Tri-City Cervical Cancer Prevention Study among Women in the Justice System

三城市司法系统中女性宫颈癌预防研究

基本信息

批准号：
10738325
负责人：
Megha Ramaswamy
金额：
$ 3.85万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-12-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10738325
关键词：
Accounting Address Affect Behavior Behavior Therapy Behavioral Model Caring Cervical Cervical Cancer Screening Cities Climate Clinical Communities Community Health Complex Coupled Criminal Justice Development Disparity Environment Geography Goals Health Health Insurance Health system High Risk Woman Housing Imprisonment Intervention Interview Investigation Jail Justice Kansas Learning Life Longitudinal Surveys Longterm Follow-up Malignant Neoplasms Malignant neoplasm of cervix uteri Mental Health Methods Modeling Motivation Natural History Outcome Pap smear Patients Pharmaceutical Preparations Policies Population Prevention Provider Public Health Recommendation Recording of previous events Research Resources Risk Risk Behaviors Sampling Service setting Services Sexual Health Shapes Site Structure Supervision System Time Trauma Trust Variant Victimization Vulnerable Populations Woman Women&apos s Group barrier to care cancer prevention cancer risk cervical cancer prevention cost effective design experience follow-up health belief health care availability health care delivery health determinants health disparity health literacy high risk population probation recruit screening screening guidelines sociodemographics therapy design

项目摘要

ABSTRACT Women with criminal justice histories persist as one of the groups most affected by cervical cancer, with 4- 5 times the rates of cancer compared to other women. Our research team has spent the last 8 years investigating the factors that account for this disparity. We have found that abnormal Pap tests are high, with sexual health risk, trauma, women's life circumstances, and low cervical health literacy as facilitators of risk and barriers to care. But questions remain about justice-involved women's screening trajectories over time given complex cervical screening recommendations and the difficulty of interfacing with health systems and navigating complex health insurance environments. Thus, there is insufficient information available to inform interventions that address justice-involved women's cervical cancer prevention needs in the community. The specific objective of this study is to develop a better understanding of the natural history of cervical cancer risk and prevention behaviors among community-based justice-involved women. The long-term goal of this study is to identify strategies for where and how to intervene to change the factors and environments that structure women's cervical health risk. We have a unique opportunity to conduct a natural history study of cervical health risk and screening among community-based justice-involved women in three geographically and demographically diverse cities. We plan to leverage three existing samples of community-based, justice-involved women – in Kansas City, MO, Birmingham, AL, and Oakland, CA – to become one of the first long-term cancer prevention studies of high-risk women across cities in the U.S. By studying three geographically and demographically diverse cities, we can draw conclusions about factors at each level of inquiry across study sites, accounting for variation in cities and increasing our ability to generalize findings. By leveraging samples generated by our ongoing projects in each city, we also offer a cost-effective and feasible way to engage in long-term follow-up of hard to reach women, with whom we've already established trust and rapport. In our first aim, we use the Behavioral Model for Vulnerable Populations (BMVP) to explain the natural history of cervical health risk behaviors, screening, and treatment among community-based justice-involved women (N~600) over a 5-year period in three cities. In the second aim, we use a mixed methods approach to unpack the ways in which significant domains of the BMVP operate in the daily lives of a subsample of women (N~60) recruited from the larger sample. Public health significance of this study centers on two products: 1) Development of a multi-level conceptual framework that explains the environment in which justice-involved women engage in cervical cancer prevention. 2) Creation of intervention models that address “upstream” determinants of health in clinical and service settings, while addressing justice-involved women's unique needs.

抽象的具有刑事司法历史的妇女仍然是受宫颈癌影响最大的群体之一，有4-- 与其他女性相比，癌症发生率是5倍。我们的研究团队在过去的8年中度过了调查解释这种差异的因素。我们发现异常子宫颈测试很高，有性健康风险，创伤，妇女的生活环境以及宫颈健康素养低的风险促进者和护理障碍。但是随着时间的流逝，有关涉及正义的妇女筛查轨迹的问题仍然存在考虑到复杂的宫颈筛查建议以及与卫生系统和接口的难度导航复杂的健康保险环境。那是没有足够的信息来告知解决社区中针对正义妇女宫颈癌的需求的干预措施。这项研究的具体目标是更好地了解宫颈的自然史癌症风险和预防妇女的预防行为。长期目标这项研究是为了确定在何处以及如何干预以改变因素和环境的策略构建妇女的宫颈健康风险。我们有一个独特的机会来进行宫颈健康风险和筛查的自然历史研究在三个地理和人口统计多元化的城市中，基于社区的司法妇女。我们计划利用堪萨斯城的三个现有的基于社区的司法妇女的样本， MO，AL伯明翰和加利福尼亚州奥克兰 - 成为第一个长期预防癌症的研究之一在美国各个城市的高风险妇女通过研究三个地理和人口统计多样化的城市，我们可以得出关于研究地点各个询问级别的因素的结论，这说明了差异城市并提高我们概括发现的能力。通过利用我们正在进行的样本每个城市的项目，我们还提供了一种经济高效且可行的方式，以进行长期跟踪接触妇女，我们已经建立了信任和融洽的关系。在我们的第一个目标中，我们使用弱势群体的行为模型（BMVP）来解释自然基于社区正义的宫颈健康风险行为，筛查和治疗的历史在三个城市的5年期间，妇女（n〜600）。在第二个目标中，我们使用混合方法解开BMVP重要领域在妇女子样本的日常生活中运作的方式（n〜60）从较大的样本中招募。该研究的公共卫生意义基于两种产品：1）开发多层次概念框架解释了与正义妇女参与宫颈的环境预防癌症。 2）创建解决“上游”确定健康的干预模型临床和服务环境，同时满足涉及正义的妇女的独特需求。

项目成果

期刊论文数量（13）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Sources of Information and Health Care Experiences Related to COVID-19 among Women Involved in Criminal Legal System in Three U.S. Cities.

DOI：
10.31038/awhc.2020351
发表时间：
2020-12
期刊：
Archives of women health and care
影响因子：
0
作者：
Lorvick J;Hemberg J;Cropsey K;Wickliffe J;Faust A;Comfort M;Ramswamy M
通讯作者：
Ramswamy M

Validating self-reported cervical cancer screening among women leaving jails.

验证出狱妇女自我报告的宫颈癌筛查情况。

DOI：
10.1371/journal.pone.0219178
发表时间：
2019
期刊：
PloS one
影响因子：
3.7
作者：
Webb,Shelby;Kelly,PatriciaJ;Wickliffe,Joi;Ault,Kevin;Ramaswamy,Megha
通讯作者：
Ramaswamy,Megha

Health and Health Service Needs: Comparison of Older and Younger Women with Criminal-Legal Involvement in Three Cities.

DOI：
10.1177/08982643211025443
发表时间：
2022-01
期刊：
JOURNAL OF AGING AND HEALTH
影响因子：
2.8
作者：
Emerson, Amanda;Lipnicky, Ashlyn;Comfort, Megan;Lorvick, Jennifer;Cropsey, Karen;Smith, Sharla;Ramaswamy, Megha
通讯作者：
Ramaswamy, Megha

Decentering trust to connect with criminal legal system-involved women in research.

去中心化信任以与涉及刑事法律系统的女性参与研究建立联系。