Centralized colorectal cancer screening outreach and patient navigation for vulnerable populations in North Carolina: study protocol for the SCORE randomized controlled trial.
Centralized colorectal cancer screening outreach and patient navigation for vulnerable populations in North Carolina: study protocol for the SCORE randomized controlled trial.
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北卡罗来纳州弱势人群的集中式结直肠癌筛查外展和患者导航：SCORE随机对照试验的研究方案
DOI：
10.1186/s43058-021-00194-x
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发表时间：
2021-10-07
影响因子：
--
通讯作者：
Scaling Colorectal Cancer Screening Through Outreach, Referral, and Engagement (SCORE) Study Protocol Consortium
中科院分区：
文献类型：
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作者：
Malo TL;Correa SY;Moore AA;Ferrari RM;Leeman J;Brenner AT;Wheeler SB;Tan X;Reuland DS;Scaling Colorectal Cancer Screening Through Outreach, Referral, and Engagement (SCORE) Study Protocol Consortium
虽然结直肠癌（CRC）筛查在降低CRC死亡率方面是有效的，但社区卫生中心（CHC）服务的弱势人群的筛查率仍低于国家目标。北卡罗来纳州的社区卫生中心在实现CRC筛查目标方面面临挑战，因为它们往往资源不足，实施和维持人口健康干预措施的能力有限，并且通常独立于彼此和区域结肠镜检查提供者。通过外展，转诊和参与（SCORE）项目扩展结直肠癌筛查旨在通过实施多层次干预来解决与CHCs合作进行CRC筛查的障碍，其中包括邮寄粪便免疫化学测试（FIT）外展和患者导航到后续结肠镜检查的集中支持基础设施。本文介绍了协议的SCORE实施试验。我们将进行一项2型混合有效性实施试验，该试验将评估增加CRC筛查和随访率的有效性，同时评估实施结果。计划的试验样本将包括4000名处于平均CRC风险并应进行筛查的CHC患者。参与者将以1：1的比例随机接受常规护理或多层次干预，包括邮寄FIT外展和患者导航支持，以随访FIT异常患者的结肠镜检查。主要有效性结局是在随机化后6个月完成任何CRC筛选试验。我们还将对执行结果和决定因素进行多层次评估。这项混合有效性-实施试验将评估干预措施的有效性和实施情况，该干预措施为独立于其他医疗机构运营的CHC提供邮寄FIT筛查和患者导航的集中基础设施。这项研究的结果将提高对集中式方法的有效性和决定在弱势患者群体中成功实施的因素的理解。该试验于2020年5月28日在ClinicalTrials.gov（标识符NCT 04406714）上注册。
Although colorectal cancer (CRC) screening is effective in reducing CRC mortality, screening rates in vulnerable populations served by community health centers (CHCs) remain below national targets. CHCs in North Carolina are challenged to reach CRC screening targets as they tend to be under-resourced, have limited capacity to implement and sustain population health interventions, and typically operate independently from one another and from regional colonoscopy providers. The Scaling Colorectal Cancer Screening Through Outreach, Referral, and Engagement (SCORE) project is designed to address barriers to CRC screening in partnership with CHCs by implementing a multilevel intervention that includes centralized support infrastructure for mailed fecal immunochemical test (FIT) outreach and patient navigation to follow-up colonoscopy. This paper describes protocols for the SCORE implementation trial. We will conduct a type 2 hybrid effectiveness-implementation trial that will assess effectiveness at increasing CRC screening and follow-up rates while also assessing implementation outcomes. The planned trial sample will include 4000 CHC patients who are at average CRC risk and due for screening. Participants will be randomized 1:1 to receive either usual care or a multilevel intervention that includes mailed FIT outreach and patient navigation support to follow-up colonoscopy for those with abnormal FIT. The primary effectiveness outcome is completion of any CRC screening test at six months after randomization. We will also conduct a multilevel assessment of implementation outcomes and determinants. This hybrid effectiveness-implementation trial will evaluate the effectiveness and implementation of an intervention that provides centralized infrastructure for mailed FIT screening and patient navigation for CHCs that operate independently of other healthcare facilities. Findings from this research will enhance understanding of the effectiveness of a centralized approach and factors that determine successful implementation in vulnerable patient populations. The trial was registered on May 28, 2020, at ClinicalTrials.gov (identifier NCT04406714).
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
120.7
作者：
Corley, Douglas A.;Jensen, Christopher D.;Levin, Theodore R.
通讯作者：
Levin, Theodore R.
影响因子：
10.3
作者：
Church, TR;Yeazel, MW;Engelhard, D
通讯作者：
Engelhard, D
影响因子：
39
作者：
Gupta S;Halm EA;Rockey DC;Hammons M;Koch M;Carter E;Valdez L;Tong L;Ahn C;Kashner M;Argenbright K;Tiro J;Geng Z;Pruitt S;Skinner CS
通讯作者：
Skinner CS