The Upstream Center: Income Interventions to Address the Fundamental Causes of Cancer Inequities

上游中心：解决癌症不平等根本原因的收入干预措施

• 批准号: 10661407
• 负责人: MELISSA L. BONDY
• 金额: $ 209.5万
• 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/10661407
• 关键词: Address; Advanced Malignant Neoplasm; Affect; Area; Behavior; Behavioral; California; Cancer Burden; Cancer Control; Cancer Etiology; Cancer Science; Cancer health equity; Catchment Area; Cause of Death; Cessation of life; Collaborations; Communities; Complex; Data Scientist; Development; Diet; Environment; Food; Foundations; Health; Health Services Accessibility; Health behavior; Health system; Healthcare; Housing; Incidence; Income; Income Tax; Individual; Inequity; Intervention; Learning; Low income; Malignant Neoplasms; Mediating; Methodology; Outcome; Personal Satisfaction; Persons; Physical activity; Pilot Projects; Play; Policies; Policy Developments; Policy Maker; Population; Poverty; Poverty Areas; Process; Research; Research Personnel; Research Project Grants; Resources; Risk Factors; San Francisco; Science; Social Change; Social Sciences; Social Work; Supplementation; Testing; Training; Transportation; Universities; Wages; Work; cancer prevention; cancer risk; career; career development; deprivation; economic disparity; evidence base; improved; innovation; mathematical model; member; mortality; novel; poor communities; prevent; programs; research and development; screening; social; social determinants; social disparities; social health determinants; stress reduction; structural determinants

Overall Component: Project Summary/Abstract Persistent poverty environments impose particular challenges for cancer prevention, with complex and intersecting factors creating barriers at the individual, health system, and population level. Improving cancer outcomes in these areas requires transformational, multisector solutions targeting fundamental causes and social determinants of health, with research and policy development processes that are co-created with the impacted communities. To address this challenge, we will form the UPSTREAM Research Center, an innovative approach to the fundamental problem of income deprivation by leveraging state programs for Guaranteed Basic Income and the Earned Income Tax Credit (EITC). Our team science approach to this problem is supported by the unparalleled resources at Stanford University, the University of California, San Francisco and the University of California, Davis. Our work advances multiple conceptual and methodological innovations through two main research projects: 1) an ongoing partnership with the California Department of Social Services to access and evaluate a $35M intervention of Guaranteed Basic Income in persistent poverty areas with a focus on modifiable cancer risk factors and intermediate outcomes; 2) the impact of increases in income support through the EITC, which in California has a unique focus on lower income wage earners, as well as undocumented workers. Our Specific Aims are to: Aim 1. Build a collaborative community of residents in persistent poverty areas, policy makers, trainees, cancer and social science researchers and data scientists that co-create programs to address the fundamental impacts of income deprivation, Aim 2. Evaluate the impact of income-based interventions in demographically diverse persistent poverty areas in Northern CA, Aim 3. Develop a mathematical model, with community input, that can assist in predicting long-term impacts of income-focused interventions on cancer incidence, providing community members, policy makers, and researchers with guidance on how best to eliminate the increased burden of cancer in persistent poverty areas, Aim 4. Develop and implement a career enhancement program that will facilitate the training and career development of a diverse cadre of interdisciplinary early-career scholars who are committed to advancing cancer health equity through research and practice in persistent poverty areas, and Aim 5. Implement innovative and collaborative cancer prevention and control programs identified through the UPSTREAM Research Center research projects and our community partners to develop long-term sustainable strategies in our Northern CA Catchment Areas and across the Persistent Poverty Centers Network. Results from this novel groundbreaking work will lay the foundation for transformative approaches to address cancer prevention and control programs in the face of severe economic and social disadvantage through capacity building and sustainable partnerships with policymakers, state and local agencies and community partners.

总体组成部分：项目摘要/摘要 持续的贫困环境给癌症预防带来了特殊的挑战，其复杂性和 交叉因素在个人、卫生系统和人口层面造成障碍。改善癌症 这些领域的成果需要针对根本原因的变革性多部门解决方案 健康的社会决定因素，以及与社会共同创建的研究和政策制定进程 受影响的社区。为了应对这一挑战，我们将成立 UPSTREAM 研究中心， 通过利用国家计划来解决收入剥夺这一根本问题的创新方法 保证基本收入和所得税抵免 (EITC)。我们团队对此采取科学方法 该问题得到了斯坦福大学、加州大学圣何塞分校无与伦比的资源的支持 弗朗西斯科和加州大学戴维斯分校。我们的工作推进了多种概念和方法论 通过两个主要研究项目进行创新：1）与加州农业部的持续合作伙伴关系 社会服务部门将获得并评估 3500 万美元的基本收入保障干预措施，以解决持续贫困问题 重点关注可改变的癌症风险因素和中间结果的领域； 2）增加的影响 通过 EITC 提供收入支持，该计划在加利福尼亚州特别关注低收入工薪阶层， 以及无证工人。我们的具体目标是： 目标 1. 建立居民协作社区 在持续贫困地区，政策制定者、学员、癌症和社会科学研究人员以及数据科学家 共同制定计划来解决收入剥夺的根本影响，目标 2。评估 基于收入的干预措施对北加州人口多样化持续贫困地区的影响，目标 3. 根据社区意见开发数学模型，帮助预测长期影响 以收入为中心的癌症发病率干预措施，为社区成员、政策制定者和 研究人员就如何最好地消除持续贫困地区日益增加的癌症负担提供指导， 目标 4. 制定并实施职业提升计划，以促进培​​训和职业发展 培养一支由跨学科早期职业学者组成的多元化骨干队伍，他们致力于推进 通过在持续贫困地区的研究和实践实现癌症健康公平，以及目标 5。实施 通过 UPSTREAM 确定的创新和协作癌症预防和控制计划 研究中心的研究项目和我们的社区合作伙伴共同制定长期可持续战略 我们的北加州集水区和整个持续贫困中心网络。这本小说的结果 开创性的工作将为解决癌症预防和治疗问题的变革性方法奠定基础 面对严重的经济和社会劣势，通过能力建设和 与政策制定者、州和地方机构以及社区合作伙伴建立可持续的伙伴关系。