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.

项目概要 亚裔美国人是美国所有种族/族裔群体中增长最快的人口，并且 华裔是美国亚裔人口中最大的群体，占美国亚裔人口总数的 24% 人口。在成年华裔美国人中，大约 43% 的人表示英语水平有限 (LEP);这一比例在外国出生的华裔美国人中更高，其中 56% 拥有 LEP。这些 鉴于研究表明 LEP 与 参与癌症筛查。事实上，LEP 可能导致宫颈癌中观察到的差异 与非西班牙裔白人相比，华裔美国女性的筛查率较低（65.8%） 女性（82.8%）。国家健康访谈调查 (NHIS) 的估计也指出了类似的差异 筛查，与黑人/非裔美国人相比，中国女性报告巴氏试验使用率较低 (68.7%) 女性 (84.3%) 和 AI/AN 女性 (81.2%) 以及与菲律宾人等其他亚洲亚群体相比 （82.7%）。重要的是，在新移民中，中国女性接受子宫颈抹片检查的比例最低。 多种因素导致患有 LEP 的美国华裔女性未进行筛查，包括缺乏 保险或定期医疗保健提供者、缺乏时间、语言困难和尴尬。新兴 支持人乳头瘤病毒 (HPV) 检测自我采样的技术可能会提供有价值的、 为筛查不足和医疗服务不足的华裔美国女性赋权的循证策略 拥有 LEP 才能参与宫颈癌筛查。尽管之前的研究表明 在资源匮乏的社区环境中可以可行地提供 HPV 自我采样，但没有一项研究重点关注 华裔美国女性，尽管该人群的宫颈癌筛查率最低 费率。因此，本行政补充的目标是检查社区中的 HPV 自我采样情况 150 名患有 LEP 的华裔美国女性样本。在这项随机研究中，75 名女性将接受我们的 之前测试过关于宫颈癌筛查加导航以及 HPV 的社区教育计划 自采样套件； 75 名女性将接受我们之前测试过的社区教育计划以及 导航至基于临床的筛查。拟议补充的目的是： (1) 比较提供的比率 自行采集样本与在 150 名美籍华人中进行临床宫颈癌筛查的比较 患有 LEP 的女性。自我采样或临床筛查的参与情况将在 6 个月的随访中进行评估。它 假设参加 HPV 自我采样计划的华裔美国女性中提供 自行收集的样本将高于在基于诊所的计划中获得临床样本的女性比例 为基础的筛选。本增刊中提出的研究将是第一个评估 HPV 的随机研究 对服务不足的患有 LEP 的华裔美国女性进行自我抽样。我们的研究结果将为未来提供证据—— 旨在加强对这一未充分研究人群的筛查的计划。