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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Even though recent work has demonstrated that the disparity in cancer incidence and mortality is decreasing among members of ethnic and racial groups, African Americans and Hispanics continue to experience excess rates of cancer morbidity and mortality. Research is now being conducted to disentangle the effects of biological, behavioral, and sociocultural determinants of racial and ethnic disparities in cancer morbidity and mortality. Although understanding the role of cultural factors to cancer prevention and control behaviors has been the focus of much of this research, knowledge about the contribution of these factors to screening behaviors and avoidance of cancer risk factors has proceeded at slow rate because of the limited availability of reliable and valid methods for assessing these characteristics in ethnically and racially diverse populations. Culture is a multi-dimensional construct that includes beliefs and values; however, previous studies have focused on describing myths and folk beliefs about cancer among African Americans and Hispanics. This method of assessing cultural factors has had a limited impact on minimizing cancer disparities because myths and folk beliefs are not generalizable to all members of ethnic and racial groups. Methods for assessing cultural values related to cancer prevention and control that are reliable and valid for ethnically and racially diverse populations is needed to achieve the long-term objective of reducing and eliminating ethnic and racial disparities in cancer morbidity and mortality. Therefore, the specific aims of this study are to (1) develop a multi-dimensional cultural values assessment tool (MCVAT) that is sensitive to cultural values for cancer prevention and control among African Americans, Hispanics, and Caucasians; (2) evaluate the psychometric properties of the MCVAT among these diverse ethnic and racial groups; and (3) evaluate the construct, discriminant, and predictive validity of the instrument in these groups. Subjects eligible to participate in the study are African American, Caucasian, and Hispanic men and women ages 18-75. The study will be implemented in three phases. In Phase I we will conduct qualitative research to generate items for the MCVAT and in Phase II, we will conduct a cross-sectional survey study to evaluate the psychometric properties of the MCVAT. In Phase III, we will conduct a prospective, longitudinal survey study to evaluate the construct, discriminate, and predictive validity of the MCVAT. To accomplish these goals, we have assembled an investigative team of experts in culture, psychometrics, cancer prevention and control, and survey research. This study will provide a psychometrically sound instrument that can be used in clinical and research settings to provide culturally sensitive care and interventions to ethnically and racially diverse populations.