Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.
Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.
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DOI：
10.1007/s11764-007-0025-y
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发表时间：
2007-09-01
期刊：
影响因子：
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通讯作者：
Farace, Elana
中科院分区：
文献类型：
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作者：
Lengerich, Eugene J;Kluhsman, Brenda C;Farace, Elana
2002年，在1000万被诊断患有癌症的人中，有10.4%患有结肠直肠癌（CRC）。距离、地形、获得护理和文化差异等障碍对儿童权利委员会的存活率可能尤其与农村社区有关。我们测试了这样的假设：来自农村癌症联盟和医院的团队将制定社区计划（CP）来提高CRC生存率。我们使用基于社区的参与式研究和PRECEDE-PROCEED模型来培训来自宾夕法尼亚州和纽约的农村癌症联盟和医院的团队。我们在三个时间点测量了知识，并用McNemar检验检验了变化，并进行了多重比较校正（p < 0.0167）。我们还对CP内容进行了定性审查。最初招募到研究的15家联盟或医院中有14家（93.3%）完成了CP。公共卫生知识、对癌症存活率国家行动计划的赞助以及CRC存活率和治疗增加。团队识别感知障碍和社区资产。所有团队都计划提高对社区资产的认识，几乎所有团队都计划加强对CRC幸存者的治疗相关护理和心理社会护理; 50%的团队计划加强初级护理和CRC筛查。这项研究表明，农村组织有兴趣和能力计划提高CRC生存率，包括CRC生存率与初级保健的联系。农村癌症联盟和医院可能是为国家行动计划制定地方行动的工具。本研究中描述和调查的基于社区的倡议似乎有助于农村社区CRC癌症幸存者获得更全面的护理。这些努力可以在其他农村社区推广，并可能影响多种癌症幸存者的护理和生活质量。虽然通过社区倡议可以增加获得卫生服务的机会，但我们仍然需要衡量这些倡议对农村地区癌症幸存者长期健康和福祉的影响。
In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure the impact of such initiatives on the long term health and well being of cancer survivors in rural locations.