NYC Cancer Outreach Network in Neighborhoods for Equity and Community Translation

纽约市社区癌症外展网络促进公平和社区翻译

• 批准号: 10456583
• 负责人: Bruce D Rapkin
• 金额: $ 100万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10456583
• 关键词: NYC; Cancer; Outreach; Network; Neighborhoods

Project Summary/Abstract Social determinants of health (SDH) play a substantial role in the existence of disparities in cancer screening, risk factors, and outcomes. Racism, food insecurity, housing instability, language barriers, lack of transportation and childcare, residential segregation, neighborhood poverty, and health insurance access are associated with breast, cervical, and colorectal cancer disparities and delays in cancer screening, diagnostic testing, and care. Systemic racism is a fundamental cause of cancer disparities and is reflected in highly segregated, impoverished, and high population density neighborhoods with built and food environments that inhibit healthy behaviors. These same neighborhoods often are federally designated medically underserved areas with limited access to culturally- and linguistically-appropriate healthcare services and are geographically remote from high quality cancer centers. NYC CONNECT (New York City Cancer Outreach Network in Neighborhoods for Equity and Community Translation) is a multi-sector and multi-institutional proposal that builds on a long history of conducting community-based SDH interventions and community-clinical linkage strategies in NYC to advance health equity. Collaborating partners include a CDC-funded NYC Cancer Prevention and Control Research Network Center, two NCI-designated Cancer Centers, the Food Bank for NYC, and their network of multi-sector community, clinical and government partners. We will build on NYU’s existing community-based community- clinical linkage program which: 1) involves patient navigators who share similar characteristics and lived experiences as the communities they serve and are imbedded in community settings in partnership with trusted community organizations; 2) utilizes a whole-person approach to cancer prevention and control that screens for unmet SDH and links participants to appropriate SDH services; and 3) facilitates access to health insurance and other resources for uninsured and low-income individuals and navigation from cancer screening to treatment services. We will deepen this intervention’s effect by addressing systemic racism working in partnership with the Food Bank for NYC, trusted grassroots community partners, a network of federally qualified health centers and community medicine clinics. Through a co-creation process with community stakeholders, we will apply a participatory and trauma-informed approach to community-building and development to identify racial equity strategies that are informed by critical race theory. To assess causal mechanisms that underlie the different elements of the intervention that lead to improved cancer screening rates, we will utilize theories of empowerment and social capital at the community level and change management framework at the health systems level. Using an Extension of RE-AIM to Enhance Sustainability model, we will assess implementation factors to optimize reach, uptake, and scalability of community and clinical strategies aimed to reduce systemic racism, address SDH, and reduce cancer disparities.

项目概要/摘要 健康的社会决定因素 (SDH) 在癌症筛查中存在的差异中发挥着重要作用， 风险因素和结果。 种族主义、粮食不安全、住房不稳定、语言障碍、缺乏交通。 儿童保育、居住隔离、社区贫困和医疗保险的获取与 乳腺癌、宫颈癌和结直肠癌在癌症筛查、诊断测试和护理方面的差异和延迟。 系统性种族主义是癌症差异的根本原因，反映在高度隔离、贫困、 人口密度高的社区，其建筑环境和食品环境会抑制健康行为。 同样的社区通常是联邦政府指定的医疗服务不足的地区，获得医疗服务的机会有限 适合文化和语言的医疗保健服务，并且地理位置远离高质量 NYC CONNECT（纽约市社区癌症外展网络，促进公平和 社区翻译）是一项多部门和多机构的提案，建立在悠久的历史基础上 在纽约市开展基于社区的 SDH 干预措施和社区临床联系战略，以推进 健康. 公平 合作伙伴包括疾病预防控制中心 (CDC) 资助的纽约市癌症预防和控制研究中心 网络中心、两个 NCI 指定的癌症中心、纽约市食品银行及其多部门网络 我们将以纽约大学现有的社区、临床和政府合作伙伴为基础。 临床联系计划：1) 涉及具有相似特征和生活经历的患者导航员 他们所服务的社区的经验，并与值得信赖的伙伴合作融入社区环境 社区组织；2) 采用全人方法来预防和控制癌症 未满足的 SDH 并将参与者与适当的 SDH 服务联系起来；3) 促进获得健康保险和 为无保险和低收入个人提供的其他资源以及从癌症筛查到治疗的导航 我们将与相关部门合作解决系统性种族主义问题，从而加深干预措施的效果。 纽约市食品银行、值得信赖的基层社区合作伙伴、联邦合格的健康中心网络以及 通过与社区利益相关者的共同创建过程，我们将应用 采用参与性和基于创伤的方法进行社区建设和发展，以确定种族平等 以批判种族理论为基础的策略来评估不同背后的因果机制。 提高癌症筛查率的干预措施的要素，我们将利用赋权理论 社区层面的社会资本以及卫生系统层面的变革管理框架。 RE-AIM 的扩展以增强可持续性模型，我们将评估实施因素以优化 旨在减少系统性种族主义、解决社区和临床战略的影响力、采用率和可扩展性 SDH，并减少癌症差异。