Understanding determinants of lung cancer preventive care in at-risk urban American Indians and Alaska Natives: A mixed-methods study.

Autor:	Tsosie U; Cancer Genetics and Prevention, Fred Hutchinson Cancer Center, Seattle, WA, USA., Anderson N; Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA., Woo N; Cancer Genetics and Prevention, Fred Hutchinson Cancer Center, Seattle, WA, USA., Dee C; Office of Community Outreach and Engagement, Fred Hutchinson Cancer Center, Seattle, WA, USA., Echo-Hawk A; Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA, USA., Baker L; Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA, USA., Rusk AM; Division of Pulmonary Medicine, Mayo Clinic, Phoenix, AZ, USA.; Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, USA.; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Rochester, MN, USA.; Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN, USA., Barrington W; Department of Child, Family and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, USA.; Center for Anti-Racism and Community Health (ARCH), School of Public Health, University of Washington, Seattle, WA, USA., Parker M; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.; Seven Directions: A Center for Indigenous Public Health, University of Washington, Seattle, WA, USA., Triplette M; Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA.; Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.
Jazyk:	angličtina
Zdroj:	Preventive medicine reports [Prev Med Rep] 2024 Jul 14; Vol. 45, pp. 102822. Date of Electronic Publication: 2024 Jul 14 (Print Publication: 2024).
DOI:	10.1016/j.pmedr.2024.102822
Abstrakt:	Introduction: Lung cancer is the leading cause of cancer death among American Indian and Alaska Native (AI/AN) people, and AI/AN people have the highest rate of smoking of any racial or ethnic group in the US. There is limited research to inform culturally-relevant strategies for lung cancer prevention inclusive of lung cancer screening (LCS). The objective of this study was to understand determinants of LCS and tobacco cessation care in at-risk urban-dwelling AI/ANs. Materials and Methods: This was a mixed-methods community-based participatory research study including complimentary qualitative discussions and surveys conducted in Seattle, Washington, USA from 2022 to 2023. The study measures and analytic approach integrated the Consolidated Framework for Implementation Research and Tribal Critical Race Theory and qualitative transcripts were analyzed using thematic analysis. Participants were self-identified AI/AN people who were age ≥ 40 and had ≥ 10-year history of commercial cigarette smoking. Results: Forty-five participants completed surveys and participated in discussions, 48% were female, the median age was 58 and median smoking history was 24 pack-years of commercial cigarette use. Themes revealed prominent barriers to LCS care including access, costs, awareness, and fear. Many reported previous negative and discriminatory encounters within and outside the health system which may also serve as barriers. Most participants endorsed cancer screening and increased education, recommending Indigenous-centered, delivered, and tailored programs, as well barrier-directed support. Conclusions: In a broad sample of at-risk urban-dwelling AI/AN people, our findings suggest enthusiasm for preventive care but several complex barriers. Participants endorsed culturally-tailored programs which could provide relevant education and address barriers. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Matthew Triplette reports financial support was provided by National Cancer Institute. Matthew Triplette reports financial support was provided by the American Thoracic Society, CHEST Foundation and American Lung Association. Matthew Triplette reports a relationship with GO2 Foundation for Lung Cancer that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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