Project 2: A randomized trial of outreach and inreach strategies for boosting colorectal cancer screening in a Federally-Qualified Health Center primarily serving low income Hispanic/Latinos

项目 2：在主要为低收入西班牙裔/拉丁美洲人服务的联邦合格健康中心进行外展和内展策略的随机试验，以促进结直肠癌筛查

• 批准号: 9349472
• 负责人: Samir Gupta
• 金额: $ 22.75万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-26 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9349472
• 关键词: Address; Advisory Committees; Affordable Care Act; Applications Grants; Cancer Center; Caring; Centers for Disease Control and Prevention (U.S.); Client; Clinic; Collaborations; Colorectal Cancer; Communities; Community Health Aides; Community Health Centers; Community Outreach; Complement; Comprehensive Cancer Center; Cost Sharing; County; Education; Effectiveness; Effectiveness of Interventions; Environment; Evaluation; Evidence based intervention; Extramural Activities; Face; Federally Qualified Health Center; Health; Health Insurance; Hispanics; Individual; Intervention; Latino; Lead; Linguistics; Low income; Medicaid; Medical; Mexico; Minority; Modeling; National Cancer Institute; Outcome; Patients; Physicians; Population; Positioning Attribute; Preventive service; Primary Health Care; Process; Provider; Randomized Controlled Trials; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Research Project Grants; Resources; Screening for cancer; Services; Telephone; Testing; Time; Underinsured; Underserved Population; Uninsured; Universities; Work; Workplace; base; cancer health disparity; care delivery; colorectal cancer screening; community partnership; compare effectiveness; ethnic minority population; evidence base; follow-up; innovation; intervention effect; minority scientist; mortality; outreach; racial and ethnic; randomized trial; satisfaction; screening; treatment as usual; trial comparing

PROJECT SUMMARY/ABSTRACT Colorectal cancer (CRC) screening saves lives, but screening rates are low among underserved populations, particularly Latinos. The screening rate in the predominantly Latino population served by San Ysidro Health Center (SYHC, a Federally Qualified Health Center (FQHC)), is just 31%, similar to that reported for Latinos nationally, but lower than the overall national average of 65%. Previous research has demonstrated that inreach interventions at point of medical care such as patient navigation after screening referral, and outreach outside of usual medical care (such as with mailed invitations) can increase screening rates among underserved populations. However, since these have undergone limited evaluation among low income predominantly Spanish-speaking Latinos, it is unclear which approach is best, and whether implementing both approaches would be synergistic for optimizing screening rates. We hypothesize that two culturally and linguistically tailored interventions: a) an inreach strategy (IR, consisting of community health worker-delivered in clinic education regarding CRC screening and other components), and b) an outreach strategy (OS, consisting of mailed invitations to complete screening with an enclosed fecal immunochemical test (FIT) and telephone reminders) can substantially increase screening, and further, that the two interventions together will be substantially better than either alone. To test these hypotheses, we propose a randomized trial comparing usual care, IR, OS, and IR+OS for CRC screening. The proposed research is innovative because it seeks to identify the matrix of interventions required to optimize CRC screening in a Latino underserved population, is highly feasible, and has potential to be impactful for reducing cancer disparities among underserved populations, including Latinos, served at FQHCs and beyond. This project fits within the organizing framework of the partnership based on several aspects. First, it represents a hypothesis-driven research project that brings together investigators from MCC and SDSU to test strategies for addressing cancer disparities. Second, the project has a community outreach focus, as the work is entirely set within a FQHC. Third, the work increases involvement of MCC in research related to underserved populations. Fourth, the work will result in additional extramural grant applications to support cancer disparities research, particularly by new investigators who are minority scientists, such as Dr. Sheila Castañeda (Project Co-Lead). Fifth, the partnership follows the model of the Outreach Core, in which we seek to increase the impact of CC and ISUPSs collaborations by partnering our work with FQHCs.

项目摘要/摘要 结直肠癌（CRC）筛查可挽救生命，但筛查率较低 种群，尤其是拉丁美洲人。主要是拉丁裔人口的筛查率 San Ysidro Health Center（SYHC，联邦资格健康中心（FQHC））仅为31％，类似于 该报告在全国范​​围内报道了拉丁美洲人，但低于全国平均水平65％。以前的 研究表明，在医疗点（例如患者导航）的INREACH干预措施 筛选转介和在通常的医疗服务之外（例如邮寄邀请函）之外的推广后，可以 提高服务不足人群的筛查率。但是，由于这些受到了有限 低收入主要是说西班牙语的拉丁美洲人，目前尚不清楚哪种方法是 最好的，以及是否实施两种方法将是优化筛选率的协同作用。 我们假设两个在文化和语言上量身定制的干预措施：a）一种方法策略（ir， 由社区卫生工作者组成的有关CRC筛查和其他有关CRC筛查的诊所教育 组件）和b）外展策略（OS，由邮寄邀请函组成，以完成筛选 使用封闭的粪便免疫化学测试（fit）和电话提醒可以大大增加 筛选，进一步的，两种干预措施将比单独进行的两种干预措施要好得多。 为了检验这些假设，我们提出了一项随机试验，以比较常规护理，IR，OS和IR+OS CRC筛选。拟议的研究具有创新性，因为它试图确定 优化拉丁裔服务不足人群中CRC筛查所需的干预措施，非常可行， 并有可能影响减少服务不足的人群的癌症分布， 包括拉丁美洲人，在FQHCS及其他地区服务。该项目符合组织框架 基于几个方面的伙伴关系。首先，它代表了一个假设驱动的研究项目 MCC和SDSU的研究人员共同测试解决癌症分布的策略。第二， 项目具有社区外展的重点，因为这项工作完全设置在FQHC内。第三，工作增加了 MCC参与与服务不足人群有关的研究。第四，这项工作将导致额外 壁外赠款申请以支持癌症分配研究，特别是由新调查人员 是少数族裔科学家，例如SheilaCastañeda博士（共同领导者）。第五，伙伴关系遵循 宣传核心的模型，我们试图通过该模型来增加CC和ISUPS合作的影响 与FQHCS合作。