Increasing African-Immigrants Breast Cancer Screening

增加非洲移民乳腺癌筛查

基本信息

批准号：
10023195
负责人：
Jamilia Raki Sly
金额：
$ 21.19万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-23 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10023195
关键词：
Address Africa African African American Age Behavior Belief Breast Cancer Detection Breast Cancer Education Caring Collaborations Communication Communities Country Data Education Face Familiarity Focus Groups Funding Future Goals Health Health Insurance Health behavior Health education Healthcare Hepatitis B Home environment Human Immigrant Immigration Individual Institution Insurance Intervention Interview Knowledge Language Latina Lead Link Mammographic screening Mammography Medical Methods Minority Minority Groups Modeling New York City Participant Play Population Poverty Preventive Preventive care Preventive healthcare Preventive screening Preventive service Primary Care Physician Primary Health Care Randomized Clinical Trials Reporting Risk Role Screening for cancer Services Surveys Testing Treatment Efficacy Underserved Population Visit Woman Work base cancer health disparity cancer prevention community based service design evidence base health belief health care availability health disparity health literacy high school innovation malignant breast neoplasm mortality predictive modeling programs screening screening guidelines screening program service organization stem success tool tv watching

项目摘要

New York City (NYC) is home to a large and diverse immigrant population. Many of these groups face significant barriers to preventive health care, including lack of insurance, poor health care access and language difficulties. Most African immigrant women are likely to live below the poverty line and have low health literacy, are less likely to have health insurance and visit a doctor, particularly for primary/preventive care. Without access to primary care, many preventive services, such as breast cancer screenings go unattended. The barriers and facilitators to breast cancer screening for other minority groups from underserved populations, such as African Americans and Latina women have been studied. Less is known about these for African immigrant women and how to most effectively engage their participation in regular screening. Our data of over 2,000 African-born immigrants living in NYC show that 77% report not having health insurance; 75% do not have a primary care physician; and 57% have less than a high school education. As for cancer screening, when corrected for age, 44% have never had a mammogram. Through our unique collaboration with the African Services Committee and the African Advisory Council of the Bronx, two non- governmental community-based service organizations, we are poised to have a significant impact on these immigrant women, who have emigrated from more than 20 countries in Africa. This is a population with great need for increased breast cancer knowledge, access to breast cancer screening, and basic medical care. The Health Belief Model (HBM) provides a framework for addressing cultural health barriers by positing that making a decision to engage in a health behavior is determined by weighing perceived threats versus benefits. Health education programs developed using HBM constructs are effective tools towards reducing barriers that lead to health disparities in cancer. Further, the presentation of health information via narrative communication (i.e., storytelling; personal testimonials) is an effective method of educating participants about cancer prevention and screening. Our work in minority and immigrant communities has shown that combining narrative communication and navigation assistance can increase participation in breast cancer screening. However, the efficacy of these interventions has not been empirically tested among African-born immigrants. The long term goal of the proposed project is to conduct a randomized clinical trial that tests the adapted intervention to increase breast cancer screening rates for African-born immigrants. In the short term, we plan to pursue the following specific aims: (1) Identify barriers and facilitators to breast cancer screening among African-born immigrants and (2) Culturally adapt and pilot test the Witness Project breast cancer education program for African-born women. Thus, we will culturally adapt an effective, innovative intervention to address this significant health disparity in African-born immigrant communities. Once we have pilot tested the feasibility and acceptability of the intervention, we will apply for R01 funding.

纽约市（纽约市）是大量移民人口的所在地。这些小组中的许多人面对预防性医疗保健的重大障碍，包括缺乏保险，医疗保健不良的机会和语言困难。大多数非洲移民妇女可能生活在贫困线以下，并且健康素养，不太可能拥有健康保险并去看医生，尤其是主要/预防性关心。无需获得初级保健，许多预防服务，例如乳腺癌筛查无人看管。从服务不足的其他少数群体筛查乳腺癌筛查的障碍和促进者已经研究了人口，例如非裔美国人和拉丁裔妇女。对这些知之甚少非洲移民妇女以及如何最有效地参与定期筛查。我们居住在纽约市的2,000多名非洲出生的移民的数据表明，有77％的人报告没有健康保险; 75％没有初级保健医生； 57％的人比高中教育少。至于癌症筛查年龄纠正时，有44％的乳房X线照片从未进行过乳房X线照片。通过我们的独特与非洲服务委员会和布朗克斯非洲咨询委员会合作，两个非 - 政府基于社区的服务组织，我们准备对这些组织产生重大影响移民妇女，他们从非洲20多个国家移民。这是一个很棒的人口需要增加乳腺癌知识，获得乳腺癌筛查和基本医疗服务。健康信念模型（HBM）为解决文化健康障碍提供了一个框架决定从事健康行为的决定是通过权衡感知的威胁而不是好处。使用HBM结构制定的健康教育计划是减少的有效工具导致癌症健康差异的障碍。此外，通过叙述呈现健康信息沟通（即讲故事；个人推荐）是对参与者进行教育的有效方法预防癌症和筛查。我们在少数民族和移民社区的工作表明，结合叙事交流和导航援助可以增加参与乳腺癌筛查。但是，这些干预措施的疗效尚未在非洲出生的移民中进行经验检验。拟议项目的长期目标是进行一项随机临床试验，以测试适应的临床试验干预以增加非洲出生的移民的乳腺癌筛查率。在短期内，我们计划追求以下特定目的：（1）确定障碍和促进因子在乳腺癌中进行筛查非洲出生的移民和（2）文化适应和试点测试证人项目乳腺癌教育非洲出生的妇女计划。因此，我们将在文化上适应有效的创新干预措施来解决非洲出生的移民社区的这种重大健康差异。一旦我们进行了飞行员测试和干预的可接受性，我们将申请R01资金。