The effects of teamwork and system support on colorectal cancer screening in primary care practices
The effects of teamwork and system support on colorectal cancer screening in primary care practices
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DOI：
10.1016/j.cdp.2007.08.004
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发表时间：
2007-01-01
影响因子：
--
通讯作者：
Crabtree, Benjamin F.
中科院分区：
文献类型：
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作者：
Hudson, Shawna V.;Ohman-Strickland, Pamela;Crabtree, Benjamin F.
背景：虽然癌症筛查在美国普遍增加，结直肠癌（CRC）筛查率仍然很低。大多数CRC筛查干预措施都集中在患者或个别临床医生身上，而没有检查实施CRC筛查的办公室环境。本研究探讨是否初级保健的做法，涉及工作人员在一般形式的健康教育有较高的CRC筛查率比做法，不。方法：从22个新泽西和宾夕法尼亚州的家庭医学实践的横截面数据进行了分析。数据包括对795名符合CRC筛查条件的男性和女性（年龄50-70岁）的图表审计以及每种做法的做法信息调查。广义估计方程用于确定CRC筛查相关性。结果：总体而言，31.3%（n = 249）的患者接受了CRC筛查。报告使用护理或健康教育工作者为患者提供有关饮食，运动或烟草使用等主题的行为咨询的做法显着更有可能具有更高的CRC筛查率（z = 7.30，p < 0.0001）。他们的患者的CRC筛查几率比其他实践中的患者高2.96倍（95% CI，2.21-3.96）。提醒系统的使用也与较高的CRC筛查相关（z = 4.96，p < 0.0001）。在使用提醒系统的实践中，患者的CRC筛查几率比其他人高2.57倍（95% CI，1.77-3.74）。结论：这些研究结果表明，实现更好的CRC筛查率的干预措施不需要只关注CRC。更高的CRC率可以通过利用非医生执业成员提供更多的一般健康行为改变患者教育的贡献来实现。(c)2007年国际预防肿瘤学会。由爱思唯尔有限公司出版。保留所有权利。
Background: While cancer screening is generally increasing in the U.S., colorectal cancer (CRC) screening remains low. Most CRC screening interventions focus either on patients or individual clinicians without examining the office context in which CRC screening is implemented. This study examines whether primary care practices that involve staff in general forms of health education have higher CRC screening rates than practices that do not. Methods: Cross-sectional data from 22 New Jersey and Pennsylvania family medicine practices were analyzed. Data include chart audits for 795 men and women eligible for CRC screening (age 50-70) and practice information surveys for each practice. Generalized estimating equations were used to determine CRC screening correlates. Results: Overall, 31.3% (n = 249) of patients received CRC screening. Practices that reported using nursing or health educator staff to provide behavioral counseling to patients on topics such as diet, exercise or tobacco use were significantly more likely to also have higher CRC screening rates (z = 7.30, p < 0.0001). Their patients had 2.96 times increased odds of CRC screening than those in other practices (95% C.I., 2.21-3.96). Reminder system use was also associated with higher CRC screening (z = 4.96, p < 0.0001). In practices that used reminder systems, patients had 2.57 times increased odds of CRC screening than others (95% C.I., 1.77-3.74). Conclusions: These findings suggest that interventions to achieve better CRC screening rates do not need to focus solely on CRC. Higher CRC rates may be achieved by capitalizing on the enhancing contributions of non-physician practice members providing more general health behavior change patient education. (c) 2007 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved.