Secondary Analysis of NC-BCSP Mammography Use Evaluation

NC-BCSP乳腺X线摄影使用评价的二次分析

• 批准号: 6707741
• 负责人: JO ANNE L EARP
• 金额: $ 13.14万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-02 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6707741
• 关键词: African American; Medicare /Medicaid; behavioral /social science research tag; bioimaging /biomedical imaging; breast neoplasms; clinical research; early diagnosis; female; geographic difference; health behavior; health care referral /consultation; health care service availability; health care service evaluation; health care service utilization; health disparity; health services research tag; human data; human old age (65+); longitudinal human study; low socioeconomic status; mammography; medically underserved population; physicians; rural area; social support network

DESCRIPTION (provided by applicant): The North Carolina Breast Cancer Screening Program (NC-BCSP) has conducted a ten-year effectiveness trial of a natural helper lay health advisor intervention in 10 counties (5 interventions, 5 comparisons) in eastern North Carolina to increase mammography use by low-income, rural, African American women. Three waves (baseline and 2 follow-ups) of interview data collected from a stratified random sample of, initially, 1000 Black women (500 intervention, 500 comparison) indicate that NC-BCSP's lay health advisor intervention was modestly effective overall after 30 months (at first follow-up IT2] in 1997), and associated with a greater increase in recent mammography use among specific subgroups, particularly women with annual family incomes under $12,000. The proposed exploratory study uses all three waves of cohort data to determine: 1) whether NC-BCSP's intervention effect was sustained over the full 8 years of the evaluation (T1-T3), and for which subgroups; 2) what factors are associated with, and what pathways mediated, the intervention's effect initially (T1 - T2,) and in the second follow-up period (T2-T3); 3) how successfully an existing administrative data set (Medicare) can be used, instead of self-report data, to evaluate intervention effectiveness; and 4) whether geographical proximity, as measured by GIS software, of lay advisors to cohort respondents can serve as a useful proxy for self-report measures of exposure to the lay advisors. Analyses will use multivariate models with logistic regression and generalized estimating equations to account for repeated mammography reports. The proposed secondary analyses of this unique longitudinal data set will provide valuable insights for designing more effective, better targeted, and more cost-effective interventions to reach the hardest-to-reach rural women still not being screened regularly. The goal of this grant is to understand the differences between continuous users, backsliders, late adopters and non-users of screening mammography, and the mechanisms, which explain variation in these groups' exposure to the intervention and their use, or non-use, of mammography.

描述（由申请人提供）：北卡罗来纳州乳腺癌筛查计划 (NC-BCSP) 在北卡罗来纳州东部 10 个县（5 项干预措施，5 项比较）进行了一项为期 10 年的自然辅助非专业健康顾问干预措施的有效性试验，以增加低收入、农村、非裔美国妇女对乳房 X 光检查的使用。从最初 1000 名黑人女性的分层随机样本中收集的三波（基线和 2 次随访）访谈数据（500 名干预，500 名比较）表明 NC-BCSP 的非专业健康顾问干预在 30 个月后总体上是适度有效的（第一次后续行动 IT2] 于 1997 年），并且与最近特定亚组中乳房 X 光检查使用的大幅增加有关，特别是家庭年收入低于12,000 美元。 拟议的探索性研究使用所有三波队列数据来确定：1）NC-BCSP 的干预效果是否在整个评估的 8 年（T1-T3）中持续存在，以及针对哪些亚组； 2) 哪些因素与最初（T1 - T2）和第二个随访期（T2-T3）干预效果相关，以及哪些途径介导； 3) 如何成功地使用现有的管理数据集（医疗保险）代替自我报告数据来评估干预效果； 4) 通过地理信息系统软件测量，非专业顾问与队列受访者的地理接近程度是否可以作为自我报告接触非专业顾问的指标的有用指标。分析将使用具有逻辑回归和广义估计方程的多变量模型来解释重复的乳房X光检查报告。 拟议对这个独特的纵向数据集进行二次分析将为设计更有效、更有针对性和更具成本效益的干预措施提供宝贵的见解，以帮助那些最难接触到但尚未定期筛查的农村妇女。这笔赠款的目的是了解筛查性乳房X光检查的持续使用者、倒退者、晚期采用者和非使用者之间的差异，以及解释这些群体接触干预措施及其使用或不使用的差异的机制，乳房X光检查。