Developing Neighborhood Archetypes for Understanding Disparities in Cancer

开发社区原型以了解癌症的差异

• 批准号: 8604276
• 负责人: Salma Shariff-Marco
• 金额: $ 16.2万
• 依托单位: CANCER PREVENTION INSTIT OF CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-16 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8604276
• 关键词: Accounting; Address; Affect; African American; Area; Asian Americans; Asians; California; Cancer Etiology; Cancer Patient; Censuses; Characteristics; Classification; Communities; Community Healthcare; Complex; Critical Pathways; Data; Data Set; Data Sources; Databases; Diagnosis; Dimensions; Disease; Environment; Ethnic Origin; Family; Food; Goals; Health; Health Policy; Hispanics; Home environment; Household; Individual; Intervention; Link; Literature; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Minority; Mission; Neighborhoods; Not Hispanic or Latino; Outcome; Pacific Island Americans; Pathway interactions; Policies; Population Heterogeneity; Population Research; Process; Public Health; Race; Research; Resources; Rural; Safety; Sampling; Shapes; Social Characteristics; Social Environment; Socioeconomic Status; Source; System; Testing; Time; United States National Institutes of Health; Vulnerable Populations; Work; base; food environment; health disparity; improved; innovation; insight; low socioeconomic status; malignant breast neoplasm; mortality; neoplasm registry; novel; novel strategies; patient population; population based; population health; public health relevance; social; suburb; success

PROJECT SUMMARY/ABSTRACT Disparities in cancer survival continue to persist by race/ethnicity, socioeconomic status (SES) and nativity. Neighborhood factors are critical pathways through which disparities are shaped and perpetuated. However, the literature has shown mixed results and neighborhood-based interventions have had limited success. To advance research on neighborhoods and health, new approaches need to reflect the fact that neighborhood effects on health arise through complex and dynamic processes, underscoring the importance of studying not only the individual effects of neighborhood features on health outcomes, but also their synergistic effects. A promising approach is to encompass multiple dimensions within a single classification system, archetypes, that capture meaningful distinctions across neighborhoods (e.g., Low SES, rural; Poor, urban minority; Middle-class suburban/exurban families). The archetype approach is an efficient way to maximally integrate multiple sources of available information on neighborhood characteristics and has the potential to identify improved opportunities for intervening and reducing health disparities. Leveraging a comprehensive database of small- area level data on social and built neighborhood environments and applying novel statistical approaches, this application proposes to develop neighborhood archetypes around two time periods, 2000 and 2010, for the large, diverse state of California. The central hypotheses are that 1) multiple neighborhood factors can be combined together to form neighborhood archetypes; and 2) that cancer mortality among breast and prostate cancer patients will vary by these neighborhood archetypes, and these associations will vary by race/ethnicity and nativity. The specific aims of this study are to: 1) Investigate the utility of the archetypes approach to characterize distinct neighborhoods across California. Specifically, we will extend to the census block group level previously developed census tract neighborhood archetypes using confirmatory latent class analysis (LCA). We will also expand, with additional built and social environment features, prior neighborhood archetypes using exploratory LCA. 2) Examine the associations between neighborhood archetypes and survival among a population-based, racially/ethnically diverse set of breast and prostate cancer patients. Specifically, we will test whether neighborhood archetypes are associated with all cause and cancer- specific mortality and whether this association is moderated by race/ethnicity. We will also test whether nativity moderates the neighborhood archetype associations among Hispanics and Asian Americans. The resulting neighborhood archetypes will provide an innovative resource for future research. Applying the archetypes to investigate breast and prostate cancer survival among California's diverse population, this research will yield insights into how neighborhood characteristics work synergistically with each other and interact with individual characteristics to influence health. This research has the potential to contribute to a broader, more fundamental understanding of place effects on health, with applications to both population health and health disparities research.

项目摘要/摘要 癌症生存的差异继续由种族/种族，社会经济地位（SES）和耶稣降生持续存在。 邻里因素是差异和永久差异的关键途径。然而， 文献表明结果不同，基于邻里的干预措施的成功有限。到 对社区和健康的提前研究，新方法需要反映以下事实。 通过复杂而动态的过程产生对健康的影响，强调了研究的重要性 只有邻里特征对健康结果的个人影响，也只有其协同作用。一个 有希望的方法是在单个分类系统（原型）中包含多个维度 捕获各个社区之间有意义的区别 郊区/郊区家庭）。原型方法是最大化多重整合的有效方法 有关邻里特征的可用信息来源，并有可能确定改进的 干预和减少健康差异的机会。利用一个综合的小型数据库 有关社交和建筑社区环境和采用新颖统计方法的区域级别数据， 申请建议在2000年和2010年开发大约两个时间段的邻里原型 大型，多样化的加利福尼亚州。中心假设是1）多个社区因素可以是 合并在一起形成邻里原型； 2）乳房和前列腺中的癌症死亡率 癌症患者将因这些邻里原型而有所不同，这些关联将因种族/种族而异 和诞生。这项研究的具体目的是：1）研究原型方法的实用性 为了表征整个加利福尼亚州的不同社区。具体而言，我们将扩展到人口普查区块 小组级以前使用确认潜在类别开发了人口普查区域原型 分析（LCA）。我们还将扩大额外的建筑和社交环境功能，先前的社区 使用探索性LCA的原型。 2）检查邻里原型与 基于人群的种族/种族多样性的乳腺癌和前列腺癌的生存 患者。具体而言，我们将测试邻里原型是否与所有原因和癌症相关联 特定的死亡率以及该关联是否受种族/民族的主持。我们还将测试是否耶稣 主持西班牙裔和亚裔美国人之间的社区原型协会。结果 邻里原型将为未来的研究提供创新的资源。将原型应用于 研究加利福尼亚多样化人群中的乳腺癌和前列腺癌的生存，这项研究将产生 深入了解邻里特征如何相互协同工作并与个人互动 影响健康的特征。这项研究有可能为更广泛，更大的贡献做出贡献 对地方对健康的影响的基本了解，并适用于人口健康和健康 差异研究。