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.

项目概要 非裔美国人的结直肠癌 (CRC) 发病率和死亡人数仍然存在差异 与美国其他种族/族裔群体相比以及坚持基于证据的 CRC 筛查 建议可以减少这些差异。与基于粪便的 CRC 筛查测试相比，其优点 其他筛选方法包括便利性和较低成本。然而，基于粪便的 CRC 筛查通常 必须每年进行一次，筛查异常的个人必须能够访问并完成筛查 粪便测试呈阳性结果后进行结肠镜检查。没有保险或保险不足的患者 健康保险或面临财务或结构性障碍可能需要社区的额外支持 健康中心 (CHC) 完成结肠镜检查筛查，CHC 可能会遇到确保安全的挑战 为此类患者提供结肠镜检查。 Test Up Now 教育计划 (TUNE-UP) 是一项为期 5 年的行为教育计划 针对 45-64 岁非裔美国人的临床试验，他们是佛罗里达州北部两家合作社区卫生中心之一的患者，并且 测试为期 6 周的创新社区健康顾问 (CHA) 干预是否可以增加基于粪便的 CRC 与常规护理方法相比进行筛查。参与者在基线、3 个月和 9-12 个月时接受调查 衡量主要研究结果，即完成基于粪便的筛查。在本次后续监测研究中 现在提议，我们将与 TUNE-UP 参与者重新建立联系并获得知情同意 检查 CHA 干预对随后的两次年度筛查是否有持续影响，以及是否 结果纵向变化。因此，我们提出了一项对时间敏感的建议，以评估重复年度筛查 这个 CHC 患者队列。目标 1 将检验以下假设：参加 TUNE-UP 试验的 CHC 患者 并接受 CHA 干预将显示出更高的依从随后基于粪便的 CRC 的可能性 与被分配到常规护理研究组的 TUNE-UP 参与者相比，进行了筛查。目标 2 拟议的研究将利用社区合作参与研究 (CPPR) 框架来探索 CHC 在北部非裔美国患者中实施结直肠癌筛查教育干预的背景 佛罗里达。拟议的 TUNE-UP 监测研究对于解决持续存在的问题具有重要意义、创新性和及时性。 通过方便和可及的粪便，非裔美国人中结直肠癌发病率和死亡率的差异 最近更新的 USPSTF 建议中的基于筛查的内容，即在年龄开始 CRC 筛查 45. 此外，这项研究将能够在挑战中监测结直肠癌预防筛查项目 Covid-19 大流行的影响，并将加深对决策因素之间关系的理解 以及非裔美国人的结直肠癌筛查。该研究计划还将提高研究能力 佛罗里达农工大学与健康中心合作开展研究并让研究生参与。