A mixed methods study examining early onset anal cancer and current screening practices, attitudes, and perceived risk among people living with and without HIV in the Deep South

一项混合方法研究，调查了南方腹地感染者和未感染艾滋病毒的人的早发性肛门癌以及当前的筛查实践、态度和感知风险

• 批准号: 10387325
• 负责人: Anna D Junkins
• 金额: $ 4.03万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10387325
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Age; Age-Years; Alabama; Attitude; Behavior; Cancer Control Research; Cancer Patient; Caring; Cause of Death; Certification; Characteristics; Clinic; Clinical; Complex; Data; Data Analyses; Databases; Deep South; Detection; Development; Diagnosis; Disease; Doctor of Philosophy; Early Diagnosis; Electronic Health Record; Epidemic; Epidemiology; Face; Foundations; General Population; Goals; HIV; HIV Infections; HPV-High Risk; Health Personnel; Hospitals; Human Papillomavirus; Incidence; Individual; Infection; Interview; Knowledge; Malignant Neoplasms; Malignant neoplasm of anus; Methods; National Cancer Institute; Not Hispanic or Latino; Nurse Practitioners; Outcome; Pathogenesis; Patients; Persons; Physicians; Play; Population; Privacy; Prognosis; Provider; Public Health; Questionnaires; Recommendation; Recording of previous events; Reporting; Research; Research Methodology; Research Personnel; Research Training; Risk; Risk Factors; Role; Screening for cancer; Social Behavior; Statistical Data Interpretation; Surveys; System; Testing; Time; Training; Universities; anal pap smear; black men; black men who have sex with men; black women; cancer prevention; co-infection; cohort; cost; digital; early onset; early screening; experience; high risk; improved; insight; men; men who have sex with men; pathogen; patient subsets; racial and ethnic; rectal; research and development; routine screening; screening; screening guidelines; sex; sexual risk behavior; social stigma; targeted treatment; uptake

PROJECT SUMMARY/ABSTRACT The purpose of the proposed F31 application is to support Ms. Anna Junkins (PI) in research training and development during her PhD training in Epidemiology on her trajectory to becoming an independent cancer researcher. The primary goals of the proposed research are 1) to identify predictors of early onset anal cancer (<50 years of age at diagnosis), and 2) utilize a mixed methods research (MMR) approach to identify and explain factors associated with anal cancer screening uptake among men living with HIV (MLHIV) and their providers in the Deep South. The first Aim will identify predictors of early onset anal cancer who have received care at the University of Alabama at Birmingham (UAB) Hospital. Electronic health records (EHR) at UAB provide detailed demographic, clinical, and socio-behavioral data which will be used in the statistical analyses to predict early onset cancer. Next, using a MMR approach, Aim 2 and Aim 3 will identify and explain barriers and facilitators to anal cancer screening, and explore attitudes about screening and perceived risk among MLHIV and their healthcare providers. The quantitative part of the MMR approach (Aim 2) will include analysis of survey data from UAB’s 1917 Clinic cohort database to identify predictors of screening. Following the data analysis in Aim 2, an in-depth interview (IDI) guide will be developed to explain predictors of screening uptake in Aim 3. This qualitative Aim will include IDI among a subpopulation of patients whose data was analyzed in Aim 2, and healthcare providers (physicians and nurse practitioners) at the UAB 1917 Clinic. The IDIs will aim to further explore attitudes about screening, history of screening, barriers and facilitators to screening, and perceived risk. The long-term goal of the proposed research is to improve the lives of people living with HIV (PLHIV) and those most at risk for early onset anal cancer by informing national anal cancer screening guidelines through 1) identifying risk factors of early onset anal cancer; and 2) identifying and explaining patient-level and provider- level facilitators and barriers to screening among PLHIV in the Deep South. The primary training goals include: 1) increase knowledge and experience in the utilization of EHR to answer complex research questions regarding early onset anal cancer; 2) gain certification in applied MMR in early detection and screening of anal cancer among PLHIV in the South; and 3) increase expertise and independence in cancer prevention and control research. The overall goal of the proposed training is to prepare Ms. Anna Junkins with a strong foundation for independent research in early detection of cancer among PLHIV. .

项目概要/摘要 拟议的 F31 申请的目的是支持 Anna Junkins 女士（PI）的研究培训和 流行病学博士培训期间她成为独立癌症患者的发展轨迹 拟议研究的主要目标是 1) 确定早发性肛门癌的预测因素。 （诊断时年龄 <50 岁），以及 2) 利用混合方法研究 (MMR) 方法来识别和解释 与男性艾滋病毒感染者（MLHIV）及其提供者进行肛门癌筛查相关的因素 第一个目标将确定在该中心接受过护理的早发性肛门癌的预测因素。 阿拉巴马大学伯明翰分校 (UAB) 医院的电子健康记录 (EHR) 提供详细信息。 人口统计、临床和社会行为数据将用于统计分析以预测早期 接下来，目标 2 和目标 3 将使用 MMR 方法来识别并解释癌症发生的障碍和促进因素。 肛门癌筛查，并探讨 MLHIV 及其感染者对筛查和感知风险的态度 MMR 方法的定量部分（目标 2）将包括调查数据的分析。 根据目标 2 中的数据分析，从 UAB 的 1917 年临床队列数据库中确定筛查的预测因素。 将制定深度访谈 (IDI) 指南来解释目标 3 中筛查采用率的预测因素。 定性目标将包括在目标 2 中分析数据的患者亚群中的 IDI，以及 UAB 1917 诊所的医疗保健提供者（医生和执业护士）将致力于进一步推动这一目标。 探讨对筛查的态度、筛查历史、筛查的障碍和促进因素以及感知风险。 拟议研究的长期目标是改善艾滋病毒感染者（PLHIV）和那些感染艾滋病毒的人的生活。 通过以下方式告知国家肛门癌筛查指南，最有可能罹患早发性肛门癌： 1) 识别早发性肛门癌的危险因素；以及 2) 识别并解释患者级别和提供者- 南部地区艾滋病病毒感染者筛查的促进因素和障碍。 主要培训目标包括： 1) 增加使用 EHR 的知识和经验， 回答有关早发性肛门癌的复杂研究问题；2) 获得应用 MMR 的认证 南方艾滋病病毒感染者中肛门癌的早期发现和筛查；3) 提高专业知识和能力； 癌症预防和控制研究的独立性 拟议培训的总体目标是做好准备。 Anna Junkins 女士在 PLHIV 癌症早期检测方面拥有坚实的独立研究基础。 。