Increasing CRC Screening in Primary Care Settings

增加初级保健机构的结直肠癌筛查

• 批准号: 6945984
• 负责人: USHA MENON
• 金额: $ 47.81万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6945984
• 关键词: African American; behavior modification; behavioral /social science research tag; belief; cancer risk; caucasian American; clinical research; colorectal neoplasms; data collection methodology /evaluation; disease /disorder prevention /control; early diagnosis; health behavior; health care service utilization; health services research tag; human subject; interview; longitudinal human study; motivation; neoplasm /cancer diagnosis; patient care management; racial /ethnic difference

DESCRIPTION (provided by applicant): Regular screening reduces both morbidity and mortality from colorectal cancer (CRC). Screening rates, however, remain low suggesting the need for innovative research designed to increase screening behavior. The purpose of this study is to compare the effectiveness of two interventions (Tailored Health Communications [THC] and Motivational Interviewing [MI]) in increasing CRC screening behavior. Both interventions are based on a strong conceptual framework derived from the Health Belief Model (HBM) and Transtheoretical Model (TTM), allowing us to explore the underlying mechanisms through which these interventions impact behavior change. The primary aim of this study is to compare CRC screening test use among 804 participants randomly allocated to control or intervention conditions; 402 participants will be recruited from each site (Salt Lake City, UT and Nashville, TN). The three study groups will receive (1) standard care, (2) tailored health communication, and (3) motivational interviewing. Eligibility criteria for study participants includes being 50 years or older, not having CRC, and being of average or moderate risk for CRC. Study participants will be surveyed by telephone about CRC related beliefs pre-intervention (Time 1), one month post intervention (Time 2), and at 6 and 12 months (Times 3 and 4 respectively). Salt Like City participants will be primarily Caucasian and those from Nashville will be African American. Dichotomous behavioral outcomes (had screening test or not) and stages of CRC screening test adoption (based on the TTM) will be assessed, as well as sociodemographic and belief predictors of screening behavior. Binomial and multinomial logistic regression models will be used to evaluate screening test use and stage of test adoption. Sociodemographic and belief variables will be used as covariates, with intervention groups at the primary independent predictor. Descriptive statistics and ANOVA will be employed to assess between intervention differences in amenable beliefs. Path (mediation) analysis will be performed to further explore the underlying mechanisms through which THC and MI may differentially affect CRC screening behavior.

描述（由申请人提供）：定期筛查可降低结直肠癌（CRC）的发病率和死亡率。但是，筛查率仍然很低，这表明需要旨在增加筛查行为的创新研究。这项研究的目的是比较两种干预措施（量身定制的健康通信[THC]和动机访谈[MI]）在增加CRC筛查行为方面的有效性。两种干预措施均基于从健康信念模型（HBM）和跨理论模型（TTM）得出的强大概念框架，使我们能够探索这些干预措施影响行为改变的基本机制。这项研究的主要目的是比较804名随机分配给控制或干预条件的参与者中的CRC筛选测试使用； 402名参与者将从每个地点（盐湖城和田纳西州纳什维尔）招募。这三个研究小组将获得（1）标准护理，（2）量身定制的健康沟通以及（3）动机访谈。研究参与者的资格标准包括50岁以上，没有CRC，并且CRC的平均风险或中等风险。研究参与者将通过电话调查有关CRC相关的干预前（时间1），干预后一个月（时间2）和6和12个月（分别为3和4）（分别为3和4）。像城市参与者一样的盐将主要是高加索人，纳什维尔的盐将是非裔美国人。将评估二分法行为结果（是否进行了筛查测试），CRC筛选测试的采用阶段（基于TTM）将得到评估，以及筛选行为的社会人口统计学和信念预测指标。二项式和多项式逻辑回归模型将用于评估筛选测试使用和测试的阶段。社会人口统计学和信念变量将用作协变量，而主要独立预测指标的干预组。描述性统计和ANOVA将被用来评估正式信念的干预差异。将进行路径（中介）分析，以进一步探索THC和MI可能会不同影响CRC筛查行为的潜在机制。