Empowering Latinas to Obtain Breast Cancer Screenings

帮助拉丁裔获得乳腺癌筛查

• 批准号: 9757718
• 负责人: Yamile Molina
• 金额: $ 14.68万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9757718
• 关键词: Address; Adherence; Advisory Committees; Advocate; Affect; Applications Grants; Area; Behavior; Breast; Breast Cancer Detection; Breast Cancer survivor; Cancer Center; Caring; Chicago; Clinical; Communities; Community Health; Community Health Aides; Control Groups; Detection; Development; Diagnosis; Diffusion; Education; Educational Intervention; Educational workshop; Environment; Evaluation; Family; Focus Groups; Friends; Funding; Gender; Goals; Grant; Guidelines; Health; Health Fairs; Health Promotion; Health Services; Health behavior; Hispanic-serving Institution; Illinois; Individual; Institutes; Institution; International Union Against Cancer; Intervention; K-Series Research Career Programs; Knowledge; Latina; Latino; Lead; Learning; Light; Literature; Malignant Neoplasms; Manuscripts; Measures; Medical Records; Mentors; Mentorship; Meta-Analysis; Methods; Minority; Observation in research; Outcome; Participant; Pathway Analysis; Patient Self-Report; Patients; Pattern; Policies; Population Heterogeneity; Positioning Attribute; Preventive; Preventive service; Process; Psychosocial Factor; Public Health Schools; Recording of previous events; Records; Research; Research Personnel; Resources; Sampling; Science; Scientist; Screening for cancer; Self Efficacy; Social Network; Source; System; Time; Training; Trust; United States National Institutes of Health; Universities; Urban Health; Woman; Work; Writing; anticancer research; arm; base; bilingualism; cancer health disparity; career; career development; community based participatory research; comparative; comparative efficacy; data format; density; design; disparity reduction; empowered; empowerment; evidence base; experience; health empowerment; health equity; improved; interest; intervention effect; investigator training; longitudinal analysis; malignant breast neoplasm; meetings; metropolitan; mortality; neoplasm resource; outreach; peer; pilot trial; post intervention; programs; protective effect; psychosocial; public health priorities; radiologist; research study; residence; responsible research conduct; screening; screening guidelines; secondary analysis; social; symposium; therapy development; volunteer

Candidate. I am a driven early career investigator with the long-term goal of becoming an independent scientist in the field of cancer disparities. My major research interests concern identification and incorporation of psychosocial facilitators to breast cancer screening into interventions to reduce disparities in late stage detection. In that light, I have conducted observational, mixed method, community-based participatory research (CBPR) studies and led secondary analyses which indicate social outreach (e.g., conversations with family and friends) and volunteerism are associated with breast cancer screening among Latinas. The next logical step is to develop an intervention that would empower women to engage in social outreach and volunteerism and examine its effects on these women and their networks. I however need training and mentorship to take this next step. My four career objectives are thus to gain expertise in: 1) leading empowerment interventions; 2) implementing CBPR interventions; 3) using social network analysis; and 4) competitive grant writing. My training plan at the University of Illinois at Chicago (UIC) consists of didactic training (coursework, seminars, and workshops), participation in scientific conferences, manuscript development, submission of NIH grant applications, and mentorship from scientists with strong track records in mentorship and expertise in empowerment strategies (Dr. Ferrans), intervention science (Drs. Ferrans, Mermelstein, Geller), social network analysis (Dr. Schneider), and grant writing (all). I will also be trained in the responsible conduct of research. These experiences will position me to be a unique investigator that can compare the potential of different participatory-based interventions to improve individual- and network-level outcomes for the underserved. Environment. UIC is ideally suited for my career progression into independence and implementation of the proposed research. It is one of the top 50 research-funded institutions in the nation and a designated Hispanic- Serving Institution. It has strong partnerships with local Latino communities and is committed to cancer health equity. There are a number of career development opportunities, including, but limited to, seminars, workshops, and other resources through the School of Public Health, Cancer Center (UICC), Center for Research on Women and Gender, and the Institute for Health Research and Policy. Research Plan. Latinas suffer disproportionately from breast cancer relative to non-Latina Whites (NLWs), including late stage detection. While there have been controversies in breast cancer screening, non-adherence to guideline-concordant screening continues to be a major modifiable determinant of breast cancer outcome disparities. Thus, increasing participation in breast cancer screening among Latinas, especially care that corresponds with clinical and academic guidelines, is a public health priority. Participatory approaches are popular methods to improve screening within this group and have included approaches that 1) deliver education to non-adherent Latinas and 2) train community health advocates (community health workers, breast cancer survivors) to engage in breast health promotion. The second approach (empowerment interventions) concerns training participants to engage in social outreach (e.g., having conversations with family and friends about breast health) and volunteering (e.g., helping in health fairs, engaging in civic campaigns about breast cancer programs). Patient activation and volunteerism literature suggest that empowerment interventions may have `added value' for participants themselves over delivering education in terms of preventive health psychosocial factors and practices. Relative to education interventions, empowerment interventions may also affect women's networks, as they may be more likely to disseminate evidence-based breast health promotion among their family and friends. To date, little research has compared interventions' effects on individual-level outcomes or used formal social network analysis to examine network effects. The proposed work adds to the literature through empirically comparing two approaches (education versus empowerment) on three sets of outcomes: 1) women's own screening, 2) women's own self-efficacy, norms, support, knowledge; and 3) women's networks (measured by egocentric analysis). I will lead this work and will benefit from the collective expertise and resources of my mentors (Drs. Ferrans, Mermelstein, Geller) and collaborators (Dr. Schneider, The Resurrection Project, Metropolitan Chicago Breast Cancer Task Force, Sinai Urban Health Institute, University of Illinois Cancer Center). Aim 1 intervention development will be accomplished through continuous stakeholder engagement and specifically through meetings and focus groups with a bilingual, bicultural community advisory engagement board (CEAB), UICC radiologists and target participants (non-adherent Latinas). We have already begun this process and are obtaining formative data. After we develop intervention materials, a pilot trial will be conducted with an area-level treatment control group design in Chicago. Participants will be 150 Latinas with no history of health volunteerism, residence in one of two targeted areas, and non-adherence to US Preventive Services Task Force screening guidelines. Aim 1 intervention evaluation will involve an analysis to compare differences in receipt of a medical record-confirmed screening within six months of participating in the study. Aim 2 will be an analysis to compare interventions' effects on self-efficacy, norms, support, knowledge across three time points – pre-intervention, immediately post-intervention, and six months post-intervention. Aim 3 will be a social network analysis, specifically egocentric, to compare interventions' effects on breast health, network size, and network density as well as will number of peers referred to the study.

