Exploring Sociodemographic and Behavioral Factors Underlying Racial/Ethnic Dispar

探索种族/民族差异背后的社会人口和行为因素

基本信息

批准号：
8909075
负责人：
Stephanie Anne Navarro Silvera
金额：
$ 13.82万
依托单位：
MONTCLAIR STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-15 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8909075
关键词：
Accounting Address Adherence Area Award Awareness Behavior Behavioral Breast Cancer Detection Cancer Control Cancer Etiology Cancer Institute of New Jersey Case-Control Studies Cervical Cancer Screening Characteristics Classification Collaborations Communication Communities Complex Computers Cross-Sectional Studies Data Data Analyses Demographic Factors Development Development Plans Diagnosis Diet Dominican Education Educational process of instructing Enrollment Epidemiologic Studies Epidemiology Ethnic Origin Faculty Food Future Geographic Locations Goals Guidelines Health Health Services Accessibility Health behavior Hispanics Home environment Individual Institutes Institution Intervention Joints K-Series Research Career Programs Knowledge Latina Latino Lead Library Services Life Style Literature Low income Malignant Neoplasms Malignant neoplasm of cervix uteri Malignant neoplasm of esophagus Mammography Measures Medical Medicine Mentors Methodology Mexican Modeling Neighborhoods New Jersey Not Hispanic or Latino Outcome Pap smear Participant Perception Persons Population Population Heterogeneity Poverty Preventive Public Health Schools Puerto Rican Race Reading Recruitment Activity Research Research Personnel Resources Risk Factors Role Screening for cancer Services Socioeconomic Status Students Time TimeLine Training Trees United States Universities Variant Visit Wages Woman Work cancer epidemiology cancer health disparity cancer prevention career career development college cost doctoral student experience graduate student health disparity high risk insight interest malignant breast neoplasm malignant stomach neoplasm meetings member mortality multidisciplinary novel nutrition nutrition education post-doctoral training programs racial and ethnic racial and ethnic disparities racial disparity risk perception screening social socioeconomics symposium tool

项目摘要

DESCRIPTION (provided by applicant): Through my doctoral and post-doctoral training, I have a broad background in cancer epidemiology, with specific training and expertise in nutrition. As a doctoral student at Yale University, I analyzed data from a large multicenter case-control study of esophageal and gastric cancers. As part of this study, I examined dietary and lifestyle risk factors, including the use of novel statistical approaches such as principle components analysis and classification and regression tree analysis. During my time at Albert Einstein College of Medicine (AECOM), I analyzed data from the National Breast Screening Study (NBSS) where I examined the roles of various lifestyle and medical risk factors for numerous cancer outcomes. As a result of these experiences, I am aware of the importance of developing and maintaining successful collaborations through frequent communication among project members and of constructing a realistic research plan and timeline. My past training has provided me with the initial tools to conduct epidemiologic studies and led to my deep interest in racial/ethnic disparities in cancer outcomes. However, I lack the breadth of knowledge in three areas (Social Epidemiology, Cancer Prevention and Control, and Spatial Analyses) necessary to conduct and lead multidisciplinary studies of cancer prevention behaviors and cancer disparities. Further, due to lack of research mentoring opportunities at my current institution, an my heavy teaching load, my development as an independent researcher in this area has been limited. To accomplish my career goal of becoming an independent investigator, and a recognized expert in the disparities in cancer outcomes, I am proposing a career development plan in which I will expand my training through coursework in social epidemiology, health disparities, and spatial analysis as well as through guided readings, regular meetings with mentors and consultants, center visits, and attendance at selected seminars, and conferences. I will be working with an outstanding mentoring team, including Drs. Demissie and Bandera (both at UMDNJ) and Dr. Jones (Yale University), all of whom are experts in the field of cancer prevention and control and health disparities and who have extensive experience mentoring masters and doctoral level students and junior faculty. The Department of Epidemiology at UMDNJ engages in a number of epidemiology activities, courses, and seminars, (www.umdnj.edu) including activities at the School of Public Health, the Institute for the Elimination of Health Disparities (IEHD), and the Cancer Institute of New Jersey. Dr. Demissie, as Director of IEHD, and Dr. Bandera's work with CINJ, will also provide great opportunities for intellectual interactions and future collaborations with both of these institutes. In addition, we have identified a number of consultants, including Dr. Yu, who is at my home institution, who will provide training and assistance in GIS, Dr. Palmer who will provide assistance in recruiting participants from SNAP-Ed and EFNEP, Dr. Dubin who will provide expertise and assistance in statistical methodology and Drs. Natale-Periera and Echeverria who will provide expertise in health disparities and social epidemiology. During the entire period of the award, my department chair and college Dean, have agreed to provide substantial support to devote at least 9 person months (75% full-time professional effort) to develop my research program, which includes limiting my teaching load, supporting my salary that goes above and beyond the $100,000 cap for K awards, reducing my responsibility to represent the Department in College and University committees, and providing me with necessary resources including, office space, secretarial support, graduate student support, and access to computer support and library services. The proposed K01 Career Development Award will also allow the development of an epidemiologic research program in Cancer Disparities in New Jersey. Breast and cervical cancer are leading causes of cancer for women in the United States, respectively and racial/ethnic disparities in diagnosis and mortality are well noted in the literature. These disparities are explained, in part, by unequal access to cancer screening across socioeconomic and racial groups, however little is known about the impact of perception of access to cancer screening on cancer screening behaviors. This study will assess the association between race/ethnicity, perceived access to screening, and individual-level socioeconomic (SES) and demographic factors and area-level characteristics, including SES, availability of low- or no-cost cervical cancer screening and mammography, on screening behavior using a cross-sectional study of low-income women enrolled in the New Jersey Supplemental Nutrition Assistance Program - Education (SNAP-Ed) or Expanded Food and Nutrition Education Programs (EFNEP). Multivariate models will examine the individual and joint effects of geographic and perceived access on adherence to breast and cervical cancer screening guidelines, after adjusting for individual- and area-level characteristics. These findings will serve to examine the complex interaction between socioeconomic status and health behaviors, how they differ between non-Hispanic Black, non-Hispanic White and Hispanics, in New Jersey, which has one of the highest cancer rates in the nation. This project will also serve to develop preliminary data to support an R01 application proposing to conduct a larger scale study, and possibly, an intervention to address these issues in this community.

