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Kin KeeperSM:一项基于社区的随机对照试验的设计和基线特征,旨在促进黑种人、拉丁裔和阿拉伯裔妇女进行癌症筛查。

Kin KeeperSM: design and baseline characteristics of a community-based randomized controlled trial promoting cancer screening in Black, Latina, and Arab women.

机构信息

Department of Obstetrics, Gynecology & Reproductive Biology, College of Human Medicine Michigan State University, East Lansing, MI 48824, USA.

出版信息

Contemp Clin Trials. 2013 Mar;34(2):312-9. doi: 10.1016/j.cct.2012.12.005. Epub 2012 Dec 28.

Abstract

BACKGROUND

Although breast and cervical cancer deaths have declined due to early screening, detection, and more effective treatment, racial and ethnic disparities persist. This paper describes the study design and baseline characteristics of a randomized controlled trial (RCT) evaluating the effectiveness of the Kin Keeper(SM) Cancer Prevention Intervention, a family-focused educational intervention for underserved women applied in a community-based setting to promote health literacy and screening adherence to address cancer disparities.

METHODS

Female public health community health workers (CHWs) were trained to administer the intervention. They recruited female clients from their public health program caseload and asked each to assemble two to four adult female family members for the breast and cervical cancer home-based education sessions the CHWs would deliver in English, Spanish or Arabic. We randomized the clients into the kin keeper group (treatment) or the participant client group (control).

RESULTS

Complete data were obtained on 514 Black, Latina, and Arab women. Close to half were unemployed and had yearly family income below $20,000. Thirty-four percent had no medical insurance, and 21% had diabetes. Almost 40% had no mammography in the last year. Treatment and control groups were similar on most sociodemographics but showed differences in breast and cervical screening history.

CONCLUSIONS

This innovative study demonstrates the implementation of an RCT using community-based participatory research, while delivering cancer prevention education across woman's life span with women not connected to the health care system.

摘要

背景

尽管由于早期筛查、检测和更有效的治疗,乳腺癌和宫颈癌的死亡率有所下降,但仍存在种族和民族差异。本文描述了一项随机对照试验(RCT)的研究设计和基线特征,该试验评估了 Kin Keeper(SM)癌症预防干预措施的有效性,这是一种以家庭为重点的教育干预措施,适用于以社区为基础的环境,旨在提高健康素养和筛查依从性,以解决癌症差异问题。

方法

经过培训的社区公共卫生工作者(CHWs)对女性进行干预。他们从公共卫生项目的患者名单中招募女性客户,并要求每位客户召集两到四位成年女性家庭成员参加 CHWs 将以英语、西班牙语或阿拉伯语提供的乳腺癌和宫颈癌家庭教育课程。我们将客户随机分为 Kin Keeper 组(治疗组)或参与者客户组(对照组)。

结果

514 名黑种人、拉丁裔和阿拉伯裔女性的完整数据。将近一半的人失业,家庭年收入低于 20000 美元。34%的人没有医疗保险,21%的人患有糖尿病。近 40%的人在过去一年没有进行过乳房 X 光检查。治疗组和对照组在大多数社会人口统计学特征上相似,但在乳腺癌和宫颈癌筛查史方面存在差异。

结论

这项创新性研究展示了使用社区参与式研究实施 RCT 的过程,同时在未与医疗保健系统相连的女性中提供跨越女性生命周期的癌症预防教育。

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本文引用的文献

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Multilevel interventions and racial/ethnic health disparities.多层次干预与种族/民族健康差异。
J Natl Cancer Inst Monogr. 2012 May;2012(44):100-11. doi: 10.1093/jncimonographs/lgs015.
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Breast cancer screening trends in the United States and ethnicity.美国乳腺癌筛查趋势与种族。
Cancer Epidemiol Biomarkers Prev. 2012 Feb;21(2):351-7. doi: 10.1158/1055-9965.EPI-11-0873. Epub 2011 Dec 6.
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Outcomes of community health worker interventions.社区卫生工作者干预措施的效果。
Evid Rep Technol Assess (Full Rep). 2009 Jun(181):1-144, A1-2, B1-14, passim.
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Expanding the influence of cancer education.
J Cancer Educ. 2010 Sep;25(3):275-6. doi: 10.1007/s13187-010-0137-3.

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