Evaluation of the Effectiveness and Implementation of an Adapted Evidence-Based Mammography Intervention for African American Women.
Evaluation of the Effectiveness and Implementation of an Adapted Evidence-Based Mammography Intervention for African American Women.
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DOI：
10.1155/2015/240240
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发表时间：
2015
影响因子：
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通讯作者：
Ausborn VA
中科院分区：
文献类型：
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作者：
Highfield L;Hartman MA;Bartholomew LK;Balihe P;Ausborn VA
乳腺癌死亡率的差异仍然存在，特别是对于没有保险的妇女和少数民族妇女。有一些有效的循证干预措施（EBI）可以解决乳房X线摄影筛查的障碍;然而，社区对它们的吸收和使用有限。很少有癌症特异性研究在新的背景下评估适应性EBI，更少的是考虑实施。本研究旨在（1）评价经调整的乳腺X线摄影EBI在改善非裔美国妇女预约方面的有效性，（2）描述在新实践环境中的实施过程。我们使用1型混合设计来测试有效性，并使用准实验设计实现。Logistic回归和意向治疗分析用于评估乳腺摄影预约出勤率。未入住率为44%（比较）与19%（干预）。干预组中女性参加预约的调整后几率为3.88（p < 0.001）。在意向治疗分析中，女性参加预约的调整比值为2.31（p < 0.05）。调整后的EBI有效性为3.88（调整后OR），而原始计划为2.10（OR），表明计划效果增强。确定了一些执行障碍和促进因素。我们的研究结果支持以前的研究指出，依次测量EBI的疗效和有效性，其次是实施，可能会丢失重要的上下文信息。
Breast cancer mortality disparities continue, particularly for uninsured and minority women. A number of effective evidence-based interventions (EBIs) exist for addressing barriers to mammography screening; however, their uptake and use in community has been limited. Few cancer-specific studies have evaluated adapted EBIs in new contexts, and fewer still have considered implementation. This study sought to (1) evaluate the effectiveness of an adapted mammography EBI in improving appointment keeping in African American women and (2) describe processes of implementation in a new practice setting. We used the type 1 hybrid design to test effectiveness and implementation using a quasi-experimental design. Logistic regression and intent-to-treat analysis were used to evaluate mammography appointment attendance. The no-show rate was 44% (comparison) versus 19% (intervention). The adjusted odds of a woman in the intervention group attending her appointment were 3.88 (p < 0.001). The adjusted odds of a woman attending her appointment in the intent-to-treat analysis were 2.31 (p < 0.05). Adapted EBI effectiveness was 3.88 (adjusted OR) versus 2.10 (OR) for the original program, indicating enhanced program effect. A number of implementation barriers and facilitators were identified. Our findings support previous studies noting that sequentially measuring EBI efficacy and effectiveness, followed by implementation, may be missing important contextual information.