Pilot Project 1: Testing the effectiveness of an intervention to foster cervical cancer screening promotion for Latinx trans men among medical students

试点项目 1：测试干预措施的有效性，以促进医学生中拉丁裔跨性别男性的宫颈癌筛查推广

• 批准号: 10762083
• 负责人: Matthew B. Schabath
• 金额: $ 8.39万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-24 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762083
• 关键词: Active Learning; Address; Attitude; Automobile Driving; Behavior; Behavioral; Body part; Cancer Center; Caring; Cervical Cancer Education; Cervical Cancer Screening; Clinical; Collaborations; Communities; Competence; Data; Disparity; Effectiveness of Interventions; Emotional; Ethnic Origin; Ethnic Population; Exhibits; Feasibility Studies; Female; Florida; Fostering; Funding; Gender; Gender Identity; Guidelines; Health Knowledge Attitudes Practice; Health Personnel; Health Sciences; Healthcare; Hispanic Populations; Incidence; Individual; Interdisciplinary Study; Intervention; Interview; Knowledge; Latino Population; Latinx; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Masculine; Measures; Medical Education; Medical Students; Modeling; Nature; Participant; Patient Self-Report; Patient Simulation; Patients; Persons; Pilot Projects; Politics; Population; Prevention; Prevention Guidelines; Provider; Puerto Rico; Randomized, Controlled Trials; Recommendation; Reduce health disparities; Research; Research Design; Research Personnel; Research Project Grants; Screening for cancer; Services; Standardization; Stigmatization; Testing; Treatment Efficacy; Universities; Work; assigned female at birth; cancer health disparity; cervical cancer prevention; cisgender; design; disease disparity; effective intervention; effectiveness testing; ethnic minority; experience; gender affirmation; gender expression; gender minority; health disparity; high risk; implementation measures; implementation outcomes; implementation strategy; improved; intersectionality; intervention effect; male; man; medical schools; nonbinary; online intervention; provider behavior; screening; sex assigned at birth; simulation; skills; social; social cognitive theory; student training; theories; tool; transgender men

ABSTRACT | PILOT RESEARCH PROJECT Transmen (TM) and non-binary individuals (NB; individuals assigned female sex at birth who identify as a man, male, or another diverse non-binary gender identity on the masculine spectrum) are at higher risk of screening- detectable cancers. The incidence of cervical cancer among Latinx (a gender-neutral term designating Hispanics/Latinos (H/L)) is the highest among all ethnic groups in the US. Thus, Latinx TM and NB (LTM-NB) are at a higher risk for cervical cancer as they lie at the intersection (i.e., gender and ethnic minorities) of two populations that experience health disparities for this disease. Individual and interpersonal level factors in interactions with health care providers such as the gendered nature of testing, “misgendering” or use of incorrect pronouns, and avoidance to discuss issues about body parts associated with their assigned at birth gender have been identified as some of the key aspects driving cervical cancer disparities among LTM-NB. In addition, healthcare providers’ negative attitudes and insensitivity can contribute to emotional discomfort for testing, adding another screening barrier. Our previous studies among LTM-NB in Puerto Rico and Florida show that providers lack knowledge about specific healthcare needs, have negative stigmatizing attitudes, and manifest discriminatory behaviors in clinical interactions with LTM-NB. However, although there are existing guidelines to foster cancer early detection and prevention among TM, no guidelines or interventions address the increased disparities encountered by ethnic minority LTM-NB. We developed a brief online intervention to improve medical students’ competencies for cervical cancer education and screening promotion among LTM- NB. The efficacy of this intervention has already been tested and exhibited medium to large effect sizes. The Aims of this proposed study are: Aim 1) Test the effectiveness of the intervention in increasing medical students’ knowledge, attitudes, and skills for providing healthcare to LTM-NB. This will be achieved by conducting a randomized controlled trial with participants from Ponce Health Science University and from Moffitt Cancer Center-University of South Florida. Quantitative measures (knowledge and attitudes) and SPS direct observations (behaviors) will be collected to examine the intervention’s effectiveness. The rationale for this aim is to determine the additional effect of the measure. Aim 2) Determine the acceptability, appropriateness, and feasibility of implementing the interventions in real-world medical educational settings. We will implement quantitative self-report measures and individual interviews with a sub-sample of participants from the experimental condition (n=10) to examine implementation outcomes (acceptability, appropriateness, and feasibility). The impact of this study will reveal new effective interventions and implementation strategies. The translational implications of this work will result in providing medical schools with a cross-cultural tool to train students on cervical cancer prevention for LTM- NB.

摘要|试点研究项目 变性人（TM）和非二进制个人（NB；分配出生时分配男性的男人， 男性谱系上的男性或其他潜水员的非性别认同）筛查的风险更高 - 可检测的癌症。拉丁裔中宫颈癌的事件（性别中性术语指定 西班牙裔/拉丁裔（H/L）是美国所有种族中最高的。那是Latinx TM和NB（LTM-NB） 宫颈癌的风险更高，因为它们处于两个交叉口（即性别和少数民族）的风险 为这种疾病经历健康分配的人群。个人和人际级别因素 与医疗保健提供者的互动，例如测试的性别性质，“错误性”或不正确的使用 代词，避免讨论与分配性别分配的身体部位的问题 被确定为驱动LTM-NB中宫颈癌差异的一些关键方面。此外， 医疗保健提供者的负面出勤率和不敏感会导致情绪不适，以进行测试， 添加另一个筛选障碍。我们先前在波多黎各和佛罗里达州的LTM-NB中进行的研究表明 提供者缺乏有关特定医疗保健需求的知识，具有负面污名化的吸引力，并表现出来 与LTM-NB临床相互作用的歧视行为。但是，尽管有现有的准则 促进癌症在TM中的早期检测和预防，没有指南或干预措施解决增加 少数民族LTM-NB遇到的差异。我们开发了简短的在线干预以改善医疗 学生在LTM-NB中的宫颈癌教育和筛查促进的能力。效率 该干预措施已经进行了测试，并暴露于大型效果大小。这个建议的目的 研究是：目标1）测试干预措施在增加医学生知识的有效性，与会者， 以及向LTM-NB提供医疗保健的技能。这将通过进行随机对照试验来实现 来自Ponce Health Science University和South Moffitt Cancer Center-University的参与者 佛罗里达。定量测量（知识和参加）和SPS直接观察（行为）将是 收集以检查干预措施的有效性。此目的的理由是确定 测量的效果。目标2）确定实施的可接受性，适当性和可行性 现实世界中医学教育环境的干预措施。我们将实施定量的自我报告措施，并 从实验条件（n = 10）的参与者子样本进行的个人访谈以检查 实施结果（可接受性，适当性和可行性）。这项研究的影响将揭示 新的有效干预和实施策略。这项工作的翻译含义将导致 在为医学院提供跨文化工具，以培训学生为LTM-的宫颈癌预防。 NB。