Research Project

研究项目

• 批准号: 8727458
• 负责人: GLORIA D CORONADO
• 金额: $ 1.67万
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8727458
• 关键词: Adherence; Cancer Prevention Intervention; Centers for Disease Control and Prevention (U.S.); Cervical Cancer Screening; Clinic; Communities; Community Networks; County; Data; Diagnostic; Educational Curriculum; Funding; Goals; Health Promotion; Hispanics; Human Resources; Incidence; Instruction; Intervention; Interview; Latina; Latino; Low income; Malignant neoplasm of cervix uteri; Medical Records; Mexican; National Health Interview Survey; Pap smear; Patient Self-Report; Patients; Population; Primary Health Care; Randomized; Relative (related person); Reporting; Research Project Grants; Risk Factors; Sampling; Services; Testing; Time; United States; Washington; Woman; Work; arm; base; cancer health disparity; cervical cancer prevention; cost; cost effectiveness; efficacy testing; experience; farm worker; follow-up; improved; intervention program; mortality; post intervention; programs; screening

PROJECT SUMMARY (See instructions): Latinos are the fastest growing population in the United States (US). The incidence of cervical cancer among Latino women is about 70% higher than that among non-Latino Whites [1]. Latino women also experience 50% higher cervical cancer mortality than non-Latino whites [1]. The disproportionate burden of cervical cancer among Latinas is thought to be attributed to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The overall goal of the proposed project is to test the efficacy of a culturallyappropriate clinic-based program to increase Pap test utilization and improve adherence to follow-up after an abnormal Pap test in a sample of Latino women in the Yakima Valley of Washington State. The primary specific aims for this project are to: 1) Assess the relative efficacy of two culturally-appropriate, tailored programs to increase cervical cancer screening among Latino women, the two programs are: a) a low-intensity program, consisting of a video approach to cervical cancer screening; and b) a higher intensity program that consists of the video plus a promotora-intervention to encourage cervical cancer screening; 2) Assess the costeffectiveness of the two intervention programs. A secondary aim ofthis proposal is to: 1) Evaluate the efficacy of a patient navigator program to improve adherence and reduce time to follow-up among women who receive abnormal Pap tests in the participating clinics. The components of this aim are to: a) conduct qualitative one one-one interviews among 20 Latino women with a recent abnormal Pap test to identify salient factors related to adherence to recommended follow-up; b) develop and pilot-test a culturally-appropriate patient navigator program to improve adherence and reduce time to receipt of recommended follow-up. The primary aims will be evaluated by assessing changes in the use of screening services for cervical cancer (based on self-report and medical record review) in pair-wise comparisons of the intervention and control arms, six months following randomization. Cost per woman screened will be calculated for each intervention arm. The secondary aim will be evaluated by assessing pre- and post-intervention changes in the proportions of women who receive recommended follow-up within 90 days of an abnormal Pap test and changes in the time to treatment.

项目摘要（参见说明）： 拉丁裔是美国增长最快的人口。拉丁裔女性宫颈癌的发病率比非拉丁裔白人高约 70%[1]。拉丁裔女性的宫颈癌死亡率也比非拉丁裔白人高 50% [1]。拉丁裔宫颈癌负担过重被认为是由于筛查率低以及巴氏涂片检查异常后对建议的诊断随访的依从性差。拟议项目的总体目标是测试一个基于文化的临床计划的有效性，以提高巴氏涂片检查的利用率，并提高华盛顿州亚基马谷拉丁裔女性样本巴氏涂片检查异常后随访的依从性。该项目的主要具体目标是： 1) 评估两个适合文化、量身定制的计划的相对功效，以增加拉丁裔女性的宫颈癌筛查，这两个计划是：a) 低强度计划， 包括宫颈癌筛查的视频方法； b) 更高强度的计划，包括视频和促进宫颈癌筛查的干预措施； 2) 评估两种干预方案的成本效益。该提案的第二个目标是： 1) 评估患者导航计划的有效性，以提高在参与诊所接受异常巴氏涂片检查的女性的依从性并减少随访时间。该目标的组成部分是： a) 对 20 名近期巴氏涂片检查异常的拉丁裔女性进行定性一对一访谈，以确定与遵守建议的随访相关的显着因素； b) 开发并试点测试适合文化的患者导航程序，以提高依从性并缩短收到建议随访的时间。主要目标将通过在随机分组后六个月内对干预组和对照组进行成对比较来评估宫颈癌筛查服务的使用变化（基于自我报告和病历审查）。将计算每个干预组的每名女性筛查成本。次要目标将是 通过评估干预前和干预后在巴氏涂片检查异常后 90 天内接受建议随访的女性比例的变化以及治疗时间的变化来进行评估。