The impact of tailored interventions on a community health center population.
The impact of tailored interventions on a community health center population.
复制标题
量身定制的干预措施对社区卫生中心人群的影响。
DOI：
10.1016/s0738-3991(98)00122-0
复制
发表时间：
1999
影响因子：
3.5
通讯作者：
Barber,LT
中科院分区：
文献类型：
--
作者：
Rimer,BK;Conaway,M;Lyna,P;Glassman,B;Yarnall,KS;Lipkus,I;Barber,LT
我们在北卡罗来纳州达勒姆的一个社区卫生中心进行了一项为期4年的随机研究，该中心主要为低收入黑人提供服务。患者（基线时为1318例）被随机分配到三个研究组之一：提供者提示干预单独，提供者提示和定制的印刷材料或前一组和定制的电话咨询。这项研究的目的是确定是否越来越密集，量身定制的印刷和电话干预也越来越有效地促进遵守乳房X光检查，巴氏试验和整体癌症筛查的依从性。因此，定制印刷干预（印刷和电话）的组合应该比提供者单独提示干预或印刷干预和提示组合更有效。这是为数不多的研究之一，以检查整体癌症筛查依从性的措施，并评估组合定制干预措施在促进癌症筛查依从性方面的益处。患者对干预措施给予了极高的评价。在双变量水平上，我们发现最密集的组（提供者提示干预，定制印刷通信和定制电话咨询）对巴氏试验依从性（P=0.05）和多变量水平的边缘显著性（P=0.06）以及总体筛查依从性（P = 0.06）有显著影响。对乳房X光检查没有显著影响，可能是因为大多数患者定期接受乳房X光检查。我们还发现了一些重要的亚组差异。例如，在定制印刷和咨询小组中，有更大比例的妇女报告了巴氏试验，因为她们认为这些材料是“为我准备的”。“这些结果表明，一系列有针对性的干预措施可能有助于帮助那些经常被贴上”难以接触“标签的妇女。'
We conducted a 4-year randomized study in a community health center that serves primarily low income Blacks in Durham, North Carolina. Patients (1318 at baseline) were assigned randomly to one of three study groups: provider prompting intervention alone, provider prompting and tailored print materials or the previous group and tailored telephone counseling. The purpose of the study was to determine whether increasingly intensive, tailored print and telephone interventions also were increasingly effective in promoting adherence to mammograms, Pap tests and overall cancer screening compliance. Thus, the combination of tailored print interventions (print and telephone) should have been more effective than the provider prompting intervention alone, or the print intervention and prompting combination. This is one of the few studies to examine a measure of overall cancer screening compliance and to assess the benefit of combinations of tailored interventions in promoting adherence to cancer screening. Patients gave extremely high ratings to the interventions. At the bivariate level, we found a significant effect of the most intensive group (provider prompting intervention, tailored print communications and tailored telephone counseling) on Pap test compliance (P=0.05) and borderline significance at the multivariate level (P=0.06) as well on overall screening compliance (P=0.06). There was not a significant effect on mammography, probably because a majority of the patients were receiving regular mammograms. We also found some important subgroup differences. For example, a larger proportion of women reported Pap tests in the tailored print and counseling group when they believed the materials were `meant for me.' These results show that a combination of tailored interventions may have potential for reaching the women who have too often been labeled the `hard to reach.'