Increasing Colorectal Cancer Screening in Alaska Native Men

增加阿拉斯加原住民男性结直肠癌筛查

基本信息

批准号：
10218913
负责人：
Clemma Jacobsen Muller
金额：
$ 16.93万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-18 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10218913
关键词：
Address Adult Age Alaska Alaska Native American Cancer Society American Indians Blood Cancer Survivor Cessation of life Clinic Clinical Clinical Practice Guideline Colonoscopy Colorectal Cancer Computerized Medical Record Consent DNA Data Diagnosis Diagnostic Disease Economics Enrollment Ensure Ethnic Origin Ethnic group Evidence based intervention Exploratory/Developmental Grant Feces Feedback Focus Groups Foundations Frequencies Future Guidelines Health Health Care Visit Health Personnel Healthcare Systems Home Incidence Individual Intervention Intervention Trial Interview Lesion Life Malignant Neoplasms Methods Minority Groups Morbidity - disease rate Native-Born Not Hispanic or Latino Patient Recruitments Patients Population Preparation Procedures Race Randomized Randomized Controlled Trials Reaction Reporting Research Risk Schedule Screening Result Structure Surveys Survival Rate Survivors Testing Text Messaging TimeLine Treatment outcome Underserved Population Woman Workload aged base cancer diagnosis cancer health disparity clinical practice colorectal cancer prevention colorectal cancer risk colorectal cancer screening colorectal cancer treatment comparison intervention cost design economic evaluation effective intervention effectiveness testing electronic data ethnic minority population experience follow-up health economics high risk high risk population home test implementation study improved informant male man men mortality patient response post intervention preference premalignant prevent primary outcome racial minority screening screening disparities screening guidelines secondary outcome text messaging intervention theories therapy design treatment arm treatment as usual uptake waiver

项目摘要

ABSTRACT Alaska Native men have higher colorectal cancer (CRC) incidence and mortality than any other US racial or ethnic group. Screening can prevent CRC and improve treatment outcomes by detecting disease in early stages, but Alaska Native men also have low CRC screening uptake. Colonoscopy is the most accurate CRC screening method and results in the most years of life saved. It only requires rescreening every 10 years, but it is a clinic- based procedure and needs extensive preparation. Other screening options include home-based tests that detect blood in the stool and require rescreening every year. More recently, a home-based method has been developed that tests stool for DNA indicative of CRC and requires rescreening every 3 years. Current guidelines recommend CRC screening for average risk adults starting between ages 45-50, but people at higher risk should start at younger ages. Many interventions have been developed to promote CRC screening. Among these, interventions that use text messaging or other electronic health messages to reach people outside of the clinical setting have shown promise for improving CRC screening. In a previous study, our research team developed an intervention that sends up to 3 text messages to Alaska Native people patients of the Southcentral Foundation (SCF) healthcare system in Anchorage, Alaska. We tested the intervention in a randomized controlled trial with 2,386 Alaska Native SCF patients ages 40-75. The intervention increased CRC screening by 50% in women, but it had no effect in men. In the current implementation study, we propose a theory-based approach to culturally tailor the existing text message intervention for Alaska Native men. We will use surveys and focus groups with SCF patients, and key informant interviews with SCF healthcare providers, to assess barriers and facilitators to optimize colorectal cancer screening in Alaska Native men. We anticipate that revisions will include changing the content and frequency of the text messages, and promoting home-based stool DNA screening in addition to colonoscopy. We will then test the effectiveness of the tailored intervention with 600 Alaska Native men ages 40-75 who are active patients at SCF. Eligible men will be identified from the electronic medical record and randomized in equal proportions to the intervention or usual care control conditions. The primary outcome is CRC screening completed within 6 months of sending the first text message. Secondary outcomes include clinical findings and follow-up procedures associated with screening. All data will be collected from the electronic medical record, and we will obtain a waiver of consent for direct patient recruitment. Follow-up interviews will assess patient response to the intervention. If effective, this study has implications for increasing CRC screening in men from other racial and ethnic minority groups who experience CRC disparities.

抽象的阿拉斯加土著男性的结直肠癌（CRC）的发病率和死亡率高于任何其他美国种族或民族。筛查可以通过在早期发现疾病来防止CRC并改善治疗结果，但是阿拉斯加的土著男子的CRC筛查吸收也很低。结肠镜检查是最准确的CRC筛查方法和结果在生命的大部分时间里都节省了。它仅需要每10年进行一次筛选，但这是一个诊所基于程序和需要广泛的准备。其他筛选选项包括基于家庭的测试检测凳子中的血液，每年需要重新分组。最近，一种基于家庭的方法开发了测试凳子的DNA指示CRC的DNA，并且需要每3年进行一次重新分组。当前的准则建议从45-50岁开始的平均风险成年人进行CRC筛查，但风险较高的人应该从年轻人开始。已经开发了许多干预措施来促进CRC筛查。其中，使用文本消息传递或其他电子健康消息的干预措施来触及临床之外的人设置显示了改善CRC筛查的希望。在先前的研究中，我们的研究团队开发了干预措施最多发送3条短信给阿拉斯加本地人的中西部基金会患者（SCF）阿拉斯加安克雷奇的医疗保健系统。我们在一项随机对照试验中测试了干预措施 2,386名阿拉斯加本地SCF患者40-75岁。干预措施使CRC筛查在女性中增加了50％，但这对男人没有影响。在当前的实施研究中，我们提出了一种基于理论的文化方法量身定制阿拉斯加本地男性的现有短信干预。我们将使用调查和焦点小组与 SCF患者以及与SCF医疗保健提供者的主要线人访谈，以评估障碍和促进者优化阿拉斯加土著男性的结直肠癌筛查。我们预计修订将包括更改文本消息的内容和频率以及促进基于家庭的粪便DNA筛选。结肠镜检查。然后，我们将测试600名阿拉斯加本地男性年龄的量身定制干预措施的有效性 40-75岁是SCF的活跃患者。符合条件的男性将从电子病历中确定，并与干预措施或通常的护理控制条件相等地随机分配。主要结果是 CRC筛查在发送第一条短信的6个月内完成。次要结果包括临床发现和随访程序与筛查有关。所有数据将从电子中收集病历，我们将获得直接患者招募的同意书。后续采访将评估患者对干预的反应。如果有效，这项研究对增加CRC筛查有影响来自其他种族和少数民族群体的男性，经历了CRC差异。