Family Cancer Literacy to Promote Mammography Screening among Navajo Women

家庭癌症知识普及促进纳瓦霍妇女的乳房X光检查

• 批准号: 8138457
• 负责人: Christi A Patten
• 金额: $ 2.18万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-07 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8138457
• 关键词: Advisory Committees; American Indian and Alaska Native; Appointment; Appointments and Schedules; Behavior Therapy; Behavioral Research; Breast; Breast Cancer Detection; Cancer Center; Cancer Center Planning Grant; Cancer Control; Cancer Etiology; Cancer Family; Caring; Cause of Death; Cells; Clinical Trials; Collaborations; Communication; Communities; Control Groups; Diagnosis; Early Diagnosis; Education; Educational Materials; Enrollment; Ethnic group; Evaluation; Family; Family member; Feedback; Female; Focus Groups; Fright; Funding; Futility; Future; Glossary; Grant; Healed; Health; Health education; Home environment; Home visitation; House Call; Individual; Institution; Intervention; Interview; Knowledge; Language; Life; Malignant Neoplasms; Mammography; Measures; Medical; Minority; Morbidity - disease rate; NIH Program Announcements; Navajo; Oral; Patients; Phase; Prevention program; Production; Provider; Public Health; Randomized; Randomized Clinical Trials; Records; Schedule; Screening procedure; Services; Source; Staging; Stigmata; Survival Rate; Testing; Time; Translating; Translations; Treatment Efficacy; Woman; Writing; base; cancer health disparity; cancer prevention; care systems; cervical cancer prevention; college; community based participatory research; design; experience; follow-up; healing; intervention effect; literacy; malignant breast neoplasm; mortality; public health relevance; research study; social stigma; tribal college

DESCRIPTION (provided by applicant): This proposal describes a community-based participatory research study to develop and pilot test a new behavioral intervention to promote mammography screening among Navajo women. From a public health perspective, the intervention has the potential to reach many Navajo women, as 80% of women scheduled for mammography appointments do not follow through. These women (over 1,500 each year) are referred to the Nation Breast and Cervical Cancer Prevention Program (NNBCCPP). A key barrier toward implementing cancer prevention and control efforts in the Navajo community is a lack of cancer literacy or cultural and conceptual knowledge regarding cancer. Other barriers to screening are fear of cancer, stigma of cancer (even talking about cancer) often experienced by the patient, family and community, and lack of knowledge about the etiology of cancer and importance of early detection. Therefore, communication about cancer is impeded within Navajo families and the community. This proposal builds on our successful partnership and collaboration with Dini College (the Navajo tribal college). The proposed study is designed to assess the feasibility and potential efficacy of a cancer-literacy focused, family-based intervention on completion of mammography screening for Navajo women. The intervention will include culturally and linguistically appropriate educational materials about cancer (e.g., the Navajo Cancer Glossary). The project will be implemented in two phases. During Phase 1, we will develop the family cancer literacy intervention with feedback from our community advisory committee. In addition, the Cancer Literacy Measure will be adapted for Navajo women through focus groups and individual interviews. Phase 2 will consist of a formative evaluation of the intervention. The NNBCCPP patient and a female family member will be randomly assigned in pairs to the control condition (existing NNBCCPP health education services, N=40 pairs) or to receive these health education services plus the family cancer literacy intervention (N=40 pairs). We will assess the intervention's feasibility and acceptability as indicated by the recruitment and retention rates and qualitative ratings of treatment acceptability. In addition, we will examine the effect of the intervention compared with the control group on the proportion of women who complete mammography screening at 3-month follow-up documented by NNBCCPP records. We will also examine changes in Cancer Literacy Measure scores from baseline to 3-month follow-up among both patients and family members. We expect that as a result of this project, we will have developed a replicable, feasible, and acceptable intervention, the efficacy of which can be tested in future large-scale randomized clinical trials. In addition, the adapted Cancer Literacy Measure could be used in future cancer prevention and control projects within the Navajo Nation. The overall objective is to reduce breast cancer morbidity and mortality among Navajo women. PUBLIC HEALTH RELEVANCE: Among American Indian and Alaska Native (AI/AN) women, breast cancer is more likely to be diagnosed at an advanced stage and the 5 year breast cancer survival rates are lower than any other ethnic group. Among Navajo women scheduled for a mammography screening appointment, the no show rate is markedly high (80%). This study proposes to develop a family-based cancer literacy intervention that includes culturally and linguistically appropriate education about breast cancer to promote mammography screening among Navajo women.

描述（由申请人提供）：该提案描述了一项基于社区的参与性研究，旨在开发和试点测试一种新的行为干预措施，以促进纳瓦霍妇女的乳房 X 光检查。从公共卫生的角度来看，这项干预措施有可能惠及许多纳瓦霍妇女，因为 80% 计划进行乳房 X 光检查的妇女没有遵守。这些女性（每年超过 1,500 名）被转介至国家乳腺癌和宫颈癌预防计划 (NNBCCPP)。在纳瓦霍社区实施癌症预防和控制工作的一个关键障碍是缺乏癌症素养或有关癌症的文化和概念知识。筛查的其他障碍包括对癌症的恐惧、患者、家人和社区经常经历的癌症耻辱（甚至谈论癌症），以及缺乏对癌症病因和早期检测重要性的了解。因此，纳瓦霍家庭和社区内关于癌症的交流受到阻碍。 该提案建立在我们与迪尼学院（纳瓦霍部落学院）成功的伙伴关系和协作的基础上。拟议的研究旨在评估以癌症扫盲为重点、以家庭为基础的干预措施对纳瓦霍妇女完成乳房X光检查的可行性和潜在功效。干预措施将包括文化和语言上适当的癌症教育材料（例如纳瓦霍癌症术语表）。该项目将分两个阶段实施。在第一阶段，我们将根据社区咨询委员会的反馈制定家庭癌症扫盲干预措施。此外，癌症扫盲措施将通过焦点小组和个人访谈的方式针对纳瓦霍妇女进行调整。第二阶段将包括对干预措施的形成性评估。 NNBCCPP 患者和一名女性家庭成员将被随机分配至对照条件组（现有 NNBCCPP 健康教育服务，N=40 对）或接受这些健康教育服务加家庭癌症素养干预（N=40 对）。我们将根据招募率和保留率以及治疗可接受性的定性评级来评估干预措施的可行性和可接受性。此外，我们将检查与对照组相比，干预措施对 NNBCCPP 记录记录的 3 个月随访时完成乳房 X 光检查的女性比例的影响。我们还将检查患者及其家庭成员从基线到 3 个月随访的癌症素养测量分数的变化。我们期望通过该项目，我们将开发出一种可复制、可行且可接受的干预措施，其有效性可以在未来的大规模随机临床试验中得到检验。此外，经过调整的癌症素养测量可用于纳瓦霍族未来的癌症预防和控制项目。总体目标是降低纳瓦霍妇女的乳腺癌发病率和死亡率。 公共卫生相关性：在美洲印第安人和阿拉斯加原住民 (AI/AN) 女性中，乳腺癌更有可能在晚期被诊断出来，并且 5 年乳腺癌生存率低于任何其他种族群体。在计划进行乳房 X 光检查的纳瓦霍女性中，缺席率明显较高 (80%)。本研究建议开发一种基于家庭的癌症扫盲干预措施，包括在文化和语言上适当的乳腺癌教育，以促进纳瓦霍妇女进行乳房X光检查。