The Role of Collective Efficacy on Colorectal Cancer Disparities in Queens, New York
thesisposted on 2019-02-01, 00:00 authored by Demetria Cain
Examining social determinants of health (SDOH) are imperative for understanding how the contexts in which individuals are situated affect their health outcomes. Features of place provide a conceptual framework to characterize neighborhood environments and their relationship with cancer screening uptake and cancer disparities. Features of place are compositional (resident characteristics), contextual (available services), and collective (social processes) factors. Compositional and contextual indicators are more established, while collective indicators are less available to measure neighborhood social processes at a local level. Collective efficacy is a commonly used collective feature of place and neighborhood social process indicator measuring perceptions towards a neighborhood’s capability to address local health concerns. However, resident composition affects these perceptions and additional research is needed to determine how the measurement functions in diverse neighborhoods, including whether the collective efficacy scale measures this trait similarly among different race and ethnic groups. Also, whether collective factors moderate compositional factors on cancer disparities by examining their impact on cancer screening and late stage cancer diagnoses across Queens, New York. Finally, whether a library program to improve cancer screening behavior worked better in neighborhoods with higher versus lower collective efficacy. This research informs the development of Healthy People 2020 leading health indicators for SDOH to include collective social processes. Community health researchers and practitioners will gain knowledge to further consider neighborhoods as dynamic settings where features of place work in conjunction with each other. The implications of which will benefit the advancement of healthier neighborhoods through assessment, intervention development, and resource allocation.