Evaluating a remotely delivered, digital health CRC screening intervention among racially diverse patients of a community health center

评估社区卫生中心不同种族患者的远程数字健康 CRC 筛查干预措施

• 批准号: 10660569
• 负责人: Leah M. Frerichs
• 金额: $ 65.1万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10660569
• 关键词: Address; Affect; Age; American; American Indians; Appointment; Attention; Black race; Black, Indigenous, People of Color; COVID-19 pandemic; Cancer Etiology; Caring; Cessation of life; Clinic; Clinical; Colonoscopy; Colorectal Cancer; Communication; Decision Aid; Disparity; Dissemination and Implementation; Education; Effectiveness; Face; Feces; Federally Qualified Health Center; Friends; Future; Geographic Locations; Goals; Guidelines; Health Resources; Health system; Healthcare Systems; Hispanic; Individual; Inequity; Intervention; Interview; Knowledge; Lead; Linguistics; Low income; Mail Order; Malignant Neoplasms; Marketing; Measures; Methods; Modeling; Morbidity - disease rate; Neighborhood Health Center; North Carolina; Outcome; Outcome and Process Assessment; Patients; Persons; Population Heterogeneity; Preventive service; Primary Care; Process; Process Measure; Provider; Race; Randomized; Recommendation; Research; Resources; Rural; Rural Community; Services; Structural Racism; Subgroup; Technology; Testing; Translating; United States; Visit; Work; colorectal cancer screening; cost; demographics; digital health; effectiveness evaluation; effectiveness/implementation design; evidence base; future implementation; implementation evaluation; implementation outcomes; implementation process; improved; innovation; interest; marginalization; member; mortality; multi-component intervention; new technology; novel; outreach; patient oriented; patient population; patient subsets; profiles in patients; racial diversity; randomized trial; remote delivery; remote health care; response; rural area; screening; screening program; socioeconomics; tailored messaging; tool; treatment as usual

Project Summary/Abstract Colorectal cancer (CRC) screening is one of the most effective tools to reduce cancer morbidity and mortality. Yet, CRC screening rates at federally qualified health centers (FQHCs) in rural areas lag behind more well- resourced healthcare systems and national goals. Improving CRC screening in rural FQHCs requires attention to the needs of their patient populations as well as their limited resources for implementation; yet, little research has tested CRC screening programs with FQHCs that are culturally responsive, contextually relevant and alleviate implementation burden. Our long-term goal is to scale implementation of CRC screening solutions that will reduce inequities that burden FQHCs. Our team has developed a novel digital health platform, mPATH-Cloud, that has the potential to help alleviate implementation burden on clinical teams by automating many key processes, all the while delivering CRC screening communication, education, and services in ways that have proven to be culturally responsive, patient-centered, and effective. Thus, our study seeks to evaluate mPATH-Cloud with rural FQHCs to demonstrate effectiveness at improving guideline concordant screening and identify critical implementation processes and outcomes that will impact future dissemination and scalability. We will use an embedded experimental mixed methods model, which includes an individual randomized trial of the multi-component intervention, quantitative and qualitative measures to identify ways to improve tailored messaging and adapt strategies to improve effectiveness across diverse patient profiles, and quantitative and qualitative measures of processes and outcomes to improve implementation. Our team is well-situated to lead this research, which if successful, will lead to progress toward reducing inequities in low-income rural communities served by FQHCs.

项目概要/摘要 结直肠癌（CRC）筛查是降低癌症发病率和死亡率的最有效工具之一。 然而，农村地区联邦合格卫生中心 (FQHC) 的 CRC 筛查率远远落后于其他地区。 资源丰富的医疗保健系统和国家目标。改善农村家庭健康中心的结直肠癌筛查需要引起重视 满足患者群体的需求以及有限的实施资源；然而，很少 研究已经测试了具有文化响应性、情境相关性的 FQHC 的 CRC 筛查计划 并减轻实施负担。我们的长期目标是扩大 CRC 筛查的实施范围 减少 FQHC 负担的不平等的解决方案。我们的团队开发了一种新颖的数字健康 mPATH-Cloud 平台有可能通过以下方式帮助减轻临床团队的实施负担： 自动化许多关键流程，同时提供 CRC 筛查沟通、教育和 事实证明，以符合文化要求、以患者为中心且有效的方式提供服务。因此，我们的研究 寻求与农村 FQHC 一起评估 mPATH-Cloud，以证明改进指南的有效性 一致筛选并确定将影响未来的关键实施流程和结果 传播性和可扩展性。我们将使用嵌入式实验混合方法模型，其中包括 多成分干预、定量和定性措施的个体随机试验 确定改进定制消息传递的方法并调整策略以提高不同领域的有效性 患者概况，以及改进过程和结果的定量和定性测量 执行。我们的团队有能力领导这项研究，如果成功，将带来进展 旨在减少 FQHC 服务的低收入农村社区的不平等现象。