Cultural Model of Prevention in African-American Women

非裔美国妇女的预防文化模式

• 批准号: 6749439
• 负责人: KATRINA ARMSTRONG
• 金额: $ 15.85万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6749439
• 关键词: African American; behavior prediction; behavioral /social science research tag; belief; breast neoplasms; cancer prevention; chemoprevention; clinical research; culture; data collection methodology /evaluation; decision making; female; genetic susceptibility; health behavior; health care model; human subject; interview; psychometrics; questionnaires; social psychology; tamoxifen; women' s health

DESCRIPTION (provided by applicant): Use of chemoprevention, such as tamoxifen, among high-risk African American women could significantly reduce mortality among this group. However, cultural barriers may exist to African-American women adopting chemoprevention. An African American health maintenance model, characterized by the concept of the body as a fragile homeostatic system that is easily disrupted by impure elements such as unnecessary medications, negative thinking and stress, may impact chemoprevention uptake and use. In order to understand the dimensions of this model and its potential impact on chemoprevention among African American women, we intend to: 1) Verify the elements of the above model, identify any other contributing elements prior research did not uncover, and clarify dynamic relationships among the elements to define a culturally specific model of health maintenance and disease prevention among African American women; 2) Discover whether this model may affect preventive medical decision making about tamoxifen use among African American women who are at high risk of breast cancer; and 3) Lay the groundwork for future research examining how this model functions relative to other models known to be important to medical decision making. These goals will be best achieved through a two-step qualitative study, to reduce complexity and allow emerging insights to guide inquiry throughout the research process. Study 1 will guide the accurate representation of the above model and inform development of the data manual to be used in Study 2. Data from existing literature, focus groups and in-depth interviews will inform this step. Study 2 will explore what role the model defined in Study 1 plays in decision making about chemoprevention use among women at risk for breast cancer. A purposive sample of 120 African American women with a first-degree relative diagnosed with breast cancer will be sufficient to conduct analyses. Semi-structured interviews will elicit how this model might play a role in decision making about tamoxifen and consensus analysis will estimate how strongly the overall group knows about and believes in the model. Analysis will provide preliminary information regarding points of convergence and divergence between the biomedical and African American models of health maintenance. This understanding may lay the groundwork for improved understanding and trust between biomedical practitioners and African American patients.

描述（由申请人提供）：在高危非裔美国妇女中使用化学预防，例如他莫昔芬，可以显着降低这一组的死亡率。但是，采用化学预防的非裔美国妇女可能存在文化障碍。非裔美国人的健康维护模型，其特征是人体作为脆弱的体内稳态系统的概念，它很容易被不必要的元素（例如不必要的药物，负面思维和压力）破坏，可能会影响化学预防的吸收和使用。为了了解该模型的维度及其对非洲裔美国妇女化学预防的潜在影响，我们打算：1）验证上述模型的要素，确定任何其他贡献元素先前的研究都没有发现，并阐明元素之间的动态关系，以定义一种在非裔美国妇女中的健康模型预防和预防疾病的文化模型； 2）发现该模型是否会影响有关乳腺癌高风险的非裔美国妇女中使用他莫昔芬使用的预防性医学决策； 3）为将来的研究奠定基础，以研究该模型相对于其他对医疗决策重要的模型的功能。这些目标将通过两步定性研究来实现，以降低复杂性并允许新兴的见解在整个研究过程中指导询问。研究1将指导上述模型的准确表示，并告知研究2中使用的数据手册的开发。现有文献，焦点小组和深入访谈的数据将为这一步骤提供信息。研究2将探讨研究1中定义的模型在对乳腺癌风险的女性化学预防使用中的决策中扮演什么作用。一个有目的的样本，由120名被诊断为乳腺癌的一级亲戚的非洲裔美国妇女足以进行分析。半结构化的访谈将引起该模型如何在有关他莫昔芬的决策中发挥作用，并共识分析将估计整个小组对模型的了解和相信。分析将提供有关生物医学和非裔美国人健康维持模型之间收敛和差异点的初步信息。这种理解可能为改善生物医学从业者和非裔美国人患者之间的理解和信任提供了基础。