NY PREVENTION CARE MANAGER PROJECT

纽约预防护理经理项目

• 批准号: 6576858
• 负责人: Allen J. Dietrich
• 金额: $ 2.88万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6576858
• 关键词: behavioral /social science research tag; blood tests; cancer prevention; cervical /vaginal smear; clinical research; community health services; endoscopy; female; gastrointestinal imaging /visualization; health care cost /financing; health care service evaluation; health care service utilization; health services research tag; human middle age (35-64); human old age (65+); human subject; mammography; medically underserved population; patient care management; women's health

This project will test the impact and measure the costs of a prevention case manager (PCM) to improve cancer early detection provided to ethnically diverse women age 50-69 years seen in community health centers in the New York City area. Patients of four community health centers will be randomly assigned to usual care or the PCM intervention. The conceptual framework for the project is provided by the PRECEDE model. Evidence-based statements of the National Cancer Institute's CancerNet identify appropriate intervals for mammography, Pap and fecal occult blood testing, and sigmoidoscopy. Project Aims are: 1. To learn of barriers faced by this population in obtaining indicated services; 2. To assess at baseline the office environment and work processes in each participating center; 3. To develop and implement the PCM intervention to help patients overcome barriers; 4. To evaluate the impact and costs of the PCM in a randomized controlled efficacy trial. Phase I of the project involving Aims 1 and 2 will provide a baseline assessment of patient barriers and center environments. Aim 1 will be achieved through interviewing up to 50 systematically selected women in each center to learn about barriers to preventive care. Aim 2 will be addressed through questionnaires and guided discussions with clinical support staff in each center. Phase II concerns Aim 3, to refine the intervention informed by results of Phase I. The Intervention includes identification of patients who are overdue for services, culturally appropriate patient advice, assistance in overcoming barriers to care and follow-up monitoring to assist in resolution of abnormal test results. Phase III concerns Aim 4 conducting the efficacy trial. Outcome evaluation based on record review will compare the preventive status of patient cohorts between baseline and follow- up across the two study groups taking into account the work-up status of any abnormal test results with an evaluation cohort of 1400 women age 50-69 years. Process evaluation will allow accurate assessment of intervention costs, as well as observations of the practice environments and the process of providing preventive care. As a result of this project, a new model of enhancing preventive care for special populations will be tested and its efficacy and costs determined.

该项目将测试预防案例管理器 (PCM) 的影响并衡量其成本，以改善为纽约市地区社区卫生中心的 50-69 岁不同种族女性提供的癌症早期检测服务。 四个社区卫生中心的患者将被随机分配接受常规护理或 PCM 干预。 该项目的概念框架由 PRECEDE 模型提供。 美国国家癌症研究所 CancerNet 的循证声明确定了乳房 X 光检查、巴氏涂片和粪便潜血检测以及乙状结肠镜检查的适当间隔时间。 项目目标是： 1. 了解该人群在获得指定服务时面临的障碍； 2. 对各参与中心的办公环境和工作流程进行基线评估； 3. 制定并实施PCM干预措施，帮助患者克服障碍； 4. 在随机对照疗效试验中评估 PCM 的影响和成本。该项目的第一阶段涉及目标 1 和 2，将对患者障碍和中心环境进行基线评估。目标 1 将通过在每个中心采访最多 50 名系统挑选的女性来了解预防性护理的障碍来实现。 目标 2 将通过问卷调查和与每个中心的临床支持人员进行指导性讨论来解决。 第二阶段涉及目标 3，即根据第一阶段的结果完善干预措施。干预措施包括识别逾期服务的患者、适合文化的患者建议、帮助克服护理障碍以及后续监测以协助解决异常测试结果。 III 期涉及目标 4 进行的功效试验。基于记录审查的结果评估将比较两个研究组的基线和随访期间患者队列的预防状态，同时考虑到任何异常测试结果的检查状态，以及由 1400 名 50-69 岁女性组成的评估队列。 过程评估将能够准确评估干预成本，以及对实践环境和提供预防性护理的过程的观察。 该项目的结果是，将测试一种加强特殊人群预防性护理的新模式，并确定其功效和成本。