Cervical Cancer Screening in Homeless Women: A Discrete Choice Experiment

无家可归妇女的宫颈癌筛查：离散选择实验

• 批准号: 8515363
• 负责人: Eve Wittenberg
• 金额: $ 18.78万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-23 至 2014-12-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8515363
• 关键词: Address; Appointment; Attitude; Behavior; Belief; Beryllium; Cancer Control; Cervical Cancer Screening; Cessation of life; Characteristics; Childhood; Clothing; Data; Decision Analysis; Decision Making; Development; Disease; Early Diagnosis; Elements; Face; Focus Groups; Food; Future; General Population; Goals; Grant; HIV Infections; Health; Healthcare; High Prevalence; Homelessness; Housing; Income; Indium; Individual; Intervention; Language; Lead; Location; Low income; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methodology; Methods; Morbidity - disease rate; Outcome; Phase; Population; Prevention; Preventive; Privacy; Provider; Questionnaires; Recruitment Activity; Relative (related person); Research; Research Methodology; Risk; Risk Factors; Sampling; Screening for cancer; Shelter facility; Surveys; Testing; Time; United States; Vulnerable Populations; Woman; cancer prevention; control trial; cost; design; disorder risk; effective intervention; experience; high risk; improved; innovation; interest; literacy; mortality; preference; prevent; research study; screening

DESCRIPTION (provided by applicant): Cervical cancer is one of the few preventable forms of cancer, yet it still causes over 4,000 deaths in the US each year. Prevention and early detection could successfully eradicate the disease if practiced by the entire population. Most of the new cases of cervical cancer in the US are in women who have never been screened or have been screened infrequently. While most women in the US are screened for cervical cancer, pockets of the population remain unscreened or under-screened and are at risk of the disease. Homeless women are one of these pockets where cervical cancer still exerts a toll. Homeless women are screened for cervical cancer far less than all women, and even less than poor, housed women. The number of homeless women in the US is increasing, and these women will contribute more cases of cervical cancer unless effective methods to prevent new cases are developed. This research will identify the specific health and non-health aspects of cervical cancer screening that are important to homeless women in order to be screened. The study results will lead to the design of homeless-specific cervical cancer screening interventions to increase early detection among this unique population, and to prevent future cases of this disease. The proposed study will apply an innovative method of decision analysis to study individual choice in the context of cervical cancer screening. The approach uses a questionnaire to collect data on the choices people would make when faced with different combinations of factors that are important to a decision. For this study, we will first determine the relevant healh and non-health factors for the cervical cancer screening decision for homeless women, such as cost, location where the test is performed, the provider performing the test, etc. We will use this information to develop a survey including different screening scenarios that include these elements in different combinations. Homeless women recruited to the survey will choose between pairs of different combinations of screening scenarios to demonstrate their decision priorities. The resulting survey data will be analyzed to put numerical estimates on how important each element is to the choice to be screened for all homeless women in our study. The study findings will inform the design of screening interventions that can achieve the highest rate of screening for this particular population. What is preferred for homeless women may be different than that for housed, poor women, or for women of other incomes, etc. This research method allows strategies to be tailored to the preferences and desires of a particular group, to maximize the outcome of interest (in this case, screening). As an exploratory grant, our findings will be used to develop screening interventions for subsequent testing in controlled trials. This research will contribute to the NCI goal of cancer control and prevention, through early detection of disease.

描述（由申请人提供）：宫颈癌是少数可预防的癌症之一，但每年仍会导致4,000多人死亡。如果整个人群实践，预防和早期发现可能会成功消除该疾病。美国大多数新的宫颈癌病例都是从未被筛查或不经常筛查的女性。尽管美国大多数妇女都因宫颈癌而受到筛查，但人口的口袋仍未筛查或筛查不足，并且有疾病的风险。无家可归的妇女是宫颈癌仍然造成损失的这些口袋之一。 对无家可归的妇女的宫颈癌筛查远低于所有妇女，甚至少于贫穷的妇女。美国无家可归的妇女的数量正在增加，除非开发有效的方法来预防新病例，否则这些妇女将贡献更多的宫颈癌病例。这项研究将确定宫颈癌筛查的特定健康和非健康方面对无家可归的妇女来说很重要，以便进行筛查。该研究结果将导致设计无家可归的宫颈癌筛查干预措施，以增加这种独特人群之间的早期检测，并防止未来的这种疾病病例。 拟议的研究将采用一种创新的决策分析方法来研究宫颈癌筛查的个人选择。该方法使用问卷调查来收集人们在面对不同因素组合对决策重要的因素组合时会做出的选择的数据。在这项研究中，我们将首先确定无家可归妇女的宫颈癌筛查决定的相关HEAL和非健康因素，例如成本，进行测试的位置，执行测试的提供者等。我们将使用此功能 信息开发调查，包括不同的筛选场景，其中包括不同组合中的这些元素。被招募到调查的无家可归妇女将在筛查场景的不同组合之间进行选择，以证明其决定优先级。将分析所得的调查数据，以对每个元素在我们的研究中对所有无家可归妇女进行筛查的重要性进行数值估计。 研究结果将为筛查干预措施的设计提供信息，这些干预措施可以实现该特定人群的最高筛查率。对于无家可归的妇女而言，首选的可能性可能与住房，贫困妇女或其他收入的妇女等。这种研究方法允许策略根据特定群体的偏好和欲望来量身定制，以最大程度地提高兴趣结果（在这种情况下，筛查）。作为探索性赠款，我们的发现将用于制定对照试验中随后测试的筛查干预措施。这项研究将通过早期发现疾病来促进NCI控制和预防的目标。

项目成果

Using Best-Worst Scaling to Understand Patient Priorities: A Case Example of Papanicolaou Tests for Homeless Women.

使用最佳-最差尺度来了解患者的优先顺序：无家可归妇女的巴氏测试案例。

• DOI: 10.1370/afm.1937
• 发表时间: 2016
• 期刊: Annals of family medicine
• 影响因子: 4.4
• 作者: Wittenberg,Eve;Bharel,Monica;Bridges,JohnFP;Ward,Zachary;Weinreb,Linda
• 通讯作者: Weinreb,Linda

Measuring the Preferences of Homeless Women for Cervical Cancer Screening Interventions: Development of a Best-Worst Scaling Survey.

衡量无家可归妇女对宫颈癌筛查干预措施的偏好：制定最佳-最差规模调查。

• DOI: 10.1007/s40271-014-0110-z
• 发表时间: 2015
• 期刊: The patient
• 作者: Wittenberg,Eve;Bharel,Monica;Saada,Adrianna;Santiago,Emely;Bridges,JohnFP;Weinreb,Linda
• 通讯作者: Weinreb,Linda