Project 2

项目2

• 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
• 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

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：项目摘要 尽管个人级别的计划和干预措施取得了一些成功，以促进行为以防止 结直肠癌 - 持续的贫困地区的燃烧仍然特别高。许多癌症专家 预防和控制最近认为，要真正解决这个不平等的伯恩，我们必须进行多种多样 水平方法包括解决癌症的基本原因。我们提出了一个准实验 研究最大的反贫困政策计划对美国家庭的影响 - 赚取的所得税 信用（EITC），特别关注加利福尼亚两个县的当地持续贫困地区：1）Yolo，一个 加利福尼亚大学戴维斯分校（UCD）和该县的主要农业县主要农业县 加利福尼亚州最高的贫困率； 2）圣塔克拉拉（Santa Clara），斯坦福大学的城市地区，有 急剧收入不平等。自2015年以来，对于每年赚取30,000美元的家庭，加利福尼亚EITC （Caleitc）和联邦抵免额每年提供高达10,000美元。通过帮助支付的收入数量 每日费用，食物和住房，运输和医疗保健，因此也通过减轻压力 贫困，可能会影响大肠癌的几个危险因素。同样值得注意的是资格的变化 2020年在加利福尼亚发生的Caleitc - 不再需要一个社会保险号，开放 有资格获得具有个人纳税人身份证号（ITIN）的非美国公民。我们将与我们的 社区合作伙伴的区域联盟以实现以下特定目标：目标1。检查影响 关于结直肠癌危险因素和预防性筛查的加利福尼亚2015 EITC扩张（Caleitc） 目标2。估计Caleitc对结直肠癌危险因素的短期影响和筛查 居住在持续贫困地区的加利福尼亚人，目标3。定性检查3.1）Caleitc接收者的经验 了解Caleitc对与结直肠癌预防有关的行为和暴露的影响，以及 3.2）有资格了解不申请Caleitc福利的原因的非EITC接收者， 特别是在Yolo和Santa的拉丁裔和越南社区的新合格的ITIN接收者中 克拉拉县，目标4。与我们的区域联盟合作，以建立能力，以支持多层次和 通过估计EITC扩展对减少结直肠癌发病率的影响，结构干预措施 持续贫困地区的率。该项目将建立在多个机构和多学科的基础上 上游研究中心的合作，以满足预防癌症最紧迫的需求 在Yolo和Santa Clara县的持续贫困地区，重点关注拉丁裔和越南人的需求 这些社区中的人们通过我们正在进行的区域联盟社区合作。通过 Caleitc的案例，与对项目1中保证基本收入的评估协调 我们的计划将添加证据以支持倡导和行动以解决结构和社会 健康的决定因素，以促进结直肠癌预防和筛查。