The Development of Cancer Beliefs in Older Rural Appalachian Women

阿巴拉契亚农村老年妇女癌症信念的发展

• 批准号: 7136890
• 负责人: Corinne R Leach
• 金额: $ 3.23万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7136890
• 关键词: behavioral /social science research tag; belief; breast neoplasms; clinical research; female; health behavior; health care service availability; health disparity; human old age (65+); human subject; interview; low socioeconomic status; medically underserved population; model design /development; rural health; social model; women' s health

DESCRIPTION (provided by the applicant): Despite tremendous improvements in the early detection of breast cancer and related long-term survival, certain groups of women, including rural Appalachian women, continue to experience a disproportionate burden of disease. This dissertation seeks to understand how older, rural women from an underserved area of Appalachian Kentucky develop knowledge and beliefs about cancer in general and, in particular, breast cancer, over the life course and how beliefs shape the use of cancer screening services. Since existing literature demonstrates that health beliefs influence the uptake of health services, it is essential that we improve our understanding of the development and nature of cancer health beliefs. Previous quantitative studies have not been able to capture the experience or thoroughly explain why certain women do not receive cancer screenings. Use of qualitative methods, grounded theory in particular, will allow the researcher to explore underlying beliefs and meanings in an in-depth and contextualized manner. Using theoretical sampling, approximately 20 women ages 55 and older without a history of cancer diagnosis will participate in the study. Each woman will be interviewed approximately three times each due to the in-depth nature of the interview guide. While grounded theory will shape the project, we draw on the Health Belief Model, the Common Sense Model of Illness, and Anderson's (1995) Health Behavior Model to focus the research questions. Questions assess the perceived availability of health resources, health and cancer beliefs, knowledge of cancer and breast cancer screenings, and mammography, self-breast exam, and clinical breast exam thoughts and behaviors. After transcription, each interview will undergo coding and thematic analysis using NVivo 7 qualitative analysis software. Results from this study will be used to initiate a long-term focus on underserved rural populations and challenges to health service utilization. This research project seeks to enhance access to cancer services through learning more about the barriers older women in an underserved area experience, a goal consistent with the priorities of AHRQ. Indeed, the selected county falls under the Appalachian Regional Commission's "distressed" status due to the high poverty rates, low per capita income, and high rates of unemployment in the county. In addition, the sample included in the study represents identified "priority populations": elderly, rural, low-income, and women. Finally, the study begins work toward eliminating cancer disparities and reducing cancer illness and death, the two Healthy People 2010 goals, by identifying beliefs, meanings, and screening barriers among this underserved and disproportionately affected population of women.

描述（由申请人提供）：尽管早期发现乳腺癌和相关长期生存的早期发现方面有了很大的改善，但某些妇女（包括阿巴拉契亚妇女）的某些妇女仍继续承受不成比例的疾病负担。本论文旨在了解来自阿巴拉契亚肯塔基州服务欠缺地区的老年农村妇女如何发展有关癌症的知识和信念，尤其是乳腺癌，在整个生活过程中以及信念如何影响癌症筛查服务的使用。由于现有文献表明健康信念会影响卫生服务的吸收，因此我们必须提高对癌症健康信念的发展和性质的理解至关重要。以前的定量研究无法捕捉经验或彻底解释为什么某些女性未接受癌症筛查。尤其是扎根理论的定性方法的使用将使研究人员能够以深入和上下文化的方式探索潜在的信念和含义。使用理论采样，大约20名55岁及以上没有癌症诊断史的女性将参与研究。由于面试指南的深入性，每个女人将每次面试大约三次。虽然扎根的理论将塑造该项目，但我们借鉴了健康信念模型，疾病的常识模型以及安德森（Anderson）（1995）的健康行为模型，以集中研究问题。问题评估卫生资源，健康和癌症信念，癌症和乳腺癌筛查的知识以及乳房X线摄影，自我胸检查以及临床乳房检查思想和行为的可用性。转录后，每次访谈将使用NVivo 7定性分析软件进行编码和主题分析。这项研究的结果将用于长期关注服务不足的农村人口和对卫生服务利用的挑战。该研究项目旨在通过更多地了解在服务不足的地区经验中的老年妇女的障碍，这是与AHRQ的优先事项一致的，以增强癌症服务的机会。确实，由于贫困率高，人均收入较低和该县的高失业率，选定的县属于阿巴拉契亚地区委员会的“苦恼”身份。此外，研究中包括的样本代表了已确定的“优先人群”：老年人，农村，低收入和妇女。最后，这项研究开始努力消除癌症差异并减少癌症疾病和死亡，这两个健康人2010年的目标是通过确定在服务不足和受影响不成比例的妇女人群中的信念，含义和筛查障碍。