Overcoming Barriers to Colorectal Cancer Screening in Appalachia: A Pilot Study

克服阿巴拉契亚地区结直肠癌筛查的障碍：一项试点研究

• 批准号: 7459239
• 负责人: MARK B DIGNAN
• 金额: $ 8.04万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-06 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7459239
• 关键词: Address; Adherence; Advisory Committees; Affective; Age; American; Appalachian Region; Area; Behavior; Behavioral; Behavioral Research; Behavioral Sciences; Breast; Cancer Burden; Cancer Control; Cancer Control Research; Cancer Information Service; Case Manager; Clinic; Clinical; Cognitive; Colorado; Communication; Communities; Community Health Education; Community Outreach; Comprehensive Cancer Center; Computer Assisted; Computer information processing; Consultations; Core Facility; Counseling; County; Data; Delaware; Development; Doctor of Philosophy; Education; Educational Materials; Effectiveness; Epidemiology; Evaluation; Extramural Activities; First Degree Relative; Foundations; Fox Chase Cancer Center; Future; Goals; Health; Health Communication; Health Personnel; Health Sciences; Home environment; Incidence; Institutes; Intervention; Journals; Kentucky; Knowledge; Licensing; Literature; Localized Malignant Neoplasm; Mails; Malignant Neoplasms; Manuscripts; Medical center; Medicine; Mentors; Methods; New Jersey; Office Visits; Office of the Director; Ohio; Outcome; Pamphlets; Participant; Patients; Peer Review; Pennsylvania; Personal Satisfaction; Physician Assistants; Physician' s Role; Pilot Projects; Population; Population Sciences; Prevention Research; Preventive; Primary Care Physician; Primary Health Care; Principal Investigator; Process; Provider; Psychologist; Public Health; Purpose; Quality of life; Questionnaires; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Rate; Recommendation; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Research Support; Risk; Rural; Rural Population; Sampling; Schedule; Screening for cancer; Screening procedure; Services; Societies; Survivors; Telephone; Testing; Theoretical model; Tobacco; Underserved Population; Universities; Week; anticancer research; base; cancer health disparity; cancer prevention; cancer risk; career; college; colorectal cancer screening; community based participatory research; design; experience; follow-up; health belief; implementation research; innovation; member; mortality; oncology; professor; programs; prospective; social; survivorship

DESCRIPTION (provided by applicant): Purpose: The overall goal of this study is to develop methods and gather preliminary data for a future R01 study that will test the efficacy of fecal immunochemical test (FIT) screening and telephone barriers counseling in rural Appalachia. Design: A prospective, clinic-based, participatory design will be used to determine acceptability of a provider-recommended, take-home FIT kit and screening adherence with and without follow-up telephone barriers counseling. The telephone barriers counseling is based upon the Cognitive-Social Health Information Processing (C-SHIP) theoretical model. Methods: A purposive sample of patients age 50 and older, at average CRC risk, and currently non- adherent for CRC screening (n=300) attending a regularly-scheduled, office visit in two rural, Appalachian primary care clinics will be recruited and complete the baseline questionnaire in the clinic waiting room. During the patient's exam/consultation the provider will recommend CRC screening and offer a take-home, FIT screening kit and educational brochure on CRC with a request for the completed test to be mailed to a central lab for processing within one week. Non-compliers will receive a single telephone barriers counseling session to address barriers reported at baseline and during the counseling session. Those who remain non- adherent following barriers counseling will receive a second, brief telephone assessment to determine reasons for non-compliance and encourage completion of screening. Analysis: Primary outcomes are patient acceptability of the intervention and screening adherence rates with and without barriers counseling. Secondary outcomes are CRC-related knowledge and barriers to screening assessed at baseline and 3-months follow-up. Screening outcomes will be evaluated by examining percentages of completed screening following provider recommendation of screening and following barriers counseling, compared to those in the literature. A process evaluation will assess overall feasibility of the intervention. Dissemination: Findings will be disseminated through the participating clinics and their local cancer coalitions, scientific meetings, and a manuscript submitted to a peer-reviewed journal. Findings will also be used as a foundation for the development of future studies and applications for extramural research support. Contributions: This research will provide an important contribution to the understanding of patient barriers to CRC screening, the primary care physician's role in increasing CRC screening, and the discovery of effective cancer control methods that ultimately may help reduce the cancer burden in Appalachia.

描述（由申请人提供）：目的：本研究的总体目标是开发方法并收集未来R01研究的初步数据，该研究将测试粪便免疫化学测试（FIT）筛查和电话障碍在阿巴拉契亚农村地区的咨询。 设计：一种前瞻性的，基于诊所的参与式设计将用于确定提供商申请的，带回家拟合套件的可接受性，并在没有后续电话障碍咨询的情况下进行筛选依从性。电话障碍咨询基于认知社会健康信息处理（C-SHIP）理论模型。 方法：一个50岁及50岁以上患者的有目的样本，平均CRC风险，目前不遵守CRC筛查（n = 300），参加了定期进行的，在两个农村的阿巴拉契亚初级保健诊所进行定期进行的办公室访问，并将招募并在临床候车室中完成基线问卷。在患者的考试/咨询期间，提供商将建议CRC筛查，并在CRC上提供带租用的筛查套件和教育手册，并要求将完成的测试邮寄至中央实验室，以便在一周内进行处理。不合格将获得一次电话障碍咨询会议，以解决在基线和咨询期间报告的障碍。那些遵循障碍咨询的人将获得第二次简短的电话评估，以确定不合规的原因并鼓励完成筛查。 分析：主要结果是在有或没有障碍咨询的情况下干预和筛查依从率的患者可接受性。次要结果是与CRC相关的知识和在基线和3个月的随访中评估的筛查障碍。与文献相比，根据提供商的筛查和壁垒咨询的建议，将通过检查完整筛查的筛查百分比来评估筛查结果。过程评估将评估干预的总体可行性。 传播：调查结果将通过参与诊所及其当地癌症联盟，科学会议以及提交给同行评审期刊的手稿进行传播。调查结果还将用作开发未来研究和应用外壁外研究支持的基础。 贡献：这项研究将为理解CRC筛查的患者障碍，初级保健医师在增加CRC筛查中的作用以及发现有效的癌症控制方法的作用提供重要贡献，这些方法最终可能有助于减轻阿巴拉契亚的癌症负担。