描述（由申请人提供）：通过我的博士和博士后培训，我在癌症流行病学方面拥有广泛的背景，并在营养方面接受过专门的培训和专业知识。作为耶鲁大学的博士生，我分析了一项针对食管癌和胃癌的大型多中心病例对照研究的数据。作为这项研究的一部分，我检查了饮食和生活方式的危险因素，包括使用新的统计方法，例如主成分分析以及分类和回归树分析。在阿尔伯特·爱因斯坦医学院 (AECOM) 工作期间，我分析了国家乳腺筛查研究 (NBSS) 的数据，研究了各种生活方式和医疗风险因素对多种癌症结果的影响。由于这些经验，我意识到通过项目成员之间的频繁沟通以及制定切合实际的研究计划和时间表来发展和维持成功合作的重要性。我过去的培训为我提供了进行流行病学研究的初步工具，并使我对癌症结果的种族/民族差异产生了浓厚的兴趣。然而，我缺乏对三个领域（社会流行病学、癌症预防和控制以及空间分析）进行和领导癌症预防行为和癌症差异的多学科研究所必需的广泛知识。此外，由于我目前所在的机构缺乏研究指导机会，教学负担过重，我作为独立研究员在该领域的发展受到了限制。为了实现成为一名独立研究者和癌症结果差异方面公认的专家的职业目标，我提出了一项职业发展计划，其中我将通过社会流行病学、健康差异和空间分析课程来扩展我的培训例如通过指导阅读、与导师和顾问定期会面、参观中心以及参加选定的研讨会和会议。我将与一个杰出的指导团队合作，包括博士。 Demissie 和 Bandera（均来自 UMDNJ）以及 Jones 博士（耶鲁大学），他们都是癌症预防和控制以及健康差异领域的专家，在指导硕士和博士级学生以及初级教师方面拥有丰富的经验。 UMDNJ 流行病学系从事许多流行病学活动、课程和研讨会（www.umdnj.edu），包括公共卫生学院、消除健康差距研究所 (IEHD) 和癌症中心的活动新泽西研究所。 Demissie 博士作为 IEHD 主任，以及 Bandera 博士与 CINJ 的合作，也将为与这两个机构的知识交流和未来合作提供良好的机会。此外，我们还确定了一些顾问，包括我所在机构的 Yu 博士，他将提供 GIS 方面的培训和帮助，Palmer 博士将帮助招募 SNAP-Ed 和 EFNEP 的参与者，杜宾（Dubin）将提供统计方法方面的专业知识和帮助。 Natale-Periera 和 Echeverria 将提供健康差异和社会流行病学方面的专业知识。在整个获奖期间，我的系主任和学院院长同意提供大量支持，投入至少 9 个人月（75% 全职专业努力）来开发我的研究项目，其中包括限制我的教学负担，支持我超出 K 奖 100,000 美元上限的薪水，减少我在学院和大学委员会中代表系的责任，并为我提供必要的资源，包括办公空间、秘书支持、研究生支持和计算机使用权支持和库服务。拟议的 K01 职业发展奖还将促进新泽西州癌症差异流行病学研究项目的发展。乳腺癌和宫颈癌分别是美国女性癌症的主要原因，并且文献中充分注意到诊断和死亡率方面的种族/民族差异。这些差异的部分原因是不同社会经济和种族群体获得癌症筛查的机会不平等，但人们对获得癌症筛查的看法对癌症筛查行为的影响知之甚少。这项研究将评估种族/族裔、感知的筛查机会、个人层面的社会经济 (SES) 和人口因素以及地区层面的特征之间的关联，包括 SES、低成本或免费宫颈癌筛查和乳房 X 光检查的可用性、使用对参加新泽西州补充营养援助计划 - 教育 (SNAP-Ed) 或扩展食品和营养教育计划 (EFNEP) 的低收入妇女进行横断面研究来筛查行为。在调整个人和地区层面的特征后，多变量模型将检查地理和感知访问对遵守乳腺癌和宫颈癌筛查指南的个人和联合影响。这些发现将有助于研究新泽西州的社会经济地位和健康行为之间复杂的相互作用，以及它们在非西班牙裔黑人、非西班牙裔白人和西班牙裔美国人之间的差异，新泽西州是全国癌症发病率最高的地区之一。该项目还将用于开发初步数据支持 R01 申请，建议进行更大规模的研究，并可能采取干预措施来解决该社区的这些问题。