Efficacy-to-Effectiveness Transition of an Educational Program to Increase Colore

提高色彩的教育计划从功效到功效的转变

• 批准号: 8276343
• 负责人: Daniel S. Blumenthal
• 金额: $ 44.94万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-03 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8276343
• 关键词: Academia; Adoption; African American; Age-Years; Alabama; Cancer Etiology; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chi-Square Tests; Church; Clinic; Colorectal; Colorectal Cancer; Communities; Control Groups; Diffusion of Innovation; Educational Intervention; Effectiveness; Effectiveness of Interventions; Elements; Enrollment; Ethnic Origin; Evaluation; Evidence based intervention; Funding; Goals; Health; Incidence; Individual; Intervention; Intervention Community Trial; Intervention Trial; Knowledge; Leadership; Maintenance; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Morehouse School of Medicine; Names; Online Systems; Participant; Persons; Process; Public Health; Race; Randomized; Randomized Controlled Trials; Relative (related person); Research; Risk; Sample Size; Screening procedure; Side; Site; Testing; Training; Translations; United States; Universities; arm; colorectal cancer screening; cost effectiveness; effective intervention; improved; mortality; programs; success; theories; therapy design

DESCRIPTION (provided by applicant): African Americans have the highest incidence and mortality and are less likely than whites to have screening for colorectal cancer (CRC). We recently completed a five-year randomized controlled community intervention trial that demonstrated the efficacy of a small group education intervention (now named EPICS or Educational Program to Increase Colorectal Cancer Screening) that doubled the CRC screening rate compared to the control group rate. EPICS was then put into practice in partnership with the local health department and was equally effective. We are now disseminating the intervention across the state of Georgia. In this application we propose a national dissemination and implementation study. We propose using Rogers' Diffusion of Innovation Theory and Glasgow's RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework to pursue the following specific aims: 1) test passive and active approaches to disseminating EPICS to increase screening rates for colorectal cancer among African Americans; 2) measure the extent to which EPICS is accepted by community coalitions and the fidelity of implementation in various settings and 3) estimate the potential translatability and public health impact of EPICS. Diffusion of Innovations Theory will guide the process of EPICS dissemination and RE-AIM will be used to assess this dissemination and its impact. For this study we propose a cluster randomized controlled trial of 20 community coalitions from across the United States, assigned to one of four conditions: (1, passive) web-based access to facilitator training materials and toolkits without technical assistance (TA); (2, passive) the sam as 1, but with TA; (3, active) in-person access (IP) to facilitator training materials and toolkits without TA and (4, active) IP access to facilitator training materials and toolkits with TA. Each community coalition will partner with three settings for implementation: a church, clinic and community site. African Americans, 50-74 years of age, who are not current on CRC screening are eligible for study participation (n=7,200 or n=360 eligible individuals per community coalition). This assumes a sample size of 1800 per study arm, a significance level of 5% (i.e. alpha = 0.05), and a two-sided two-group chi-square test of proportions. Assuming that we observe in our study an increase in screening rates of colorectal cancer among participants in active arms compared to screening rates among participants in the passive arms, we will have greater than 99% power to detect statistically significant differences in the proportions. All statistical tests proposed for this study will be two-sided and will be performed using a significance level of 5% (i.e., alpha=0.05). PUBLIC HEALTH RELEVANCE: Colorectal Cancer (CRC) is one of the most important causes of cancer deaths (second to lung cancer), with persistent disparities documented by race/ethnicity. This project seeks to demonstrate the effectiveness of an intervention proven efficacious among African Americans, and to document its utility by describing its transition from research to real world settings. Successfully implementing the core elements of the intervention will increase CRC screening among African Americans and will help reduce CRC incidence and mortality.

描述（由申请人提供）：非裔美国人的发病率和死亡率最高，并且比白人更不可能接受结直肠癌 (CRC) 筛查。我们最近完成了一项为期五年的随机对照社区干预试验，该试验证明了小组教育干预措施（现称为 EPICS 或增加结直肠癌筛查的教育计划）的有效性，该干预措施使 CRC 筛查率与对照组相比提高了一倍。随后EPICS与当地卫生部门合作实施，同样有效。我们现在正在整个佐治亚州传播干预措施。在此申请中，我们提出了一项全国传播和实施研究。我们建议使用罗杰斯的创新扩散理论和格拉斯哥的 RE-AIM（范围、有效性、采用、实施、维护）评估框架来实现以下具体目标：1）测试被动和主动传播 EPICS 的方法，以提高结直肠癌的筛查率非裔美国人患癌症； 2) 衡量 EPICS 被社区联盟接受的程度以及在各种环境下实施的保真度； 3) 估计 EPICS 的潜在可翻译性和公共健康影响。创新扩散理论将指导 EPICS 传播过程，RE-AIM 将用于评估这种传播及其影响。对于本研究，我们提出对来自美国各地的 20 个社区联盟进行整群随机对照试验，分配给以下四种条件之一：（1，被动）基于网络访问辅导员培训材料和工具包，无需技术援助（TA）； (2、被动)同1，但有TA； （3，主动）亲自访问（IP）辅导员培训材料和工具包 无需 TA 且（4，主动）IP 可以通过 TA 访问辅导员培训材料和工具包。每个社区联盟将与三个机构合作实施：教堂、诊所和社区场所。目前未接受 CRC 筛查的 50-74 岁非裔美国人有资格参与研究（每个社区联盟 n=7,200 或 n=360 符合条件的个人）。假设每个研究组的样本量为 1800，显着性水平为 5%（即 alpha = 0.05），并且采用双边两组比例卡方检验。假设我们在研究中观察到主动组参与者的结直肠癌筛查率高于被动组参与者的结直肠癌筛查率，那么我们将有超过 99% 的功效来检测比例的统计显着差异。本研究提出的所有统计检验都将是双面的，并使用 5% 的显着性水平（即 alpha=0.05）进行。 公共卫生相关性：结直肠癌 (CRC) 是癌症死亡的最重要原因之一（仅次于肺癌），并且种族/民族之间存在持续差异。该项目旨在证明在非裔美国人中被证明有效的干预措施的有效性，并通过描述其从研究到现实世界环境的转变来记录其效用。成功实施干预措施的核心要素将增加非裔美国人的结直肠癌筛查，并有助于降低结直肠癌的发病率和死亡率。