A RCT TO PROMOTE MAMMOGRAPHY ADHERENCE AMONG CHINESE IMMIGRANT WOMEN

一项旨在促进中国移民女性坚持乳房X光检查的随机对照试验

基本信息

批准号：
8208134
负责人：
Judy Huei-yu Wang
金额：
$ 60.47万
依托单位：
GEORGETOWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2014-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8208134
关键词：
Acculturation Adherence Age American Cancer Society Area Asian Americans Asians Behavior Behavioral Belief Breast Cancer Detection California Cancer Control Caring Caucasians Caucasoid Race Chinese American Chinese People Cities Communities Community Health Control Groups Data Diagnosis District of Columbia Enrollment Evaluation Fostering Future Guidelines Health Health Educators Healthy People 2010 Home environment Immigrant Individual Interdisciplinary Study Intervention Intervention Trial Investigation Knowledge Lead Life Long-Term Effects Los Angeles Mails Maintenance Mammography Mediating Methods Minority Minority Groups Modeling New York New York City Outcome Participant Population Printed Media Process Assessment Protocols documentation Qualifying Randomized Randomized Controlled Trials Reading Recruitment Activity Relative (related person)Research Risk Screening procedure Site Social Network Social support Stress Structure Telephone Interviews Testing Theoretical model Training Translating Translations Underserved Population Universities Woman Work arm base cancer health disparity cancer site community based practice efficacy testing experience follow-up group intervention health belief health training innovation intervention effect intervention program malignant breast neoplasm metropolitan mortality multidisciplinary peer post intervention primary outcome programs public health relevance secondary outcome social theories therapy design tool tumor volunteer

项目摘要

DESCRIPTION (provided by applicant): Chinese-Americans are the largest Asian population in the US, of which 70% are immigrants. In contrast to the generally high use of mammography screening and decline in breast cancer mortality seen in the total US population, Chinese-American women have much lower mammography screening rates and their breast cancer mortality rates are not yet declining. Chinese immigrant women with breast cancer are more likely to be diagnosed with large tumors and die within 5 years than their US-born counterparts. Their low rates of mammography use are associated with knowledge, cultural and attitudinal barriers to screening. Guided by the Health Belief Model, we developed a culturally sensitive video for Chinese women. Our preliminary research showed that viewing the cultural video at home (single video mode) effectively increased Chinese women's mammography use by 12 percentage points over reading a print medium (control group) after a 6-month follow-up. The cultural video also significantly increased knowledge and reduced cultural and attitudinal barriers compared to the control group. However, our data show that a high proportion of Chinese women (59%) still had not had a mammogram after the video intervention, suggesting that a more intensive approach is needed for this population. Thus, guided by Social Network Theory, we pilot tested the video in a small- group setting in which women viewed the video together followed by a peer-led discussion (small-group video discussion). The small-group video discussion enhanced Chinese women's mammography use six-months post-intervention more than the single video mode. We do not know whether small-group video discussion through social support and networks significantly changes personal beliefs and barriers and further promotes screening behavior and whether these two intervention approaches can have long-term effects on behavioral changes. To fill these gaps, our multidisciplinary research team proposes a randomized controlled trial to identify the best intervention approach for increasing mammography adherence among Chinese immigrant women. In this proposed trial, we will recruit 910 Chinese women through Chinese community partnerships in greater Washington DC, New York, and southern California. These women will be immigrants who are non- adherent to the American Cancer Society guidelines that recommend annual mammograms for women over age 40. Participants will be randomized to the two arms: 1) small-group cultural video discussion and 2) single cultural video mode. Participants will be telephone interviewed before and after intervention to assess their changes in key barriers and receipt of mammograms by 6 months and 18 months post-intervention. The small- group video discussion will be led by a trained Chinese community health educator and a research staff using a standardized protocol at all sites. If our theoretically-guided, community-led intervention programs are effective, these programs can be disseminated in Chinese-American communities at large and be translated to other Asian groups to promote overall mammography screening rates among Chinese and Asian women. PUBLIC HEALTH RELEVANCE: Chinese-American women's mammography screening rates are far lower than the Health People 2010 target rates (70%) for women ages 40 and older. This proposed study will test the efficacy of viewing a theoretically based and culturally sensitive video followed by group discussion (vs. single viewing) in increasing mammography use. We will enroll 910 Chinese immigrant women (age e41 and last mammogram > 1 year) from Washington DC, New York City, and southern California to participate in our intervention programs. We will assess women's adherence to annual mammography screening guidelines six months and 18 months post intervention. The results of this study will identify optimal avenues for reaching Chinese immigrant women and increasing their regular screening behavior. The results of this study will lead cancer control efforts to effectively decrease breast cancer screening disparities experienced by Chinese-American women.

