Better Breast and Cervical Cancer Control for Korean American Women

韩裔美国女性更好地控制乳腺癌和宫颈癌

• 批准号: 7992401
• 负责人: HAE-RA HAN
• 金额: $ 55.29万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7992401
• 关键词: Address; Adherence; Area; Baltimore; Behavior; Behavioral; Breast Cancer Detection; Cancer Burden; Cancer Control; Cervical Cancer Screening; Communities; Community Health; Community Networks; Control Groups; Counseling; Data; Development; Diagnosis; Diagnostic Neoplasm Staging; Education; Effectiveness; Emotional; Equilibrium; Ethnic group; Face; Fostering; Funding; Glare; Goals; Guidelines; Health; Health Promotion; Health Status; Healthcare; Healthcare Systems; Immigrant; Incidence; Information Services; Intervention; Intervention Studies; Knowledge; Korean American; Language; Lead; Literacy Programs; Literature; Malignant neoplasm of cervix uteri; Mammography; Measures; Methodology; Minority; Minority Groups; Morbidity - disease rate; Outcome; Outcome Study; Pap smear; Participant; Pilot Projects; Population; Process; Protocols documentation; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Research Activity; Research Design; Research Infrastructure; Research Personnel; Research Project Grants; Sampling; Screening for cancer; Screening procedure; Staging; System; Testing; Training; United States; Washington; Woman; arm; base; cancer diagnosis; cancer prevention; community based participatory research; computerized; design; effective intervention; ethnic minority population; experience; group intervention; health disparity; health literacy; implementation research; improved; insight; literacy; malignant breast neoplasm; meetings; metropolitan; mortality; multidisciplinary; outcome forecast; outreach program; primary outcome; programs; prototype; racial and ethnic; secondary outcome; skills; theories

DESCRIPTION (provided by applicant): Despite considerable progress made in U.S. cancer control during the past 20 years, certain ethnic minority groups continue to experience significant health disparities. Breast and cervical cancer screening rates for Korean American (KA) women are far below the national goal, and below rates reported for other ethnic groups. As a result, KA women are often diagnosed at a later stage of cancer which can lead to a poor prognosis, high mortality, and subsequent emotional and financial burdens. Limited health literacy is emerging as a far-reaching, major barrier to cancer prevention behaviors, particularly among non-English speaking immigrant populations. This research application is formulated to answer research questions that address critical knowledge gaps in cancer control intervention research for linguistically and/or socially isolated ethnic minority communities using the KA community as an example. These questions are: (1) whether a health literacy-focused intervention using a community-based participatory research (CBPR) process will be effective in promoting health literacy and increasing breast and cervical cancer screening rates among KA women; and (2) whether a tailored intervention delivered by community health workers (CHWs) will be effective in such a community. The proposed study is a community-based, cluster-randomized clinical trial with two parallel arms, with a delayed intervention. A longitudinal repeated measures design will allow us to determine the effectiveness of the proposed health literacy-focused tailored cancer control intervention delivered by CHWs. A total of 480 KA women will participate in the study. The primary outcome of this study will be adherence to breast and cervical cancer screening. We hypothesize that, as compared to KA women in the control (delayed intervention) group, KA women who receive our literacy-focused tailored CHW intervention will demonstrate higher levels of adherence to screening for breast and cervical cancer. Through implementation of these research activities, we expect to establish a mechanism for disseminating critical health information for this population and to enhance a community network which will facilitate community access to breast and cervical cancer screening. While the focus of this research project is health literacy promotion and breast and cervical cancer screening among KA women, the core principles and methodology of this intervention can provide insights toward development of effective, culturally sensitive health literacy programs to meet the needs of socially and/or linguistically isolated minority groups with inadequate cancer control throughout the United States. PUBLIC HEALTH SIGNIFICANCE: Korean American (KA) women have the second highest incidence of cervical cancer nationally and are experiencing rapid increases in breast cancer incidence. Limited capacity to obtain, process, and understand basic health information and services to make appropriate health decisions (i.e., limited health literacy) is a major barrier to early detection of cancer among KA women. This study proposes to test if a health literacy-focused intervention using a community- based participatory research process will be effective in promoting health literacy and increasing breast and cervical cancer screening rates among KA women; and (2) whether a tailored intervention delivered by trained community health workers will be effective in such a community.

描述（由申请人提供）：尽管过去 20 年来美国在癌症控制方面取得了相当大的进展，但某些少数族裔群体仍然存在显着的健康差异。韩裔美国 (KA) 女性的乳腺癌和宫颈癌筛查率远低于国家目标，也低于其他族裔群体的报告率。因此，KA 女性往往在癌症晚期才被诊断出来，这可能导致预后不良、死亡率高以及随之而来的情感和经济负担。有限的健康素养正在成为癌症预防行为的一个深远的主要障碍，特别是在非英语移民群体中。本研究申请旨在回答研究问题，以 KA 社区为例，解决语言上和/或社会上孤立的少数民族社区的癌症控制干预研究中的关键知识差距。这些问题是：(1) 采用基于社区的参与性研究 (CBPR) 过程的以健康素养为重点的干预措施是否能有效促进 KA 女性的健康素养并提高乳腺癌和宫颈癌筛查率； (2) 社区卫生工作者 (CHW) 提供的定制干预措施在此类社区中是否有效。拟议的研究是一项基于社区的整群随机临床试验，有两个平行组，并延迟干预。纵向重复措施设计将使我们能够确定社区卫生工作者提供的以健康素养为中心的定制癌症控制干预措施的有效性。共有 480 名 KA 女性将参与这项研究。这项研究的主要结果是坚持乳腺癌和宫颈癌筛查。我们假设，与对照组（延迟干预）组的 KA 女性相比，接受我们以扫盲为重点的定制 CHW 干预的 KA 女性将表现出更高水平的乳腺癌和宫颈癌筛查依从性。通过实施这些研究活动，我们期望建立一个机制，为这一人群传播重要的健康信息，并加强社区网络，以促进社区获得乳腺癌和宫颈癌筛查。虽然该研究项目的重点是 KA 女性的健康素养促进以及乳腺癌和宫颈癌筛查，但该干预措施的核心原则和方法可以为制定有效的、文化敏感的健康素养计划提供见解，以满足社会和/或群体的需求。或在美国各地癌症控制不足的语言上孤立的少数群体。公共健康意义：韩裔美国 (KA) 女性的宫颈癌发病率位居全国第二，并且乳腺癌发病率正在迅速上升。获取、处理和理解基本健康信息和服务以做出适当健康决策的能力有限（即有限的健康素养）是 KA 女性早期发现癌症的主要障碍。本研究旨在测试采用基于社区的参与性研究过程的以健康素养为重点的干预措施是否能有效促进 KA 女性的健康素养并提高乳腺癌和宫颈癌筛查率； (2) 由训练有素的社区卫生工作者提供的量身定制的干预措施在这样的社区中是否有效。