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 (NYC) 拥有大量多元化的移民人口。其中许多群体面临着预防性医疗保健的重大障碍，包括缺乏保险、医疗保健获取机会差和语言困难。大多数非洲移民妇女可能生活在贫困线以下并且收入较低健康素养，不太可能拥有健康保险和去看医生，特别是初级/预防性的关心。如果无法获得初级保健，许多预防性服务（例如乳腺癌筛查）就无法获得。无人值守。服务不足的其他少数群体进行乳腺癌筛查的障碍和促进因素对非洲裔美国人和拉丁裔女性等人群进行了研究。人们对这些知之甚少非洲移民妇女以及如何最有效地让她们参与定期筛查。我们对居住在纽约市的 2,000 多名非洲出生移民的数据显示，77% 的人表示健康状况不佳保险; 75% 没有初级保健医生； 57%的人文化程度低于高中。至于如果根据年龄进行癌症筛查，44% 的人从未做过乳房 X 光检查。通过我们独特的与非洲服务委员会和布朗克斯非洲咨询委员会合作，两个非政府社区服务组织，我们准备对这些组织产生重大影响来自非洲 20 多个国家的移民妇女。这是一个拥有大量人口的需要增加乳腺癌知识、获得乳腺癌筛查和基本医疗护理。健康信念模型 (HBM) 提供了一个解决文化健康障碍的框架，它提出做出采取健康行为的决定是通过权衡感知到的威胁与好处。使用 HBM 结构开发的健康教育计划是减少导致癌症健康差异的障碍。此外，通过叙事方式呈现健康信息沟通（即讲故事、个人感言）是教育参与者了解相关知识的有效方法癌症预防和筛查。我们在少数族裔和移民社区的工作表明，结合叙述性沟通和导航辅助可以增加乳腺癌筛查的参与度。然而，这些干预措施的有效性尚未在非洲出生的移民中得到实证检验。该项目的长期目标是进行一项随机临床试验，测试适应的旨在提高非洲出生移民的乳腺癌筛查率的干预措施。短期内，我们计划追求以下具体目标： (1) 确定乳腺癌筛查的障碍和促进因素非洲出生的移民和 (2) 文化适应和试点测试见证项目乳腺癌教育为非洲出生的女性提供的计划。因此，我们将在文化上采用有效、创新的干预措施来解决非洲出生的移民社区存在这种巨大的健康差异。一旦我们进行了试点测试可行性以及干预措施的可接受性，我们将申请 R01 资金。