Using mHealth to investigate cancer inequities: The impact of discrimination on tobacco cessation among underserved populations

利用移动医疗调查癌症不平等：歧视对服务不足人群戒烟的影响

基本信息

批准号：
10389128
负责人：
JANNA GORDON
金额：
$ 1.18万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10389128
关键词：
Acute Address Affect African American population Black race Cancer Control Cause of Death Cessation of life Chronic stress Communities Complement Data Development Discrimination Disease Ecological momentary assessment Environment Exposure to Fellowship General Population Goals Grant Health Health Technology Health behavior Individual Institutes Intervention Knowledge Link Longitudinal Studies Malignant Neoplasms Malignant neoplasm of lung Measures Mediating Mental Health Mentors Methods Minority Morbidity - disease rate NCI-Designated Cancer Center Outcome Pathway interactions Physiological Population Populations at Risk Prejudice Primary Cancer Prevention Research Research Activity Research Ethics Risk Self Efficacy Sexual and Gender Minorities Smoker Smoking Smoking Behavior Smoking Cessation Intervention Statistical Methods Stigmatization Stress Time Tobacco Tobacco Use Cessation Tobacco use Training Training Activity Underserved Population Work Writing adaptive intervention cancer prevention cancer risk cigarette smoking design experience gender minority group health assessment health disparity health inequalities improved innovation insight mHealth marginalized community marginalized population member minority stress minority stressor mortality negative affect novel perceived discrimination physical conditioning programs racial discrimination research data dissemination sensor skills smoking abstinence smoking cessation smoking-related cancer social social health determinants stressor time use tobacco control trend

项目摘要

PROJECT SUMMARY/ABSTRACT Cigarette smoking is a leading cause of morbidity and mortality in the U.S. Marginalized communities, such as Black/African Americans (B/AA) and sexual and gender minorities (SGM), experience increased risk for smoking-related cancers and unique social and contextual stressors that may hinder successful quitting. For example, B/AA and SGM experience pervasive minority stressors (e.g., stigmatization and discrimination) known to negatively impact mental health, health behaviors, and physical health outcomes. Although extensive research has linked perceived discrimination with current smoking behavior among B/AA and SGM, no studies have examined how discrimination impacts smoking cessation within these groups. Mobile health (mHealth) technologies such as ecological momentary assessment (EMA) and AutoSense – a suite of wearable physiological sensors – can provide real-time, real-world assessments of lived experiences during a quit attempt to predict smoking behavior and inform the development of adaptive interventions. The objective of the proposed research is to use mHealth approaches to advance current knowledge of the mechanisms by which minority stressors such as discrimination contribute to inequities in cancer risk among B/AA and SGM. Aim 1 will utilize data from a recently completed study to analyze pathways linking real-time, real-world experiences of discrimination and smoking lapse during a quit attempt among B/AA (N = 300). Aim 2 will utilize data from an ongoing study to elucidate pathways linking real-time, real-world experiences of discrimination and smoking lapse during a quit attempt among SGM, and further compare experiences of discrimination, associated intrapersonal experiences (e.g., stress, affect), and smoking lapse between SGM and non-SGM during a quit attempt (N = 375 [300 non-SGM + 75 SGM]). Key mechanisms hypothesized to mediate the temporal association between discrimination and smoking lapse are stress, negative affect, urge, and self- efficacy. This research will be conducted at Huntsman Cancer Institute, an NCI-Designated Cancer Center that offers an exceptionally supportive and collaborative training environment. The applicant’s comprehensive training plan, developed in conjunction with an expert mentoring team, will directly support the completion of the proposed research and complement the applicant’s prior training in cancer inequities research. Fellowship training goals focus on: 1) advanced statistical methods for analyzing intensive longitudinal data; 2) mHealth assessment and intervention approaches; 3) primary cancer prevention and smoking cessation; 4) health inequities and the social determinants of health; and 5) professional development, including grant writing, research dissemination, research ethics, and mentoring. The proposed research and training activities will provide the applicant with the necessary knowledge and skills needed to establish an independent and productive research program dedicated to eliminating cancer inequities across the cancer control continuum.

项目概要/摘要吸烟是美国边缘化社区发病和死亡的主要原因，例如黑人/非裔美国人 (B/AA) 以及性少数群体 (SGM) 的风险增加与吸烟相关的癌症以及可能阻碍成功戒烟的独特社会和环境压力。例如，B/AA 和 SGM 面临着普遍的少数族裔压力（例如污名化和歧视）已知会对心理健康、健康行为和身体健康结果产生负面影响，尽管影响广泛。研究已将 B/AA 和 SGM 中的感知歧视与当前吸烟行为联系起来，但没有研究研究了歧视如何影响这些群体的戒烟。移动健康（mHealth）。生态瞬时评估 (EMA) 和 AutoSense 等技术 – 一套可穿戴设备生理学——可以在戒烟期间提供对生活体验传感器的实时、真实的评估尝试预测吸烟行为并为适应性干预措施的制定提供信息。拟议的研究是利用移动医疗方法来推进当前对该机制的了解歧视等少数民族压力因素导致 B/AA 和 SGM 之间癌症风险的不平等。目标 1 将利用最近完成的一项研究的数据来分析连接实时、真实世界的路径 B/AA 中尝试戒烟期间的歧视和戒烟经历（N = 300）将利用目标 2。来自正在进行的研究的数据，旨在阐明连接实时、现实世界的歧视经历的途径 SGM 中尝试戒烟期间的吸烟情况，并进一步比较歧视经历， SGM 和非 SGM 之间相关的个人经历（例如压力、情感）和吸烟情况在戒烟尝试期间（N = 375 [300 个非 SGM + 75 个 SGM]）。歧视和戒烟之间的时间关联是压力、负面情绪、冲动和自我感觉。这项研究将在亨斯曼癌症研究所进行，该研究所是 NCI 指定的癌症中心。为申请人提供异常支持和协作的培训环境。与专家指导团队共同制定的培训计划将直接支持完成拟议的研究并补充申请人之前在癌症不平等研究方面的培训。培训目标侧重于：1）分析纵向密集数据的先进统计方法；2）移动医疗；评估和干预方法；3) 初级癌症预防和戒烟；4) 健康；不平等和健康的社会决定因素；5) 专业发展，包括资助申请，研究传播、研究伦理和指导。为申请人提供建立独立性和独立性所需的必要知识和技能致力于消除整个癌症控制过程中癌症不平等现象的富有成效的研究计划。