Friendly Voices Program

友好之声计划

• 批准号: 6695620
• 负责人: ROWELL S ASHFORD
• 金额: $ 13.04万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-28 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6695620
• 关键词: African American; belief; cancer prevention; cervical /vaginal smear; cervix neoplasms; clinical research; community health services; diagnosis design /evaluation; female; human subject; longitudinal human study; neoplasm /cancer education; neoplasm /cancer invasiveness; outcomes research; psychological aspect of cancer; satisfaction; therapy compliance

The goal of pap smears is not to detect invasive cancer, but to detect precancerous-abnormalities that might develop into invasive cancer. Lack of adherence to follow-up treatment protocols for an abnormal pap smear limits the effectiveness of a screening program. Among women with abnormal pap smears, failure to return for follow-up care can increase morbidity, mortality, and the cost of health care. Estimates of failing to return for follow-up care among women with abnormal cytology range as high as 80%. Certain groups of women, namely African-Americans and the elderly, have poorer utilization rates of screening tests and higher mortality rates from cervical cancer. The use of community persons as lay health workers ("lay health advisors" or "community health advisors") has gained increased recognition in the United States over the last two decades. They have been used to address a broad range of community health issues in various settings. Since indigenous persons know their environments and are usually highly trusted in the community. the are better able to address health and other issues within their networks as opposed to outsiders. In many instances, they receive some type of specialized training to enhance their existing skills and knowledge. This fosters cooperative relationships with health professionals, enhances the potential to mobilize community resources, and offers new services and programs to the community We propose a randomized trial to compare standard phone reminders, made by clinic staff members, versus tailored phone reminders, made by community health advisors. The target population for this study will be African American women from an urban clinical setting, who have abnormal pap smears. The community health advisors will utilize the case manager approach in effort to improve compliance with follow-up recommendations and decrease the number of patients lost to follow-up. Follow-up data will be collected at six-month intervals for a period of eighteen months. This randomized trial represents a novel approach to improving cervical cancer-screening behavior among African American women who have abnormal pap smears. If the tailored intervention is effective. it could be an inexpensive way for other urban hospitals across the nation to improve compliance with cervical cancer screening for African American patients.

子宫颈抹片检查的目的不是检测侵入性癌症，而是检测可能发展为侵入性癌症的癌前癌。缺乏对异常子宫颈抹片检查的后续治疗方案的依从性限制了筛查计划的有效性。在具有异常子宫颈抹片检查的妇女中，未能返回后续护理可以增加发病率，死亡率和医疗保健成本。估计细胞学异常范围高达80％的女性未能返回进行随访的估计。某些妇女群体，即非裔美国人和老年人，筛查测试的利用率较差，宫颈癌的死亡率较高。在过去的二十年中，将社区人员用作外行卫生工作者（“外行健康顾问”或“社区健康顾问”）在美国获得了越来越多的认可。它们已被用来解决各种环境中广泛的社区健康问题。由于土著人知道他们的环境，并且通常在社区中受到高度信任。与局外人相比，他们可以更好地解决其网络中的健康和其他问题。在许多情况下，他们获得了某种类型的专业培训，以增强其现有技能和知识。这促进了与卫生专业人员的合作关系，增强了动员社区资源的潜力，并向社区提供新的服务和计划，我们建议进行随机试验，以比较由诊所工作人员制作的标准电话提醒，而不是社区健康顾问制作的量身定制的电话提醒。这项研究的目标人群将是来自城市临床环境的非洲裔美国妇女，这些妇女的妇女患有异常的子宫颈抹片检查。社区健康顾问将利用案件经理的方法来提高对后续建议的依从性，并减少失去随访的患者人数。随访数据将以六个月的时间间隔收集18个月。这项随机试验代表了一种新的方法，用于改善具有异常子宫颈抹片检查的非裔美国妇女的宫颈癌筛查行为。如果量身定制的干预措施有效。这对于全国其他城市医院的廉价方式可能是提高对非裔美国人患者宫颈癌筛查的依从性的廉价方式。