Development of a colorectal cancer screening intervention for Alaska Native people during a pandemic year.
Development of a colorectal cancer screening intervention for Alaska Native people during a pandemic year.
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DOI：
10.1016/j.conctc.2022.101016
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发表时间：
2022-12
影响因子：
1.5
通讯作者：
中科院分区：
文献类型：
--
作者：
阿拉斯加原住民患结直肠癌的几率是美国白人的两倍。有必要增加筛查和早期发现。我们描述了一项多目标粪便DNA检测(mt-sDNA；Cologuard®Exact Sciences，Madison WI)的随机对照试验的开发和实施，以增加人群中的CRC筛查。共有32个农村/偏远AN社区随机接受不同强度的干预(患者导航与邮寄健康教育)，而14个社区接受通常的机会性护理。结果测量包括筛查完成度和使用的方法(mt-sDNA与结肠镜检查)。卫生保健提供者访谈和患者焦点小组将用于评估患者、提供者和系统级别的CRC筛查的促进者和障碍。这项研究始于2020年4月新冠肺炎大流行期间，导致了一些挑战和研究适应。这些问题包括难以找到实验室空间，由于全州航班减少而缺乏及时的邮件服务，以及导致面对面焦点小组推迟的旅行限制。部落互动的视频会议平台取代了面对面的互动。经过广泛的搜索，确定了一个有可用空间的实验室，并建立了预处理实验室。研究人员将与患者密切合作，监控邮件服务，以使mt-sDNA试剂盒按时发送。我们还在探索使用视频会议平台作为面对面焦点小组的替代方案。尽管在新冠肺炎大流行期间遇到了挑战，我们还是成功地启动了干预行动，并在阿拉斯加建立了第一个mt-sDNA前处理实验室。
Alaska Native (AN) people experience twice the rate of colorectal cancer (CRC) as US Whites. There is a need for increased screening and early detection. We describe the development and implementation of a randomized controlled trial of the multi-target stool DNA test (mt-sDNA; Cologuard® Exact Sciences, Madison WI) to increase CRC screening among AN people. A total of 32 rural/remote AN communities were randomized to a varied intensity intervention (patient navigation vs mailed health education) compared to 14 communities receiving usual opportunistic care. Outcome measures include screening completion and method used (mt-sDNA vs colonoscopy). Health care provider interviews and AN patient focus groups will be used to assess patient-, provider-, and system-level CRC screening promoters and barriers. The study began in April 2020 during the COVID-19 pandemic, resulting in a number of challenges and study adaptations. These included difficulty finding laboratory space, lack of timely mail service due to flight reductions across the state, and travel restrictions that led to postponement of in-person focus groups. Videoconferencing platforms for Tribal engagement replaced face-to-face interactions. After an extensive search, a laboratory with space available was identified and the preprocessing laboratory established. Study staff will work closely with patients to monitor mail service to get mt-sDNA kits sent on time. We are also exploring the use of videoconferencing platforms as alternatives to in-person focus groups. Despite the challenges encountered during the COVID-19 pandemic, we successfully initiated the intervention and established the first mt-sDNA preprocessing laboratory in Alaska.
影响因子：
2.6
作者：
Power JM;Braun KL;Bersamin A
通讯作者：
Bersamin A