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）：尽管在乳腺癌的早期检测和相关的长期生存方面取得了巨大进步，但某些妇女群体，包括阿巴拉契亚农村妇女，仍然承受着不成比例的疾病负担。本论文旨在了解来自肯塔基州阿巴拉契亚山脉服务欠缺地区的老年农村妇女在生命历程中如何发展有关癌症（特别是乳腺癌）的知识和信念，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影响健康服务的接受，因此我们有必要提高对癌症健康信念的发展和性质的理解。以前的定量研究未能捕捉到这种经验或彻底解释为什么某些女性不接受癌症筛查。使用定性方法，特别是扎根理论，将使研究人员能够以深入和情境化的方式探索潜在的信念和意义。根据理论抽样，大约 20 名年龄在 55 岁及以上、没有癌症诊断史的女性将参与这项研究。由于访谈指南的深入性，每位女性将接受大约三次访谈。虽然扎根理论将塑造该项目，但我们利用健康信念模型、疾病常识模型和 Anderson (1995) 的健康行为模型来集中研究问题。问题评估对健康资源的感知可用性、健康和癌症信念、癌症和乳腺癌筛查知识、乳房X光检查、自我乳房检查以及临床乳房检查的想法和行为。转录后，每个采访都将使用 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启动对服务不足的农村人口和卫生服务利用挑战的长期关注。该研究项目旨在通过更多地了解服务欠缺地区老年妇女遇到的障碍来增加获得癌症服务的机会，这一目标与 AHRQ 的优先事项一致。事实上，由于该县贫困率高、人均收入低、失业率高，所选县属于阿巴拉契亚地区委员会的“贫困”县。此外，研究中包含的样本代表了已确定的“优先人群”：老年人、农村人、低收入群体和女性。最后，该研究开始致力于消除癌症差异和减少癌症疾病和死亡，这是《2010 年健康人民》的两个目标，方法是确定这些服务不足且受影响程度不成比例的女性群体的信念、意义和筛查障碍。