Project 2

项目2

基本信息

批准号：
10661411
负责人：
David H Rehkopf
金额：
$ 32.05万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-26 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10661411
关键词：
Address Advocacy Agriculture Behavior Behavioral California Cancer Burden Cancer Control Cancer Etiology Collaborations Colorectal Cancer Communities Country County Diet Eligibility Determination Evaluation Family Food Healthcare Home Household Housing Immigrant Incidence Income Income Tax Individual Inequality Inequity Institution Interdisciplinary Study Intervention Latino Low Income Population Persons Physical activity Policies Population Poverty Poverty Areas Preventive screening Qualifying Quasi-experiment Research Research Project Grants Risk Factors Risk Reduction Behavior Social Security Number Transportation Universities Vietnamese Work behavioral outcome cancer prevention cancer risk colorectal cancer prevention colorectal cancer risk colorectal cancer screening community engagement design evidence base experience improved interest poor communities programs screening social health determinants stress reduction structural determinants success synergism urban area

项目摘要

Research Project 2: Project Summary Despite some successes of individual-level programs and interventions to promote behaviors that prevent colorectal cancer – the burden in persistent poverty areas remains particularly high. Many experts in cancer prevention and control have recently argued that to truly address this inequitable burden we must take a multi- level approach that includes addressing the fundamental causes of cancer. We propose a quasi-experimental study of the impacts of the largest anti-poverty policy program for families in the U.S. -- the Earned Income Tax Credit (EITC), with a particular focus on local persistent poverty areas in two counties in California: 1) Yolo, a largely agricultural county which is home to University of California, Davis (UCD), and the county with the highest poverty rate in California; and 2) Santa Clara, an urban area home to Stanford University, with dramatic income inequality. Since 2015, for households earning up to $30,000 per year, the California EITC (CalEITC) and Federal Credits provide up to $10,000 a year. This amount of income, through helping pay for daily expenses, food and housing, transportation, and healthcare, and therefore also by reducing the stress of poverty, may influence several risk factors for colorectal cancer. Also notable is the change in eligibility for CalEITC that occurred in California in 2020 – having a social security number is no longer required, opening eligibility to non-U.S. citizens with an Individual Taxpayer Identification Number (ITIN). We will work with our Regional Coalition of community partners to accomplish the following specific aims: Aim 1. Examine the impact of the California 2015 EITC expansion (CalEITC) on colorectal cancer risk factors and preventative screening, Aim 2. Estimate the short-term effects of CalEITC on colorectal cancer risk factors and screening among Californians living in persistent-poverty areas, Aim 3. Qualitatively examine 3.1) CalEITC recipients’ experience to understand the impacts of CalEITC on behaviors and exposures related to colorectal cancer prevention, and 3.2) non-EITC recipients who qualify to understand the reasons for not applying for CalEITC benefits, especially among newly eligible ITIN recipients in the Latino and Vietnamese communities in Yolo and Santa Clara Counties, and Aim 4. Work with our Regional Coalition to build capacity in support of multilevel and structural interventions by estimating the effects of EITC expansion on reducing colorectal cancer incidence rates in persistent poverty areas. The project will build on the multiple institution and multi-disciplinary collaborations of the UPSTREAM Research Center to address the most pressing needs for cancer prevention in persistent poverty areas in Yolo and Santa Clara Counties, focusing on the needs of Latino and Vietnamese people in these communities through our ongoing Regional Coalition community collaborations. Through the case of the CalEITC, in coordination with the evaluation of Guaranteed Basic Income in Project 1, we expect that our program will add evidence to support advocacy and actions to address the structural and social determinants of health to promote colorectal cancer prevention and screening.

研究项目2：项目概要尽管个人层面的计划和干预措施在促进预防行为方面取得了一些成功结直肠癌——持续贫困地区的负担仍然特别高。预防和控制最近认为，要真正解决这一不公平的负担，我们必须采取多方措施我们提出了一种准实验性方法，包括解决癌症的根本原因。研究美国最大的反贫困政策计划对家庭的影响——所得税 Credit (EITC)，特别关注加利福尼亚州两个县的当地持续贫困地区：1) Yolo，一个以农业为主的县，是加州大学戴维斯分校 (UCD) 的所在地，也是拥有加州贫困率最高；2) 圣克拉拉，斯坦福大学所在地，自 2015 年以来，对于年收入不超过 30,000 美元的家庭，加州 EITC (CalEITC) 和联邦信贷每年通过帮助支付高达 10,000 美元的收入。日常开支、食住行、医疗保健，因此也可以减轻压力贫困可能会影响结直肠癌的几个危险因素。同样值得注意的是治疗资格的变化。 2020 年加州发生的 CalEITC – 不再需要社会安全号码，开放拥有个人纳税人识别号 (ITIN) 的非美国公民的资格我们将与我们合作。社区合作伙伴区域联盟旨在实现以下具体目标：目标 1. 检查影响加州 2015 年 EITC 扩展 (CalEITC) 关于结直肠癌危险因素和预防性筛查的内容，目标 2. 估计 CalEITC 对结直肠癌危险因素和筛查的短期影响生活在持续贫困地区的加州人，目标 3。定性研究 3.1) CalEITC 受益人的经历了解 CalEITC 对结直肠癌预防相关行为和暴露的影响，以及 3.2) 有资格了解不申请 CalEITC 福利的原因的非 EITC 受益人，尤其是在 Yolo 和 Santa 的拉丁裔和越南裔社区新符合资格的 ITIN 接收者中克拉拉县，目标 4：与我们的区域联盟合作，建设能力，支持多层次和通过评估 EITC 扩张对降低结直肠癌发病率的影响进行结构性干预该项目将建立在多个机构和多学科的基础上。 UPSTREAM 研究中心合作解决癌症预防最紧迫的需求在约洛县和圣克拉拉县的持续贫困地区，重点关注拉丁裔和越南裔的需求通过我们正在进行的区域联盟社区合作，帮助这些社区的人们。以 CalEITC 为例，配合项目 1 中的保障基本收入评估，我们预计我们的计划将增加证据来支持解决结构性和社会性问题的宣传和行动健康决定因素，促进结直肠癌的预防和筛查。