Grant Details
Grant Number: |
3U01CA229437-04S1 Interpret this number |
Primary Investigator: |
Nahum-Shani, Inbal |
Organization: |
University Of Michigan At Ann Arbor |
Project Title: |
Novel Use of Mhealth Data to Identify States of Vulnerability and Receptivity to Jitais Supplement |
Fiscal Year: |
2022 |
Abstract
PROJECT SUMMARY
Tobacco is the leading cause of preventable death and disease and is linked to ~20 cancers. Marginalized
women (e.g., racial/ethnic, low socioeconomic status, or sexual and gender minorities) may be more vulnerable
to environmental, social, and contextual stressors that are significant barriers to tobacco abstinence. To
improve the fundamental understanding of how sex and gender relate to health behaviors and disease
prevention, it is critical to use approaches that can identify meaningful intersections of social determinants and
how these shape experiences and health behaviors in subpopulations of understudied, underrepresented, and
underreported of women. Intersectionality posits that social identities interact with one another and with
social/contextual factors to create inequities. Thus, intersectionality is useful for shifting focus from broad
sectors of the population (e.g., all female smokers) to groups with intersecting statuses that may confer greater
health risk (e.g., low income racial/ethnic minority females). Moreover, intersectionality reflects both
between- and within-person processes. The latter highlights that the complex factors (e.g., experiences of
discrimination, encountering tobacco-facilitative environments) that may influence tobacco use are dynamic
and may change depending on time and context. Mobile health methodology (mHealth), such as AutoSense,
ecological momentary assessment (EMA), and global positioning system (GPS) provide real-time objective and
subjective assessments of how and when emotions and behaviors change depending on time and context.
Together, mHealth designs and an intersectionality framework may reveal the dynamic and complex factors
that interact to contribute to inequities in tobacco use and cancer risk in understudied, underrepresented, and
underreported women. The proposed supplement will extend the parent project (U01CA229437, MPI: Nahum-
Shani, Wetter) by harmonizing data across 7 intensive longitudinal mHealth studies of tobacco cessation in 834
diverse women, which will provide adequate power for applying an intersectionality framework to understand
mechanisms linking marginalized status among women to tobacco lapse and cessation outcomes. These fine-
grained data can yield the most detailed investigation of intersectional process to-date, including the complex
interplay between aspects of social identity (SES, race/ethnicity), social (e.g., discrimination) and contextual
factors (e.g., neighborhood disadvantage, exposure to tobacco-facilitative environments), and whether these
mediate the association of intersectional identities with lapse and long term abstinence. The proposed study is
designed to target gaps in the understanding of inequities in tobacco use and health risk among understudied,
underrepresented, and underreported subgroups of women and is directly in line with the first strategic goal of
the Office of Research on Women's Health, to “advance rigorous research that will improve the fundamental
understanding of how sex and gender, among other critical factors, influence health and disease.”
Publications
None. See parent grant details.