Individual, cultural, and area-based factors associated with survivorship care among Asian/Asian American childhood cancer survivors

与亚裔/亚裔美国儿童癌症幸存者的生存护理相关的个人、文化和地区因素

• 批准号: 10693965
• 负责人: Joel E Milam
• 金额: $ 63.31万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-06 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10693965
• 关键词: Acculturation; Address; Adult; Aftercare; Age; Area; Asian; Asian Americans; Asian population; Attitude; Belief; California; Caring; Characteristics; Childhood; Childhood Cancer Survivor Study; Chinese; Chronic; Consensus; Country; County; Data; Development; Diagnosis; Disparity; Ethnic Origin; Ethnic Population; Family; Filipino; Fostering; Guidelines; Health; Health Care Rationing; Health Services Accessibility; Healthcare; Immigrant; Incidence; Individual; Inequity; Insurance; Intervention; Interview; Knowledge; Koreans; Late Effects; Life; Longterm Follow-up; Los Angeles; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of brain; Medical; Medical center; Methods; Modeling; Morbidity - disease rate; Neighborhoods; Not Hispanic or Latino; Oranges; Outcome; Pacific Islander; Parents; Patients; Pediatric Oncology Group; Population; Recommendation; Research; Risk; Self Efficacy; Seminal; Socioeconomic Status; Stress; Subgroup; Survey Methodology; Survivors; Time; United States; Vietnamese; barrier to care; cancer prevention; cancer therapy; childhood cancer survivor; clinically significant; cohort; ethnic minority; experience; follow-up; health disparity; mortality; neoplasm registry; outreach; patient population; population based; prevent; psychosocial; racial minority; racial population; recruit; residence; socioeconomics; survivorship; young adult

Abstract With treatment advances for childhood cancer, over 80% of patients achieve long-term survival. However, cancer treatments often lead to other serious issues, including chronic health problems and early mortality. These health problems are referred to as “late effects,” defined as any adverse medical or psychosocial outcome that develops or persists after treatment. By 25 years following treatment, over two-thirds of childhood cancer survivors (CSS) have developed at least one clinically significant late effect, with over one-third developing one or more severe or life-threatening late effect. As a result, life-long cancer-focused long-term follow-up care (LTFU) is essential for CCS to screen for, prevent, and treat late effects. Our current understanding of among CCS comes primarily from a cohort of adult CCS diagnosed between 1970 and 1986 (The Childhood Cancer Survivor Study-CCSS) which is comprised of predominantly non-Hispanic white survivors. However, studies have shown that CCS from racial and ethnic minority backgrounds experience significant health disparities and thus more research is required among CCS of diverse backgrounds to understand disparities to address and reverse them. Rates of LTFU and factors influencing cancer-focused care among Asian American (AA) CCS are unknown. AA populations represent the fastest growing ethnic group in the United States and the largest group of new immigrants, with 59% of the US Asian population born in another country. This group is culturally and socioeconomically heterogenous and has grown 72% between 2000 and 2015 is projected to grow to more than 10% of the US population by 2050. Thus, the number of AA CCS is expected to increase, and a greater focus on facilitators and barriers to LTFU is needed in this underresearched population. Further, many Asian immigrants live in ethnically concentrated neighborhoods (ethnic enclaves) which may influence engagement in LTFU for AA CCS. We propose to recruit a population- based cohort of roughly 330 young adult AA CCS and their parents (N=100) in Los Angeles and Orange Counties to examine factors related to survivorship care utilization. Our aims are: Aim 1: We will characterize on a population basis the utilization of cancer-focused survivorship care among Asian CCS. Aim 2: We will examine through qualitative interviews and survey methods individual- and family-level factors associated with the utilization of cancer-focused survivorship care among AA CCS and their parents. Aim 3: We will investigate the effect of residing in an ethnically concentrated neighborhood on the utilization of LTFU. The proposed research will provide guidance to identify and address needs among AA CCS for survivorship care utilization to increase culturally congruent outreach and intervention strategies to engage and retain these CCS in care.

抽象的 随着儿童癌症的治疗进展，超过80％的患者可实现长期生存。然而， 癌症治疗通常会导致其他严重的问题，包括慢性健康问题和早期死亡率。 这些健康问题被称为“后期效果”，被定义为任何不良的医疗或社会心理 治疗后发展或持续的结果。到治疗后25年，童年超过三分之二 癌症存活（CSS）至少发展了一种临床上显着的晚期效应，超过三分之一 产生一个或多个严重或威胁生命的晚期效应。结果，以终身为中心的长期癌症 后续护理（LTFU）对于CC筛查，预防和治疗后期效果至关重要。我们的目前 对CC之间的了解主要来自1970年至1986年之间被诊断出的成人CC （儿童癌症幸存者研究-CCS），该研究主要是非西班牙裔白色 幸存者。但是，研究表明，来自种族和少数民族背景的CC经验 在潜水员背景的CC中需要进行重大健康差异，因此需要进行更多的研究 了解分布以解决并扭转它们。 LTFU的速度和影响癌症的因素 亚裔美国人（AA）CC中的护理尚不清楚。 AA人口代表增长最快的种族 美国和最大的新移民群体，美国亚洲人口的59％出生 在另一个国家。该群体在文化和社会经济上是异质的，在 预计到2050年，2000年和2015年将增长到美国人口的10％以上。 预计CC将增加，并且需要更加关注促进者和LTFU的障碍 研究人口不足。此外，许多亚洲移民生活在种族集中的社区 （族裔飞地）可能会影响AA CCS参与的LTFU。我们建议招募人口 - 洛杉矶和橙色的大约330名年轻成人AA CCS及其父母（n = 100）的队列和橙色 县检查与生存护理利用有关的因素。我们的目标是：目标1：我们将描述 在人群中，亚洲CC中以癌症为中心的生存护理利用。目标2：我们将 通过定性访谈和调查方法进行检查个人和家庭水平因素 AA CCS及其父母之间以癌症为重点的生存护理的利用。目标3：我们将调查 居住在浓缩社区中对LTFU利用的影响。提议 研究将提供指导，以确定和满足AA CCS生存护理利用的需求 增加文化上一致的外展和干预策略，以参与和保留这些CC的护理。