In response to PAR-07-380 Behavioral and Social Science Research on Understanding and Reducing Health Disparities, the proposed study focuses on identifying potential causes of disparities in breast cancer screening and cancer-related behaviors among Latina (Hispanic) women. Although the study focuses on a single population, the proposed focus on health care, cultural factors and norms, and other variables will help to elucidate the circumstances and mechanisms that may contribute to disparities in breast cancer. The primary goals of the proposed study are to elucidate psychosocial and cultural factors that are associated with a variety of cancer-related behaviors and risk factors (smoking, exercise, and body mass index), and recency of breast cancer screening (mammography), as well as to examine social, neighborhood-level, and access health care factors that may predict these behaviors. The model aims to examine the relationship between social capital, neighborhood factors, cancer screening, and cancer-related health behaviors;to test the extent to which familism, health-behavior norms concerning smoking and obesity, and fatalistic beliefs about cancer mediate the relationship between acculturation, cancer screening, and health behavior outcomes;to analyze whether access to health care mediates the relationship between neighborhood resources, social class, and screening;and to examine whether social capital predicts screening via social support. A total of 402 Latinas will be recruited from community-based settings in New York (specifically, Washington Heights/Inwood and sections of the South Bronx). Data will be collected via face-to-face interviews. Data on neighborhood characteristics will be derived from self-report, publicly-available Census data, as well as street-level observations. Employing a cross-sectional design, the theoretical model will be tested with Structural Equation Modeling statistical techniques.
The study will identify factors that promote and present barriers to breast cancer screening and cancer-related health behaviors among Latinas. Data can be used by health educators to design effective, culturally-competent educational programs, and by other health professionals to provide culturally-appropriate health services. Therefore, the research will provide a basis for the development of culturally-relevant programs, suggest points of intervention at the policy and environmental levels, and lead to future epidemiologic studies of individual and structural determinants of health behaviors in a high risk group.
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