Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center
Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center
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DOI：
10.3122/jabfm.2019.03.180026
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发表时间：
2019-05-01
影响因子：
2.9
通讯作者：
Coronado, Gloria D.
中科院分区：
文献类型：
--
作者：
Thompson, Jamie H.;Davis, Melinda M.;Coronado, Gloria D.
简介：结肠癌是美国癌症死亡的第二大原因，拉丁美洲人的筛查率不成比例地低。据认为，造成筛查率低的一个因素是拉丁美洲人在理解健康信息方面遇到的困难，因此在采取适当的健康行动方面遇到的困难。因此，我们使用了靴子营翻译（BCT），一种患者参与方法，以吸引拉丁裔利益相关者（即，患者，诊所工作人员）在精炼结肠癌筛查提醒的信息和格式为临床为基础的直接邮件粪便免疫化学检测（FIT）程序。患者参与者是拉丁美洲人，年龄在50到75岁之间，能说英语或西班牙语，并愿意在3个月的时间内亲自参加启动会议和后续电话会议。我们为讲英语和西班牙语的参与者分别举办了BCT会议。作为面对面会议的一部分，一位双语结肠癌专家介绍了结肠健康和筛查信息，BCT主持人主持了互动会议，与会者以各种方式（例如，信件，文本）审查了材料和提醒信息。参与者考虑了哪些关于结肠癌筛查的信息是重要的，分享这些信息的最佳方法，以及这些信息应该传递给患者以鼓励完成FIT的时间和频率。我们使用后续的电话，反复完善材料的基础上，从人meeting.Results的主要学习：25名成年人参加了人的会议（英语[n = 121;西班牙语[n = 13]）。患者参与者主要参加医疗补助/无保险（76%），家庭年收入低于20，000美元（67%）。从会议中提炼出的关键主题包括提高人们对筛查可以预防结肠癌的认识，强调筛查的紧迫性，强调家庭的激励影响，以及使用来自实践的个性化信息，例如“我”或“我们”在信件中的陈述或由人类提供的自动电话提醒。在这两个会议的与会者指出，接收一个自动或实时警报之前，适合的工具包邮寄和提醒2周内的适合的工具包mailing.Discussion：使用BCT，我们成功地纳入了参与者的反馈，以适应文化相关的健康信息，促进适合的测试服务于社区诊所的拉丁美洲患者。这些材料将在更大规模的推进结肠癌预防的前瞻性研究（PROMPT）试验中进行测试。
Introduction: Colon cancer is the second leading cause of cancer death in the United States, and screening rates are disproportionately low among Latinos. One factor thought to contribute to the low screening rate is the difficulty' Latinos encounter in understanding health information, and therefore in taking appropriate health action. Therefore, we used Boot Camp Translation (BCT), a patient engagement approach, to engage Latino stakeholders (ie, patients, clinic staff) in refining the messages and format of colon cancer screening reminders for a clinic-based direct mail fecal immunochemical testing (FIT) program.Methods: Patient participants were Latino, ages 50 to 75 years, able to speak English or Spanish, and willing to participate in the in-person kickoff meeting and follow-up phone calls over a 3-month period. We held separate BCT sessions for English- and Spanish-speaking participants. As part of the in-person meetings, a bilingual colon cancer expert presented on colon health and screening messages and BCT facilitators led interactive sessions where participants reviewed materials and reminder messages in various modalities (eg, letter, text). Participants considered what information about colon cancer screening was important, the best methods to share these messages, and the timing and frequency with which these messages should be delivered to patients to encourage FIT completion. We used follow-up phone calls to iteratively refine materials developed based on key learnings from the in-person meeting.Results: Twenty-five adults participated in the in-person sessions (English [n = 121; Spanish [n = 13]). Patient participants were primarily enrolled in Medicaid/uninsured (76%) and had annual household incomes less than $20,000 (67%). Key themes distilled from the sessions included increasing awareness that screening can prevent colon cancer, stressing the urgency of screening, emphasizing the motivating influence of family, and using personalized messages from the practice such as 'I' or 'we' statements in letters or automated phone call reminders delivered by humans. Participants in both sessions noted the importance of receiving an automated or live alert before a FIT kit is mailed and a reminder within 2 weeks of FIT kit mailing.Discussion: Using BCT, we successfully incorporated participant feedback to adapt culturally relevant health messages to promote FIT testing among Latino patients served by community clinics. Materials will be tested in the larger Participatory Research to Advance Colon Cancer Prevention (PROMPT) trial.