Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
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DOI：
10.1186/s12913-014-0611-4
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发表时间：
2014-11-30
影响因子：
2.8
通讯作者：
Wheeler SB
中科院分区：
文献类型：
--
作者：
Pignone MP;Crutchfield TM;Brown PM;Hawley ST;Laping JL;Lewis CL;Lich KH;Richardson LC;Tangka FK;Wheeler SB
结直肠癌（CRC）筛查是次优的，特别是对弱势群体。需要有效的干预计划来提高筛查率。我们使用离散选择实验（DCE）来了解北卡罗来纳州的弱势个体如何重视CRC筛查项目的不同方面。我们招募了来自北卡罗来纳州农村社区的年龄在50-75岁之间、平均CRC风险的讲英语的成年人，这些社区的CRC筛查率较低，针对的是那些有公共保险或没有保险和低收入的人。参与者收到有关CRC筛查和潜在计划功能的基本信息，然后完成16项任务DCE和调查问题，检查筛查计划的四个属性的偏好：可用的测试选项;所需的旅行时间;为筛查支付的钱或完成筛查的奖励;以及自掏腰包支付的后续护理费用部分。我们使用层次贝叶斯方法计算4个属性水平的个体水平效用和个体水平属性重要性得分。对于每个个体，具有最高重要性分数的属性被认为是最重要的属性。然后汇总各个效用，以产生每个属性的平均效用。我们还将基于VCE的结果与VCE后调查中直接问题的结果进行了比较。我们招募了150名成年人。平均年龄为57.8岁（范围50-74岁）; 55%为女性; 76%为白色，19%为非洲裔美国人; 87%的家庭年收入低于30，000美元; 51%没有保险。个人更喜欢较短的旅行;奖励或小额自付额与大额自付额相比;包括粪便检测作为一种选择的计划;以及更大的后续费用覆盖范围。随访费用覆盖率最常被认为是DCE最重要的属性（47%）;其次是测试奖励/共付额（33%）。从调查中，支付的后续费用的比例最常被认为是最重要的（42%的参与者），其次是测试选项（32%）。有中度协议（45%）之间的属性重要性的DCE和单一的问题在DCE后的调查。筛查测试共同负担费用和后续护理覆盖费用是这一脆弱农村人口的重要计划特征。本文的在线版本（doi：10.1186/s12913-014-0611-4）包含补充材料，可供授权用户使用。
Screening for colorectal cancer (CRC) is suboptimal, particularly for vulnerable populations. Effective intervention programs are needed to increase screening rates. We used a discrete choice experiment (DCE) to learn about how vulnerable individuals in North Carolina value different aspects of CRC screening programs. We enrolled English-speaking adults ages 50–75 at average risk of CRC from rural North Carolina communities with low rates of CRC screening, targeting those with public or no insurance and low incomes. Participants received basic information about CRC screening and potential program features, then completed a 16 task DCE and survey questions that examined preferences for four attributes of screening programs: testing options available; travel time required; money paid for screening or rewards for completing screening; and the portion of the cost of follow-up care paid out of pocket. We used Hierarchical Bayesian methods to calculate individual-level utilities for the 4 attributes’ levels and individual-level attribute importance scores. For each individual, the attribute with the highest importance score was considered the most important attribute. Individual utilities were then aggregated to produce mean utilities for each attribute. We also compared DCE-based results with those from direct questions in a post-DCE survey. We enrolled 150 adults. Mean age was 57.8 (range 50–74); 55% were women; 76% White and 19% African-American; 87% annual household income under $30,000; and 51% were uninsured. Individuals preferred shorter travel; rewards or small copayments compared with large copayments; programs that included stool testing as an option; and greater coverage of follow-up costs. Follow-up cost coverage was most frequently found to be the most important attribute from the DCE (47%); followed by test reward/copayment (33%). From the survey, proportion of follow-up costs paid was most frequently cited as most important (42% of participants), followed by testing options (32%). There was moderate agreement (45%) in attribute importance between the DCE and the single question in the post-DCE survey. Screening test copayments and follow-up care coverage costs are important program characteristics in this vulnerable, rural population. The online version of this article (doi:10.1186/s12913-014-0611-4) contains supplementary material, which is available to authorized users.
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影响因子：
--
作者：
Inadomi, John M.;Vijan, Sandeep;Janz, Nancy K.;Fagerlin, Angela;Thomas, Jennifer P.;Lin, Yunghui V.;Munoz, Roxana;Lau, Chim;Somsouk, Ma;El-Nachef, Najwa;Hayward, Rodney A.
通讯作者：
Hayward, Rodney A.
影响因子：
3.6
作者：
Nayaradou, Maximilien;Berchi, Celia;Launoy, Guy
通讯作者：
Launoy, Guy
影响因子：
8.4
作者：
van Dam, L.;Hol, L.;van Leerdam, M. E.
通讯作者：
van Leerdam, M. E.
影响因子：
4.8
作者：
Wheeler, Stephanie B.;Kuo, Tzy-Mey;Pignone, Michael P.
通讯作者：
Pignone, Michael P.
影响因子：
5.7
作者：
Brenner, Alison;Howard, Kirsten;Pignone, Michael
通讯作者：
Pignone, Michael