A Two-Stage Model for Colorectal Cancer Screening

这份KO2研究事业奖的申请概述了一个3年计划，将研究、教育和教学结合起来，以发展具有癌症预防和控制方向的卫生服务研究的职业生涯。最近，在国家一级，卫生服务、结果研究和医患决策的重要性都被强调为预防肿瘤学研究的必要和研究不足的领域[1，2]。本申请中提出的职业发展和研究计划旨在开始确立候选人作为卫生服务研究和癌症预防和控制领域的独立调查员的地位。候选人[3]之前的工作为拟议研究的总体假设提供了方法论基础：结直肠癌筛查服务的使用是一个两阶段的过程，包括适当的医生建议和患者随后的依从性。候选人的初步研究[4]和正在进行的工作提供了实际检验这一假设所需的初始数据。该分阶段计划旨在为研究人员提供剩余的必要信息，以确定接受癌症预防服务的基本流程；特别侧重于如何改进结直肠癌筛查的医生建议和沟通，以及如何减少患者障碍并促进患者对结直肠癌筛查的决策。这项建议通过对影响医生和患者决策的健康服务和行为问题的探索，促进了对癌症筛查的现有知识。虽然这项拟议研究的结果将与实现结直肠癌筛查的最佳结果相关，但该框架也可能在其他预防性卫生保健领域进行测试和应用。这项补助金申请的职业发展部分旨在对研究计划进行补充和补充，这些计划将共同塑造候选人作为一名具有预防视角的卫生服务研究的独立调查员的职业生涯。

This KO2 Research Career Award application outlines a 3-year plan for combining research, education and teaching for development of a career in health services research with a cancer-prevention and control orientation. Recently, the importance of health services, outcomes research and physician-patient decision-making have all been highlighted at the national level as necessary and understudied areas for preventive oncology research [1,2]. The career development and research plan proposed in this application are designed to begin establishing the candidate as an independent investigator in health services research and cancer prevention and control. Prior work by the candidate [3] provides the methodological basis for the proposed study's overall hypothesis: that use of colorectal cancer screening services is a two-stage process, consisting of appropriate physician recommendations and subsequent compliance by patients. A preliminary study by the candidate [4] and work in progress supply the initial data needed to practically test this hypothesis. The-phased plan is designed to provide the remainder of necessary information of investigator the processes underlying receipt of cancer prevention services; focusing specifically on how to improve physician recommendations and communication of CRC screening, and how to reduce patient barriers and facilitate patient decision-making for CRC screening. This proposal advances current knowledge about cancer screening through an exploration of the health services and behavioral issues that influence physician and patient decision-making. Although the results of this proposed study will have relevance for achieving the best outcomes in colorectal cancer screening, the framework may also be tested and applied in other areas of preventive health care. The career development portion of this grant application is intended to both compliment and supplement the research plan, which together will shape the candidate's career as an independent investigator in health services research with a prevention perspective.