Patient-Reported Barriers to Colorectal Cancer Screening

患者报告的结直肠癌筛查障碍

• 批准号: 6862472
• 负责人: STEVEN H WOOLF
• 金额: $ 12.81万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6862472
• 关键词: attitude; behavioral /social science research tag; clinical research; colorectal neoplasms; health behavior; health care model; health care service availability; health care service utilization; health services research tag; human subject; mass screening; neoplasm /cancer diagnosis; neoplasm /cancer education; primary care physician; questionnaires

DESCRIPTION (provided by applicant): Patient-Reported Barriers to Colorectal Cancer Screening: The aim is to describe the factors that primary care patients identify as their reason(s) for not undergoing screening for colorectal cancer (CRC) and the relative importance they assign to each factor. Factors of interest include all potential reasons cited by patients, ranging from cognitive and attitudinal determinants of intention to operational impediments. All such reasons are described in this study as barriers. The setting is 12 primary care practices participating in a practice-based research network in Virginia. Using ACORN administrative data, we will identify a sample of 6100 patients, age 50-75. Beginning in month 7, these patients will receive a postal survey that will ask respondents to quantify the relative importance of a detailed list of potential barriers to CRC screening. The estimated 1600 responses will undergo statistical analysis to produce an epidemiologic distribution of the relative importance of barriers in the non-adherent primary care population. Differences in barrier profiles will be examined across patient subgroups, such as age, gender, race, education, income, geographic setting, stage of change, and clinical circumstances. Before it is fielded, the postal survey will undergo development (including analysis of a general open-ended question about perceived barriers to CRC screening to be added to an existing ACORN survey sent to 1000 patients) and validation in months 1-6 to ensure comprehensiveness in addressing all potentially important barriers. The steps in development will include a systematic review of the literature and the use of an analytic matrix to construct a complete list of barriers, analysis of responses to the open-ended survey question to identify unrecognized barriers and to capture the natural language patients use to describe them, review by experts in CRC screening behavior, and patient focus groups to obtain further feedback and to pilot test the instrument. Provider and patient focus groups will inform final interpretation of the barriers survey results. The study will provide essential data for prioritizing strategies to improve CRC screening rates.

描述（由申请人提供）： 患者报告的结直肠癌筛查障碍： 目的是描述初级保健患者认为不接受结直肠癌 (CRC) 筛查的原因以及他们对每个因素的相对重要性。感兴趣的因素包括患者引用的所有潜在原因，从意图的认知和态度决定因素到操作​​障碍。 所有这些原因在本研究中都被描述为障碍。 该项目的背景是参与弗吉尼亚州基于实践的研究网络的 12 个初级保健机构。使用 ACORN 管理数据，我们将确定 6100 名年龄在 50-75 岁之间的患者样本。从第 7 个月开始，这些患者将收到一份邮寄调查，要求受访者量化 CRC 筛查潜在障碍的详细列表的相对重要性。预计将对 1600 份答复进行统计分析，以得出不依从初级保健人群中障碍相对重要性的流行病学分布。 将检查不同患者亚组的屏障特征差异，例如年龄、性别、种族、教育、收入、地理环境、变化阶段和临床情况。 在实施之前，邮政调查将在 1-6 个月内进行开发（包括对关于 CRC 筛查感知障碍的一般开放式问题的分析，并将其添加到发送给 1000 名患者的现有 ACORN 调查中）和验证，以确保全面性解决所有潜在的重要障碍。 开发步骤将包括对文献进行系统回顾，并使用分析矩阵来构建完整的障碍列表，分析对开放式调查问题的回答，以识别未识别的障碍并捕获患者用于治疗的自然语言。描述它们，由 CRC 筛查行为专家和患者焦点小组进行审查，以获得进一步的反馈并试点测试仪器。 提供者和患者焦点小组将告知障碍调查结果的最终解释。 该研究将为优先考虑提高结直肠癌筛查率的策略提供重要数据。