Preferences for colorectal cancer screening among racially/ethnically diverse primary care patients
Preferences for colorectal cancer screening among racially/ethnically diverse primary care patients
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DOI：
10.1097/mlr.0b013e31817d932e
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发表时间：
2008-09-01
期刊：
影响因子：
3
通讯作者：
Kneuper, Suzanne
中科院分区：
文献类型：
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作者：
Hawley, Sarah T.;Volk, Robert J.;Kneuper, Suzanne
背景资料：将患者的偏好纳入结直肠癌（CRC）筛查建议已被确定为增加依从性的潜在机制。本研究采用联合分析来描述在CRC筛查偏好的变化在种族/民族多样化的初级保健patients.Methods：我们招募了患者年龄50-80岁的一个大型的实践为基础的研究网络分层的白色，非洲裔美国人，或西班牙裔种族/民族完成偏好评估工具。要求参与者对8种假设的CRC筛查试验方案进行评分，这些方案由5种属性和6种方案的不同组合组成，旨在描述指南推荐的CRC筛查试验（例如，粪便潜血试验、乙状结肠镜检查、结肠镜检查和双重对比钡灌肠），包括新技术（例如，虚拟结肠镜检查、粪便免疫化学试验）。响应被用来计算测试属性的整体重要性，属性水平的相对重要性，并确定与preferences.Results相关的因素：212名初级保健患者被招募到研究（74白色，60非洲裔美国人，78西班牙裔）。在指南推荐的测试中，37%的人首选COL，31%的人首选FOBT，15%的人首选BE，9%的人首选SIG。新技术测验评分显著高于指南推荐测验评分（P < 0.05）。属性的重要性顺序是：测试涉及的内容（37%），准确性（19%），频率（17%），不适（15%）和准备（13%）。I属性的部分效用表明，收集粪便样本是最可取的，内窥镜检查无镇静最不可取。多元回归分析发现，种族/民族和特定的测试属性是独立相关的（P < 0.05）与测试preferences.Conclusions：初级保健患者有不同的偏好CRC筛查测试，可以链接到测试属性。当控制属性时，测试偏好的种族/民族差异仍然存在。根据患者的偏好定制筛选建议可能会增加筛选依从性。
Background: Incorporating patients' preferences into colorectal cancer (CRC) screening recommendations has been identified as a potential mechanism for increasing adherence. This study used conjoint analysis to describe variation in CRC screening preferences among racially/ethnically diverse primary care patients.Methods: We recruited patients ages 50-80 of a large practice-based research network stratified by white, African American, or Hispanic race/ethnicity to complete a preference assessment instrument. Participants were asked to rate 8 hypothetical CRC screening test scenarios comprised of different combinations of 5 attributes and 6 scenarios designed to depict guideline-recommended CRC screening tests (eg, fecal occult blood test, flexible sigmoidoscopy, colonoscopy, and double contrast barium enema) including new technology (eg, virtual colonoscopy, fecal immunochemical test). Responses were used to calculate the overall importance of test attributes, the relative importance of attribute levels, and to identify factors associated with preferences.Results: Two hundred twelve primary care patients were recruited to the study (74 white, 60 African American, 78 Hispanic). Of the guideline-recommended tests, 37% preferred COL, 31% FOBT 15% BE, and 9% SIG. Ratings of new technology tests were 9 significantly (P < 0.05) higher than ratings of guideline-recommended tests. The order of the importance of attributes was: what the test involved (37%), accuracy (19%), frequency (17%), discomfort (15%), and preparation ( 13%). Part-worth utilities for I attribute showed that collecting a stool sample was most preferable and endoscopy without sedation least preferable. Multivariate regression found that race/ethnicity and specific test attributes were independently associated (P < 0.05) with test preferences.Conclusions: Primary care patients have distinct preferences for CRC screening tests that can be linked to test attributes. Racial/ethnic variations in test preferences persist when controlling for attributes. Tailoring screening recommendations to patients' preferences may increase screening adherence.