Over the next several years, I plan to organize my research around investigations of cancer-related practices and attitudes among hard-to-reach populations of women. My particular interests are in the role of psychosocial factors on cancer screening behaviors among unmarried women. In this context, my objective of this proposed 5-year K07 award is to gain necessary substantive and methodological skills to conduct survey research in important subgroups of the unmarried population. My program of training and research will be under the direction of a Primary Mentor, William Rakowski, PhD and a nine-member Advisory Committee. Training activities will include: """"""""shadowing"""""""" a women's health physician; participating in activities at a survey research center; and coursework related to hidden or hard-to- reach populations, cancer biology, and qualitative research methods. The project will focus on unmarried women 40 to 75 years, with allocation among four strata defined according to legal marital status and sexual orientation: 1) Never Married women who are heterosexual; 2) Never Married women who are lesbian; 3) Divorced, Separated, or Widowed women who are heterosexual; and 4) Divorced, Separated, or Widowed women who are lesbian. The research project will be conducted in three sequential phases, using a combination of qualitative and quantitative methods.
The specific aims for each phase are: Phase I: Formative Research: 1) To explore the behavioral, cognitive, and environmental factors that influence unmarried women's decisions for breast, cervical, and colorectal cancer screening; 2) To explore relationships between breast, cervical, and colorectal cancer screening among unmarried women. Phase II: Instrument Development: 3) To develop and test survey instruments and data collection protocols for measuring factors associated with cancer screenings among unmarried women. Phase III: Field Trial: 4) To evaluate three survey protocols [mailed questionnaire, telephone interview, and computerized self-administered questionnaire] for collecting data about attitudes and practices regarding cancer screenings among unmarried women; and 5) To compare behavioral, cognitive, and environmental factors that influence comprehensive cancer screenings across subgroups of unmarried women. Phase I will consist of focus groups and individual cognitive interviews. Phase II will include focus group interviews and pretests of the survey instruments and three data collection protocols. In Phase III, women will be randomly assigned to one of three survey protocols, and data will be collected at a baseline and a 4-week reliability assessment.
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