Evidence-Based Approach to Empower Asian American Women in Cervical Cancer Screening

增强亚裔美国女性宫颈癌筛查能力的循证方法

• 批准号: 10675168
• 负责人: Carolyn Y. Fang
• 金额: $ 42.58万
• 依托单位: RESEARCH INST OF FOX CHASE CAN CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675168
• 关键词: Accounting; Administrative Supplement; Adult; African American; Asian; Asian Americans; Asian population; Black race; Cervical Cancer Screening; Chinese; Chinese American; Chinese population; Clinic; Communities; Community Health Education; Data; Emerging Technologies; English Language; Ethnic group; Evidence based program; Face; Future; Goals; Health Personnel; Human Papillomavirus; Immigrant; Insurance; Language; Light; Limited English Proficiency; National Health Interview Survey; Not Hispanic or Latino; Pap smear; Population; Randomized; Reporting; Research; Resource-limited setting; Sampling; Screening for cancer; Subgroup; Testing; Time; Woman; base; community setting; design; empowered; evidence base; evidence based guidelines; follow-up; medically underserved; programs; racial and ethnic; screening

PROJECT SUMMARY Asian Americans are the fastest growing population across all US racial/ethnic groups, and individuals of Chinese origin represent the largest US Asian subgroup, accounting for up to 24% of the total US Asian population. Among adult Chinese Americans, approximately 43% report limited English language proficiency (LEP); this rate is even higher among foreign-born Chinese Americans, among which 56% have LEP. These data are meaningful in light of studies demonstrating a strong negative association between LEP and participation in cancer screening. Indeed, LEP may be contributing to the disparity observed in cervical cancer screening rates, which are lower among Chinese American women (65.8%) compared with non-Hispanic White women (82.8%). Estimates from the National Health Interview Survey (NHIS) also note similar disparities in screening, with Chinese women reporting lower Pap test use (68.7%) compared to Black/African American women (84.3%) and AI/AN women (81.2%) and in comparison with other Asian subgroups such as Filipinas (82.7%). Importantly, among recent immigrants, proportions of Pap test use were lowest for Chinese women. Multiple factors contribute to non-screening among Chinese American women with LEP including lack of insurance or regular healthcare provider, lack of time, language difficulties, and embarrassment. Emerging technologies supporting self-sampling for human papillomavirus (HPV) testing may offer a valuable, evidence-based strategy for empowering underscreened and medically underserved Chinese American women with LEP to be able to participate in cervical cancer screening. Although prior studies have demonstrated that HPV self-sampling can be feasibly offered in low-resource community settings, not one study has focused on Chinese American women, despite the fact that this population has among the lowest cervical cancer screening rates. Therefore, the goal of this administrative supplement is to examine HPV self-sampling in a community sample of 150 Chinese American women with LEP. In this randomized study, 75 women will receive our previously tested community education program on cervical cancer screening plus navigation, along with HPV self-sampling kits; and 75 women will receive our previously tested community education program plus navigation to clinic-based screening. The aim of the proposed supplement is to: (1) Compare rates of providing a self-collected sample vs. obtaining clinic-based cervical cancer screening among 150 Chinese American women with LEP. Participation in self-sampling or clinic-based screening will be assessed at 6-month follow-up. It is hypothesized that the proportion of Chinese American women in the HPV self-sampling program who provide a self-collected sample will be higher than the proportion of women in the clinic-based program who obtain clinic- based screening. The research proposed in this supplement will be the first randomized study to evaluate HPV self-sampling among underserved Chinese American women with LEP. Our findings will inform future evidence- based programs to enhance screening in this understudied population.

项目摘要 亚裔美国人是美国所有种族/种族中增长最快的人口， 中国血统代表了美国最大的亚洲亚组，占美国亚洲总数的24％ 人口。在成年美国人中，大约有43％的人报告有限的英语能力 （LEP）;在外国出生的美国人中，这种速度甚至更高，其中有56％的人患有LEP。这些 鉴于研究表明LEP和 参与癌症筛查。实际上，LEP可能导致宫颈癌中观察到的差异 与非西班牙裔白色相比 妇女（82.8％）。国家健康访谈调查（NHIS）的估计还指出了类似的差异 筛查，与黑人/非裔美国人相比 妇女（84.3％）和AI/A/A妇女（81.2％），与其他亚洲亚组相比 （82.7％）。重要的是，在最近的移民中，对于中国妇女而言，PAP测试的比例最低。 多种因素导致在美国LEP的美国女性中不进行筛查，包括缺乏 保险或常规医疗保健提供者，缺乏时间，语言困难和尴尬。新兴 支持人乳头瘤病毒（HPV）测试的自我采样的技术可能会提供有价值的， 基于证据的策略，以授权未延续和医学服务不足的美国妇女 LEP能够参与宫颈癌筛查。尽管先前的研究表明 HPV可以在低资源社区环境中可行地提供HPV自我采样，而没有一项研究专注于 尽管这个人口具有最低的宫颈癌筛查，但美国女性妇女 费率。因此，这种行政补充的目的是检查社区中的HPV自我采样 样本的150名美国LEP的美国女性。在这项随机研究中，有75名妇女将收到我们的 先前对宫颈癌筛查以及导航的社区教育计划以及HPV 自我采样套件； 75名妇女将获得我们先前测试的社区教育计划以及 导航基于诊所的筛查。拟议的补充的目的是：（1）比较提供的速率 自我收集的样本与150名华裔美国人的基于诊所的宫颈癌筛查 LEP的妇女。参与自我采样或基于诊所的筛查将在6个月的随访中评估。它 假设在HPV自杀计划中，美国华裔女性的比例 自我收集的样本将高于基于诊所的计划中获得诊所的妇女比例 基于筛选。该补充剂中提出的研究将是评估HPV的首次随机研究 LEP服务不足的美国女性中的自我采样。我们的发现将为未来的证据提供信息 - 基于增强该研究研究人群的筛查的计划。