Monitoring Community Efforts to Increase Colorectal Cancer Screening in African Americans

监测社区为增加非裔美国人结直肠癌筛查所做的努力

• 批准号: 10627341
• 负责人: John S. Luque
• 金额: $ 15.02万
• 依托单位: FLORIDA AGRICULTURAL AND MECHANICAL UNIV
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627341
• 关键词: Address; Adherence; Adult; Affect; African American; African American population; Age; Baseline Surveys; COVID-19; COVID-19 pandemic; Cellular Phone; Cessation of life; Colonoscopy; Colorectal Cancer; Communities; Community Health; Counseling; County; Decision Making; Disparity; Drops; Early Diagnosis; Early identification; Education; Educational Intervention; Eligibility Determination; Enrollment; Ethnic Population; Evaluation; Face; Feces; Florida; Goals; Health; Health Insurance; Home; Incidence; Individual; Informed Consent; Insurance Coverage; Interruption; Intervention; Measures; Methods; Monitor; Neighborhood Health Center; Outcome; Outcome Study; Participant; Patient Schedules; Patients; Persons; Preventive; Preventive screening; Primary Care; Public Health; Recommendation; Research; Risk; Secure; Self Efficacy; Site; Surveys; Testing; Text; Time; Uninsured; United States Preventative Services Task Force; Universities; Update; Voice; adherence rate; behavioral clinical trial; burden of illness; cancer health disparity; cohort; colon cancer patients; colorectal cancer risk; colorectal cancer screening; community engaged research; community partnership; community setting; community-level factor; cost; disparity reduction; efficacy testing; evidence base; experience; follow-up; graduate student; group intervention; implementation determinants; improved; innovation; intervention effect; medically underserved; mortality; multi-component intervention; outreach; patient oriented; patient population; primary outcome; programs; racial minority population; racial population; recruit; routine screening; screening; screening guidelines; screening program; sociodemographic factors; treatment as usual

Project Summary African Americans continue to experience disparities for colorectal cancer (CRC) incidence and deaths compared to other racial/ethnic groups in the US and adherence with evidence-based CRC screening recommendations can reduce these disparities. Advantages of stool-based CRC screening tests compared to other screening methods include convenience and lower cost. However, stool-based CRC screening generally must be done annually and individuals who screen abnormally must be able to access and complete a screening colonoscopy following a positive result on a stool-based test. Patients who are uninsured or have inadequate health insurance or face financial or structural obstacles may require additional support from their community health center (CHC) to complete a screening colonoscopy, and CHCs may experience challenges securing access to colonoscopy for such patients. The Test Up Now Education Program (TUNE-UP) is a 5-year behavioral clinical trial for African Americans ages 45-64 who are patients at one of two partnering north Florida CHCs and tests whether an innovative 6-week community health advisor (CHA) intervention can increase stool-based CRC screening compared to a usual care approach. Participants are surveyed at baseline, 3-months and 9-12 months to measure the primary study outcome, completion of stool-based screening. In this follow-up monitoring study now being proposed, we will reestablish contact with TUNE-UP participants and obtain informed consent to examine if there was a sustained effect of the CHA intervention for two ensuing annual screenings and whether outcomes vary longitudinally. Thus, we present a time-sensitive proposal to assess repeat annual screening in this CHC patient cohort. Aim 1 will test the hypothesis that CHC patients who participated in the TUNE-UP trial and received the CHA intervention will show a higher likelihood of adherence with subsequent stool-based CRC screening than TUNE-UP participants who had been assigned to the usual care study group. Aim 2 of the proposed study will utilize a community-partnered participatory research (CPPR) framework to explore the CHC context for implementing CRC screening educational interventions among African American patients in north Florida. The proposed TUNE-UP Monitoring Study is significant, innovative and timely in addressing persistent disparities in CRC incidence and mortality among African Americans through convenient and accessible stool- based screening in the context of recently updated USPSTF recommendations to begin CRC screening at age 45. Additionally, this research will enable monitoring of CRC preventive screening programs amid the challenges of the Covid-19 pandemic and will increase understanding of the relationships between decision-making factors and CRC screening among African Americans. This research program will also improve the research capacity of Florida A&M University to conduct research in partnership with health centers and involve graduate students.

项目摘要 非洲裔美国人继续出现结直肠癌（CRC）的差异和死亡 与美国的其他种族/族裔群体相比，遵守循证CRC筛查 建议可以减少这些差异。基于粪便的CRC筛查测试的优势与 其他筛选方法包括便利性和较低的成本。但是，基于凳子的CRC筛查通常 必须每年完成，并且异常筛选的个人必须能够访问和完成筛查 在基于凳子的测试的阳性结果后结肠镜检查。没有保险或不足的患者 健康保险或面对财务或结构性障碍可能需要其社区的额外支持 卫生中心（CHC）完成筛查结肠镜检查，CHC可能会遇到确保挑战的挑战 此类患者的结肠镜检查。即时测试现象教育计划（TUNE-UP）是5年的行为 45-64岁的非裔美国人的临床试验，他们是北佛罗里达州的两个伙伴之一的患者 测试创新的6周社区健康顾问（CHA）干预是否可以增加基于凳子的CRC 与通常的护理方法相比，筛查。参与者在基线，3个月和9-12个月时进行调查 为了衡量主要的研究结果，请完成基于凳子的筛查。在此后续监测研究中 现在提出建议，我们将重新与调整参与者联系，并获得知情同意 检查CHA干预是否持续进行两次年度筛查以及是否存在 结果各不相同。因此，我们提出了一项时间敏感的建议，以评估重复年度筛查 这个CHC患者队列。 AIM 1将检验参加调试试验的CHC患者的假设 并接受CHA干预将显示出更高的依从性，随后基于凳子的CRC 筛选比被分配给通常的护理研究小组的调整参与者。目标2 拟议的研究将利用社区合作的参与式研究（CPPR）框架来探索CHC 在北部非裔美国人患者中实施CRC筛查教育干预措施的背景 佛罗里达。拟议的调整监测研究是重要的，创新的，并且可以及时解决持久性 非洲裔美国人CRC发病率和死亡率的差异，可通过方便且易于使用的凳子 - 在最近更新的USPSTF建议的背景下进行筛选，以开始年龄开始CRC筛查 45。此外，这项研究将在挑战中对CRC预防筛查计划进行监控 Covid-19-19的大流行，并将增加对决策因素之间关系的理解 和CRC筛查非裔美国人。该研究计划还将提高研究能力 佛罗里达农工大学（A＆M University）与卫生中心合作进行研究，并参与研究生。