（例如恐惧）并引导拉丁裔获得免费/低成本的乳腺癌护理。 跨学科团队开发了一种有前途的授权+导航（empower）方法，可以 导致在拉丁裔网络中进行更广泛的 BC 筛查。 参考美国预防服务工作组 (USPSTF) 指南，了解 BC 的相关信息，了解免费/低成本； 乳腺癌护理；并获得沟通技巧，以在整个网络中推广 BC 筛查。 我们的前提是，授权不遵守规定的拉丁裔作为乳房健康代理人可能会导致更大的 BC 对不依从的拉丁裔及其网络进行筛查，而不是将不依从的拉丁裔视为被动的 当前的提案测试了我们的前提并确定了其中的“活性成分”。 赋权方法。 在目标 1 中，我们将在联邦合格的健康中心进行个体随机对照试验 (RCT) (FQHC)。该试验将建立在我们团队当前的服务项目的基础上，在该地区提供免费/低成本的 BC 筛查。 FQHC，包括利用其与致力于领导力的社区组织的关系 在非依从性拉丁裔中，我们将比较赋权和发展的效果。 根据 USPSTF 指南，教育初次和重复 BC 筛查的方法。 在目标 2 中，我们进行一项观察性社交网络研究，我们将通过非方式招募网络成员。 在加入我们的随机对照试验的网络成员中，我们将比较授权和授权的效果。 教育四年内初次和重复 BC 筛查的方法。 在目标 3 中，我们将探索可能导致干预措施差异的变革理论机制。 对于不依从的拉丁裔 BC 筛查，我们将检查更大 BC 的中介作用。 对于网络成员的 BC 筛查，我们将检查其知识和动机。 具体来说，我们将测试非依从性拉丁裔增强的促进 BC 筛查能力的中介作用。 BC 社区倡议中志愿服务的独立影响，“桥梁”网络成员的潜力 与正式变革推动者（例如社区卫生工作者、导航员）合作、促进 BC 的可接受性、可行性 推广 BC，并向网络成员推广 BC。 我们创新、稳健的方法对于加快有前途的社区的转化具有直接影响 干预措施付诸实践。