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）： 大肠癌是美国癌症死亡的第三大主要原因，影响了所有种族和族裔的男人和女人。这些死亡中的大多数可以预防，因为CRC早期发现是高度治疗的，并且筛查导致去除腺瘤息肉会使CRC的发生率降低75％至90％。在全国范围内，在2002年，只有50％的50岁以上的成年人报告在建议的时间内进行了任何筛查测试。非裔美国人的CRC发病率和死亡率都比任何其他种族群体都高。这些健康差异部分归因于诊断的延迟，导致晚期舞台疾病。非洲裔美国人的CRC筛查参与率较低，造成了这一负担。基于交互式计算机的干预措施通过提供个性化或量身定制的健康信息和咨询来有效地促进健康行为的改变。在试点测试中，旨在促进非洲裔美国人的CRC筛查的量身定制的互动计算机干预措施，导致CRC知识增加和粪便神秘性血液测试的率更高。拟议的研究是一项随机对照试验，旨在确定量身定制的交互式计算机干预的功效，以通过将其与医生建议进行比较并将其结合起来促进CRC筛查，该建议已被发现是CRC筛查的重要预测指标。在两个中西部初级保健网络中看到的1248名非洲裔美国男女样本，他们将随机分配接受结肠癌筛查指南的未遵守情况，以接收：1）CRC筛查手册； 2）交互式计算机干预；或3）交互式计算机干预以及小册子。过程和结果变量将被检查。对粪便隐匿血液测试，乙状结肠镜检查和结肠镜检查的依从率是在6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个结果，即粪便隐匿血液测试（初始和重复）以及内窥镜筛查，同时调整潜在混淆的协变量。还将确定干预效果的介体和主持人与干预措施相关的健康信念的变化。