Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
New Mexico State University, Las Cruces, NM, USA.
Cancer Control. 2020 Jan-Dec;27(1):1073274820983026. doi: 10.1177/1073274820983026.
Quantitative approaches to the cancer incidence and mortality of a geographic region may lack understanding of the human context in the region thereby affecting how relevant cancer prevention and control activities can best be targeted to a cancer center's catchment area.
The objective of this study was to obtain and analyze qualitative data that described the barriers and facilitators in a cancer center's catchment area. A further objective was to use the assessment to plan a comprehensive approach to cancer prevention and control activities in the region.
Extensive qualitative data were gathered from 32 key informants in the 13 county catchment area. We used the Warnecke Model for Analysis of Population Health and Health Disparities to analyze the qualitative data. We coded factors affecting cancer prevention and control using a directed content analysis approach guided by the Warnecke Model.
Four outcome types included fundamental barriers such as political environment and discrimination, gaps in resources, and lack of coordinated activities. Social and physical barriers included distrust, diverse language and cultures, and geographic distance. Individual barriers included lack of system negotiation, health literacy, and poverty. Biological barriers were disparate disease rates in specific groups.
The analysis and assessment led to the creation of a catchment area wide coalition that used the results to formulate a comprehensive strategic plan to address the barriers in the region.
定量方法可用于研究某一地理区域的癌症发病率和死亡率，但可能缺乏对该区域人文背景的了解，从而影响癌症预防和控制活动如何针对癌症中心的服务区域进行有效定位。
本研究旨在获取和分析可描述癌症中心服务区域障碍和促进因素的定性数据，并利用评估结果规划该区域全面的癌症预防和控制活动。
从 13 个县的服务区域内的 32 名关键信息提供者处收集了大量定性数据。我们使用 Warnecke 人口健康与健康差异分析模型对定性数据进行分析。我们采用了以 Warnecke 模型为指导的定向内容分析方法，对影响癌症预防和控制的因素进行编码。
四种结果类型包括政治环境和歧视等根本障碍、资源差距以及缺乏协调的活动等。社会和物理障碍包括不信任、语言和文化多样性以及地理距离。个人障碍包括缺乏系统协商、健康素养和贫困。生物障碍则是特定群体中不同的疾病发生率。
分析和评估促成了一个覆盖整个服务区域的联盟的成立，该联盟利用评估结果制定了一个全面的战略计划，以解决该区域的障碍。
