Socio-Ecological Variables/Cancer Screening Behaviors?

社会生态变量/癌症筛查行为？

• 批准号: 7113651
• 负责人: NINEZ Alafriz PONCE
• 金额: $ 12.72万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7113651
• 关键词: behavioral /social science research tag; breast neoplasm /cancer diagnosis; cervix neoplasms; colorectal neoplasms; community health services; culture; data collection methodology /evaluation; education; family structure /dynamics; health behavior; health care model; health care policy; health care service availability; health care service utilization; health insurance; health services research tag; human data; human population study; managed care; meta analysis; neoplasm /cancer diagnosis; primary care physician; prostate neoplasms; racial /ethnic difference; socioeconomics; socioenvironment

DESCRIPTION (provided by applicant): This study will examine the effects of socio-ecological factors on population-based cancer screening behaviors, specifically for breast, cervix, colorectal and prostate cancers. "Socio-ecological" factors are community-level social and other environmental characteristics that may influence individuals' utilization of cancer screening. Most importantly, this investigation focuses on identifying which socio-ecological conditions contribute to racial and ethnic differences in cancer screening. The specific aims of this study are (1) to gather and link data at the individual-level, zip code-level and county-level that are relevant to cancer screening access and utilization; (2) with these data, to construct a multivariate multilevel model that predicts cancer screening utilization; and (3) use this multivariate multilevel model framework to measure racial and ethnic differentials in access and utilization of cancer screening tests by interacting individual race/ethnicity variables with selected socio-ecological variables. In this study, I will examine three domains of socio-ecological factors to assess their impact on individuals' utilization of cancer screening: (1) social resources, (2) health services, and (3) health insurance markets. In this multilevel framework, level I is measured at the individual level; it includes the dependent variable (receipt of a cancer screening test) and all associated individual-level characteristics such as sociodemographic information, health status and health insurance. Levels 2 and 3 reflect socio-ecological factors: level 2 consists of aggregate measures of social resources at the zip code-level, for example the proportion of households below poverty level, the percent of non-citizens, and the proportion of households with children; and level 3 includes county-level or county-group-level characteristics for health services and health insurance markets, for example, the percent of minority primary care physicians, the percent of oncologists and the per capita number of community health clinics. The study will use individual-level data from the California Health Interview Survey (CHIS) and socio-ecological variables drawn from a variety of sources. Combining these managed care, competition variables, with social resources and health services capacity provides a comprehensive evaluation of the health system's mediating effect on promoting cancer screening behavior of minority communities. This study complements and advances the knowledge on individual determinants of cancer screening disparities among racial and ethnic groups. And, in analyzing a comprehensive data set with multiple-levels of information, I can target needed policy changes in social and health market conditions in neighborhoods and in counties to reduce disparities in cancer screening.

描述（由申请人提供）：本研究将研究社会生态因素对基于人群的癌症筛查行为的影响，特别是针对乳房，子宫颈，结直肠癌和前列腺癌的影响。 “社会生态学”因素是社区级的社会和其他环境特征，可能会影响个人对癌症筛查的利用。 最重要的是，这项调查重点是确定哪些社会生态状况有助于癌症筛查中的种族和种族差异。 这项研究的具体目的是（1）在与癌症筛查和利用有关的个人级别，邮政编码级别和县级的数据中收集和链接数据； （2）使用这些数据，构建一个预测癌症筛查利用率的多元多级模型； （3）使用此多元多级模型框架通过将单个种族/民族变量与选定的社会生态变量相互作用，以衡量癌症筛查测试的种族和种族差异。 在这项研究中，我将研究社会生态因素的三个领域，以评估其对 个人对癌症筛查的利用：（1）社会资源，（2）健康服务和（3）健康保险市场。 在这个多级框架中，一级在单个级别进行测量；它包括因变量（接收癌症筛查测试）和所有相关的个人级特征，例如社会人口统计学信息，健康状况和健康保险。 第2级和第3级反映了社会生态因素：2级包括邮政编码级别的社会资源的总衡量标准，例如低于贫困水平的家庭比例，非公民的百分比以及带子女的家庭比例；第三级包括县级或县群体级别的健康服务和健康保险市场的特征，例如，少数族裔初级保健医生的百分比，肿瘤学家的百分比以及人均社区卫生诊所数量。 该研究将使用来自加利福尼亚健康访谈调查（CHIS）的个人级别数据以及来自各种来源的社会生态变量。 将这些托管护理，竞争变量与社会资源和卫生服务能力相结合，对卫生系统对促进少数群体癌症筛查行为的中介作用进行了全面评估。 这项研究对种族和种族之间癌症筛查差异的个体决定因素的知识进行了补充，并提高了知识。 并且，在分析具有多个信息的综合数据集时，我可以针对社区和县的社会和健康市场状况中所需的政策变化，以减少癌症筛查的差异。