REACH UP & OUT: Eliminating Breast and Cervical Cancer Disparities

高达

• 批准号: 7491951
• 负责人: ISABEL C SCARINCI
• 金额: $ 58万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-28 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7491951
• 关键词: Accounting; Advisory Committees; African American; Age; Alabama; American; Appendix; Attitude; Behavior; Behavioral; Belief; Breast; Centers for Disease Control and Prevention (U.S.); Cervical Cancer Screening; Cognitive; Communities; Community Actions; Community Health; Condition; Control Groups; County; Data; Data Reporting; Development; Education; Evaluation; Fright; Funding; Health behavior; Intervention; Interview; Knowledge; Lead; Logic; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Mammography; Medical Surveillance; Medicare; Modeling; Morbidity - disease rate; Needs Assessment; Outcome; Pap smear; Patient Self-Report; Personal Satisfaction; Phase; Preventive; Process; Purpose; Randomized; Rate; Recommendation; Research Personnel; Screening procedure; Services; Subgroup; Target Populations; Testing; Treatment Efficacy; Woman; Women' s Group; Work; base; behavior change; cancer health disparity; caucasian American; community based participatory research; community intervention; design; follow-up; health belief; improved; insight; member; mortality; programs; response; skills training; theories; therapy development; tool

DESCRIPTION (provided by applicant): It has been well documented that disparities exist between African American and white women with regard to morbidity and mortality associated with breast and cervical cancer. We have established a very active coalition, conducted comprehensive needs assessments, and developed and pilot-tested a community action plan to reduce breast and cervical cancer screening disparities between white and African American women in Alabama's Black Belt. Although effective and well received by the community, this intervention did not lead to behavior change among all women within the targeted population. The overall purpose of the proposed intervention is to further reduce breast and cervical cancer disparities between white and African American women in the Black Belt of Alabama by increasing Pap smear and mammography rates. We propose to develop and implement a multi-component intervention that uses media, education, and enhanced access, incorporating sociological and cognitive behavioral approaches in the development and implementation of the messages. This intervention is an extension of our pilot work utilizing community health advisors (CHAs) (sociologic approach). Although the pilot intervention showed significant increase in breast and cervical cancer screening among African American women in the Black Belt, there is still a hard to-reach group, which, despite our efforts, has not engaged in breast and cervical cancer screening. Based on the results of follow-up interviews with this group of women and discussions with our coalition members and CHAs, we propose the development, implementation, and evaluation of an enhanced intervention, which incorporates cognitive behavioral approaches that will challenge the barriers (e.g., fear of finding out they have cancer, the belief that screening will not make any difference) and reinforce the motivators (e.g., support from other women) to engage this group in breast and cervical cancer screening. Although the Community-Based Participatory Research and the Empowerment Model will be the overall conceptual framework used in this study, the PEN-3 and the Health Belief Model will guide intervention development and implementation. The intervention counties will receive education and cognitive/behavioral skills training delivered by CHAs, while the control counties will continue to receive our current intervention that has proven to be successful. The study will be carried out in two phases. In Phase I, we will refine the enhanced intervention and assessment tools through formative assessment. In Phase II, we will randomly assign the counties to intervention/control groups, implement, and evaluate the intervention.

描述（由申请人提供）：有充分证据表明，非裔美国女性和白人女性在乳腺癌和宫颈癌相关的发病率和死亡率方面存在差异。我们建立了一个非常活跃的联盟，进行了全面的需求评估，并制定和试点了一项社区行动计划，以减少阿拉巴马州黑带地区白人和非裔美国妇女之间的乳腺癌和宫颈癌筛查差异。尽管这种干预措施有效且受到社区好评，但并没有导致目标人群中所有妇女的行为改变。拟议干预措施的总体目的是通过提高子宫颈抹片检查和乳房X光检查率，进一步减少阿拉巴马州黑带地区白人和非裔美国女性患乳腺癌和宫颈癌的差异。我们建议制定和实施一项多成分干预措施，利用媒体、教育和增强的接触机会，在信息的制定和实施中纳入社会学和认知行为方法。这项干预措施是我们利用社区健康顾问 (CHA)（社会学方法）试点工作的延伸。尽管试点干预措施显示黑带非裔美国女性的乳腺癌和宫颈癌筛查显着增加，但仍然有一个难以触及的群体，尽管我们做出了努力，但仍未参与乳腺癌和宫颈癌筛查。根据对这组妇女的后续访谈以及与我们的联盟成员和 CHA 讨论的结果，我们建议制定、实施和评估强化干预措施，其中结合了挑战障碍的认知行为方法（例如，害怕发现自己患有癌症，相信筛查不会产生任何影响），并强化了让这一群体参与乳腺癌和宫颈癌筛查的动力（例如，其他女性的支持）。尽管基于社区的参与性研究和赋权模型将成为本研究中使用的总体概念框架，但 PEN-3 和健康信念模型将指导干预措施的制定和实施。干预县将接受 CHA 提供的教育和认知/行为技能培训，而对照县将继续接受我们目前已证明是成功的干预措施。该研究将分两个阶段进行。第一阶段，我们将通过形成性评估完善强化干预和评估工具。在第二阶段，我们将随机将县分配到干预组/对照组，实施并评估干预措施。