Promoting Colon Cancer Screening Among African Amercians

促进非裔美国人结肠癌筛查

• 批准号: 7089697
• 负责人: SUSAN M RAWL
• 金额: $ 45.19万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7089697
• 关键词: African American; behavioral /social science research tag; blood tests; cancer prevention; cancer risk; clinical research; colon neoplasms; computer assisted instruction; computer assisted medical decision making; education evaluation /planning; endoscopy; focus groups; gastrointestinal imaging /visualization; handbook; health behavior; health disparity; health services research tag; human subject; interactive multimedia; interview; neoplasm /cancer diagnosis; neoplasm /cancer education; patient oriented research; racial /ethnic difference

DESCRIPTION (provided by applicant): Colorectal cancer is the third leading cause of cancer deaths in the United States, affecting both men and women of all racial and ethnic groups. The majority of these deaths could be prevented since CRC, when discovered early, is highly treatable and screening that leads to removal of adenomatous polyps decreases CRC incidence by 75% to 90%. Nationally, in 2002, only 50% of adults aged 50 or older reported having had any screening test in the recommended intervals. Both CRC incidence and mortality rates are higher among African Americans than any other racial group. These health disparities are due, in part, to delay in diagnosis resulting in advanced stage disease at presentation. Lower rates of CRC screening participation among African Americans contribute to this burden. Interactive computer-based interventions effectively promote health behavior change by delivering individualized, or tailored, health information and counseling. In pilot testing, a tailored, interactive computer intervention designed to promote CRC screening among African Americans resulted in increased CRC knowledge and higher rates of fecal occult blood testing. The proposed study is a randomized controlled trial to determine the efficacy of a tailored, interactive computer intervention to promote CRC screening by comparing it to, and combining it with, a physician recommendation, which has been found to be a significant predictor of CRC screening. A sample of 1248 African American men and women who are being seen in two Midwestern primary care networks and who are non-adherent to colon cancer screening guidelines will be randomly assigned to receive either: 1) a CRC screening brochure; 2) an interactive computer intervention; or 3) the interactive computer intervention plus the brochure. Both process and outcome variables will be examined. Rates of adherence to fecal occult blood testing, sigmoidoscopy and colonoscopy are primary outcomes examined at 6 and 15 months. Logistic regression models will be used to test intervention effects separately for two outcomes, fecal occult blood testing (initial and repeat) and endoscopic screening, while adjusting for potentially confounding covariates. Mediators and moderators of intervention effects and changes in health beliefs related to the interventions also will be determined.

描述（由申请人提供）： 结直肠癌是美国第三大癌症死亡原因，影响所有种族和民族的男性和女性。大多数死亡是可以预防的，因为早期发现的结直肠癌是高度可治疗的，并且通过筛查切除腺瘤性息肉可将结直肠癌的发病率降低 75% 至 90%。 2002 年，在全国范围内，只有 50% 的 50 岁或以上的成年人报告在建议的时间间隔内进行了任何筛查测试。非裔美国人的结直肠癌发病率和死亡率均高于任何其他种族群体。这些健康差异部分是由于诊断延迟导致就诊时处于晚期疾病。非裔美国人结直肠癌筛查参与率较低是造成这一负担的原因之一。基于计算机的交互式干预措施通过提供个性化或量身定制的健康信息和咨询，有效促进健康行为的改变。在试点测试中，旨在促进非裔美国人CRC筛查的定制交互式计算机干预措施增加了CRC知识并提高了粪便潜血检测率。拟议的研究是一项随机对照试验，旨在通过将其与医生建议进行比较并结合起来，确定定制的交互式计算机干预对促进 CRC 筛查的功效，医生建议已被发现是 CRC 筛查的重要预测因素。 1248 名在中西部初级保健网络就诊且不遵守结肠癌筛查指南的非裔美国男性和女性样本将被随机分配接受：1) CRC 筛查手册； 2）交互式计算机干预；或 3) 交互式计算机干预加上小册子。过程和结果变量都将受到检查。粪便潜血检测、乙状结肠镜检查和结肠镜检查的依从率是 6 个月和 15 个月时检查的主要结果。逻辑回归模型将用于分别测试两种结果的干预效果：粪便潜血检测（初次和重复）和内窥镜筛查，同时调整潜在的混杂协变量。干预效果的调节因素和调节因素以及与干预措施相关的健康信念的变化也将被确定。