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：
8410029
负责人：
Judy Huei-yu Wang
金额：
$ 53.22万
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/8410029
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 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 screening 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.

描述（申请人提供）：华裔美国人是美国最大的亚裔人口，其中 70% 是移民。与美国总人口普遍较高的乳房X光检查使用率和乳腺癌死亡率下降相比，华裔美国女性的乳房X光检查率要低得多，而且她们的乳腺癌死亡率尚未下降。与美国出生的女性相比，患有乳腺癌的中国移民女性更有可能被诊断出患有大肿瘤并在 5 年内死亡。他们的乳房X光检查使用率低与筛查的知识、文化和态度障碍有关。在健康信念模型的指导下，我们为中国女性制作了具有文化敏感性的视频。我们的初步研究表明，经过 6 个月的随访，在家观看文化视频（单视频模式）比阅读纸质媒体（对照组）有效增加了中国女性乳房 X 光检查的使用率 12 个百分点。与对照组相比，文化视频还显着增加了知识并减少了文化和态度障碍。然而，我们的数据显示，很大一部分中国女性（59%）在视频干预后仍未进行乳房X光检查，这表明该人群需要采取更强化的方法。因此，在社交网络理论的指导下，我们在小组环境中对视频进行了试点测试，其中女性一起观看视频，然后进行同行主导的讨论（小组视频讨论）。小组视频讨论比单一视频模式更能提高中国女性在干预后六个月的乳房X光检查使用率。我们不知道通过社会支持和网络进行的小组视频讨论是否会显着改变个人信念和障碍并进一步促进筛选行为，以及这两种干预方法是否能够对行为改变产生长期影响。为了填补这些空白，我们的多学科研究团队提出了一项随机对照试验，以确定提高中国移民女性乳房X光检查依从性的最佳干预方法。在这项拟议的试验中，我们将通过大华盛顿特区、纽约和南加州的华人社区合作伙伴招募 910 名华人女性。这些女性将是不遵守美国癌症协会指南的移民，该指南建议 40 岁以上的女性每年进行一次乳房 X 光检查。参与者将被随机分为两组：1) 小组文化视频讨论和 2) 单一文化视频模式。参与者将在干预前后接受电话采访，以评估他们在干预后 6 个月和 18 个月时主要障碍的变化以及接受乳房 X 光检查的情况。小组视频讨论将由训练有素的中国社区健康教育者和研究人员在所有地点使用标准化协议进行领导。如果我们以理论为指导、社区主导的干预计划有效，这些计划可以在整个美籍华人社区传播，并推广到其他亚洲群体，以提高中国和亚洲女性的总体乳房X光检查率。