描述（由申请人提供）：中国裔美国人是美国最大的亚洲人口，其中70％是移民。与美国总人口中乳腺癌死亡率的普遍使用相比，中国裔美国妇女的乳腺X线摄影筛查率较低，乳腺癌死亡率尚未下降。中国乳腺癌妇女比美国出生的妇女更有可能在5年内被诊断出患有大型肿瘤，并且在5年内死亡。他们的乳房X线摄影使用率低与知识，文化和态度障碍有关。在健康信念模型的指导下，我们为中国女性开发了一个对文化敏感的视频。我们的初步研究表明，在经历了6个月的随访后，观看家庭中文化视频（单视频模式）有效地将中国女性乳腺摄影使用点增加了12个百分点（对照组）。与对照组相比，文化视频还大大提高了知识，文化和态度障碍。但是，我们的数据表明，在视频干预后，大部分的中国女性（59％）仍然没有乳房X光检查，这表明该人群需要采取更密集的方法。因此，在社交网络理论的指导下，我们在一个小组环境中测试了视频，在该设置中，女性将视频一起观看视频，然后进行同行主导的讨论（小组视频讨论）。小组视频讨论增强了中国女性乳腺X线摄影比单个视频模式多六个月。我们不知道通过社会支持和网络的小组视频讨论是否会大大改变个人信念和障碍，并进一步促进筛查行为，以及这两种干预方法是否对行为改变会产生长期影响。为了填补这些空白，我们的跨学科研究小组提出了一项随机对照试验，以确定中国移民妇女增加乳房X线摄影的最佳干预方法。在拟议的试验中，我们将通过大华盛顿特区，纽约和南加州的中国社区伙伴关系招募910名中国妇女。这些妇女将是不遵守《美国癌症协会指南》的移民，这些指南建议对40岁以上的妇女进行年度乳房X光检查。参与者将被随机分为两个武器：1）小组文化视频讨论和2）单个文化视频模式。参与者将在干预前后接受采访，以评估他们在干预后6个月零18个月内收到乳房X光检查的变化和收到乳房X光检查的变化。小组视频讨论将由受过训练的中国社区健康教育者和研究人员在所有站点进行标准化协议。如果我们的理论指导，社区主导的干预计划有效，则可以在整个中国美国社区中传播这些计划，并将其转化为其他亚洲群体，以促进中国和亚洲妇女的整体乳房X线摄影筛查率。公共卫生相关性：中国妇女乳腺X线摄影筛查率远低于40岁及40岁妇女的2010年健康人民目标率（70％）。这项拟议的研究将测试观看基于理论的和文化敏感的视频的功效，然后在增加的乳房X线摄影使用中进行小组讨论（与单一观看）。我们将招募来自华盛顿特区，纽约市和南加州的910名中国移民妇女（E41岁和最后一次乳房X光检查> 1年）参加我们的干预计划。我们将在干预后六个月零18个月遵守妇女遵守年度乳腺X线摄影筛查指南。这项研究的结果将确定达到中国移民妇女并增加其常规筛查行为的最佳途径。这项研究的结果将领导癌症控制工作，以有效地减少中国妇女遇到的乳腺癌筛查差异。