我是一名积极进取的早期职业调查员，长期目标是成为一名独立人士。 我的主要研究兴趣是癌症差异领域的科学家。 将乳腺癌筛查的心理社会促进者纳入干预措施，以减少晚期的差异 有鉴于此，我进行了观察性、混合方法、基于社区的参与性研究。 （CBPR）研究和主导的二次分析表明社会外展（例如，与家人和 朋友）和志愿服务与拉丁裔乳腺癌筛查有关。下一个合乎逻辑的步骤是。 制定一项干预措施，使妇女能够参与社会外展和志愿服务， 然而，我需要培训和指导来研究它对这些女性及其网络的影响。 因此，我的下一步职业目标是获得以下方面的专业知识：1）领导赋权干预；2） 实施 CBPR 干预措施；3) 使用社交网络分析；4) 竞争性资助写作。 伊利诺伊大学芝加哥分校 (UIC) 的培训计划包括教学培训（课程作业、研讨会、 研讨会）、参加科学会议、稿件编写、提交 NIH 拨款 申请以及来自在指导和专业知识方面拥有良好记录的科学家的指导 赋权策略（Ferrans 博士）、干预科学（Ferrans、Mermelstein、Geller 博士）、社交网络 分析（施耐德博士）和资助写作（全部）我还将接受负责任的研究行为的培训。 这些经历将使我成为一名独特的调查员，能够比较不同领域的潜力 基于参与性的干预措施，以改善服务不足人群的个人和网络层面的成果。 UIC 的环境非常适合我的职业发展和独立实施。 它是全国排名前 50 名的研究资助机构之一，也是指定的西班牙裔研究机构。 服务机构与当地拉丁裔社区建立了牢固的合作伙伴关系，并致力于癌症健康。 有许多职业发展机会，包括但不限于研讨会、 研讨会以及公共卫生学院、癌症中心 (UICC)、癌症中心的其他资源 妇女和性别研究以及健康研究和政策研究所。 研究计划。相对于非拉丁裔白人 (NLW)，拉丁裔患乳腺癌的比例更高， 尽管乳腺癌筛查存在争议，但不遵守规定。 符合指南的筛查仍然是乳腺癌结果的主要可改变决定因素 因此，增加拉丁裔乳腺癌筛查的参与度，尤其是以下护理： 符合临床和学术指南，是公共卫生的优先事项。 改善该群体筛查的流行方法包括以下方法：1) 对不依从的拉丁裔进行教育，2) 培训社区健康倡导者（社区卫生工作者、乳房 癌症幸存者）参与乳房健康促进第二种方法（赋权干预）。 涉及培训参与者参与社会外展（例如，与家人和朋友交谈 关于乳房健康）和志愿服务（例如，帮助参加健康博览会、参与有关乳房的公民运动） 患者激活和志愿服务文献表明，赋权干预措施可能 与提供预防性健康教育相比，参与者本身具有“附加价值” 相对于教育干预，赋权干预也可以。 影响女性网络，因为她们更有可能传播基于证据的乳房健康宣传 迄今为止，很少有研究比较干预措施对个人水平的影响。 结果或使用正式的社交网络分析来检查网络效应。 文献通过对三组的两种方法（教育与赋权）进行实证比较 结果：1) 女性自身的筛查，2) 女性自身的自我效能、规范、支持、知识，以及 3) 妇女网络（通过以自我为中心的分析来衡量）我将领导这项工作并将从集体中受益。 我的导师（Ferrans、Mermelstein、Geller 博士）和合作者（Schneider 博士、 复活项目、芝加哥大都会乳腺癌工作组、西奈城市健康研究所、 伊利诺伊大学癌症中心）的目标 1 干预措施的开发将通过持续不断地实现。 利益相关者的参与，特别是通过双语、双文化的会议和焦点小组 社区咨询参与委员会 (CEAB)、UICC 放射科医生和目标参与者（非依从者） 拉丁裔）。我们已经开始这一过程，并在制定干预措施后获取形成性数据。 材料，将在芝加哥进行地区级治疗对照组设计的试点试验。 参与者将是 150 名拉丁裔，没有健康志愿服务历史，居住在两个目标地区之一， 以及不遵守美国预防服务工作组筛查指南的目标 1 干预评估。 将涉及一项分析，以比较六天内接受病历确认筛查的差异 目标 2 是一项分析，以比较干预措施对自我效能的影响。 三个时间点的规范、支持、知识——干预前、干预后立即和六个时间点 干预后几个月，目标 3 将进行社交网络分析，特别是以自我为中心的分析，以进行比较。 干预措施对乳房健康、网络规模、网络密度以及同龄人数量的影响 提到了研究。