Tailored Touchscreen Colorectal Cancer Prevention in American Indian Communities

美国印第安社区的定制触摸屏结直肠癌预防

基本信息

批准号：
8086914
负责人：
K ALLEN GREINER
金额：
$ 52.68万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2015-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8086914
关键词：
Address Adherence Adoption Affect American Indians Awareness Behavior Behavior Therapy Behavioral Belief Cancer Etiology Caring Cessation of life Clinic Colonoscopy Colorectal Colorectal Cancer Communication Communities Computers Data Death Rate Decision Making Effectiveness Endoscopy Face Fecal occult blood Focus Groups Generic Drugs Health Health Services Accessibility Healthcare Systems Incidence Individual Institution Intention Intervention Link Mediating Mediation Medical Methodology Methods Minority Modality Modeling Multimedia Native Americans Participant Patient Self-Report Patients Planning Theory Population Population Group Prevention Primary Health Care Process Provider Randomized Recruitment Activity Reporting Rural Screening procedure Site Specific qualifier value Staging Surveys Testing To specify Underserved Population Work base cancer health disparity colorectal cancer prevention colorectal cancer screening comparison group computerized cost cultural values design follow-up improved innovation mortality novel preference primary care setting programs reservation-based safety net satisfaction tailored messaging theories touchscreen

项目摘要

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) mortality disproportionately impacts minorities. Few studies have addressed screening among specific minority populations such as American Indians (AI). This study will assess the efficacy of a novel tailored touch screen computer intervention based on an innovative integration of the Precaution Adoption Process Model (PAPM) and the concept of "implementation intentions," a recent elaboration of the Theory of Planned Behavior. The majority of the intervention will be delivered in tribal clinics and primary care settings on low-cost touch screen computers through multimedia audio-narrative and video messages. Studies have not tested the effectiveness of culturally tailored communications specified to stated "implementation intentions" for improving CRC screening in this group. A randomized design will test a comparison condition of generic information versus a multimedia tailored intervention that specifically addresses each participant's screening test modality preference, current CRC screening decisional stage (PAPM), and CRC screening "implementation intentions" (the "when", "where" and "how" details of screening). Behavioral intervention materials will be developed with the help of cultural experts, a pilot test, and from data gathered in a prior focus group study we used to assess key influences on CRC screening for AIs. The study will be conducted with 460 AI patients eligible for CRC screening and recruited while presenting for care in tribal or regional safety-net clinics. All participants will receive a baseline touch screen administered assessment and, depending on stated preference, be offered either an immunochemical fecal occult blood test (iFOBT-InSure TM) or colonoscopy. Participants will be randomized to either C (comparison group-computer delivered generic CRC information) or AI2 (active intervention-computer delivered culturally tailored messaging based on individual PAPM stage, behavior constructs, and "Implementation Intentions"). A brief office exit survey will assess patient-provider discussions of CRC screening and satisfaction with computerized message materials. PUBLIC HEALTH RELEVANCE: Colorectal Cancer is a major cause of cancer mortality and late stage presentation is common among minorities. American Indians, receive colorectal cancer screening at very low rates and face important cultural barriers to care in the health care system. This study is relevant to overarching approaches to reduce AI cancer health disparities because it tests a novel behavioral intervention and culturally tailored materials to improve rates of colorectal cancer screening in this underserved population group.

描述（由申请人提供）：结直肠癌（CRC）死亡率不成比例地影响少数民族。很少有研究涉及在美国印第安人（AI）等特定少数民族中进行筛查。这项研究将根据预防措施采用过程模型（PAPM）的创新整合以及“实施意图”的概念，评估新型量身定制的触摸屏计算机干预的功效，这是对计划行为理论的最新阐述。大多数干预措施将通过多媒体音频和视频消息在低成本触摸屏计算机上的部落诊所和初级保健环境中进行。研究尚未测试针对改善该组CRC筛查的“实施意图”指定的文化量身定制的通信的有效性。随机设计将测试通用信息的比较条件与多媒体量身定制的干预措施，该干预措施专门针对每个参与者的筛选测试模式偏好，当前CRC筛选决策阶段（PAPM）和CRC筛选“实现意图”（“何时”，“ where”，“ wery”，“ where”和“ secruning”详细信息）。行为干预材料将在文化专家，试点测试的帮助下开发，并根据先前的焦点小组研究收集的数据，用于评估对AIS的CRC筛查的关键影响。该研究将与有资格在部落或区域安全网诊所进行护理的460名AI患者进行CRC筛查和招募。所有参与者都将接受基线触摸屏评估，并取决于明确的偏好，可以提供免疫化学的粪便肉体测试（IFOBT-INSURE TM）或结肠镜检查。参与者将被随机分配到C（比较组计算机传递的通用CRC信息）或AI2（主动干预计算机基于单个PAPM阶段，行为构造和“实施意图”的有效干预计算机提供的文化定制消息传递）。简短的办公室退出调查将评估有关CRC筛查和计算机消息材料满意度的患者提供者的讨论。公共卫生相关性：大肠癌是癌症死亡率的主要原因，而晚期表现很常见。美洲印第安人以非常低的比率接受结直肠癌筛查，并面临医疗保健系统中重要的文化障碍。这项研究与降低AI癌症健康差异的总体方法有关，因为它测试了一种新型的行为干预措施和文化量身定制的材料，以提高该服务不足的人群组中的结直肠癌筛查率。