Preparing to Advance Colorectal Screening in Springfield

描述：结直肠癌(CRC)是第二大致病原因 与癌症相关的死亡和两人最常见的第三种癌症 以及美国的女性。1973-1995年间，非洲人的发病率 美国男性和女性的比例增加了，而且超过了白人的比例。非洲 美国男性的发病率最高。此外，尽管儿童权利公约 总人口死亡率下降21%，死亡率 65岁及以上的非洲裔美国男性增加了26%， 在65岁以下的非洲裔美国男性中，有16%。非洲裔美国女性 与任何其他种族/族裔群体的妇女相比，更有可能死于儿童权利委员会。 非洲裔美国人明显更有可能在晚期被诊断出来 而不是白人。1989年至1994年期间的五年存活率为% 白人占52%，非裔美国人占52%。众所周知，CRC筛查是 通过早期发现和通过切除癌前病变来预防有效 息肉，但未得到充分利用。 我们提出了一项可形成的可行性研究，作为 随后的随机试验测试创新策略的有效性 在社区卫生中心(CHCs)通过以下方式提高CRC筛查参与率 非裔美国人。在第一个组件中，我们将分析临床和 管理信息系统(S)目前已到位参加 社区卫生中心和其他适当地点(例如，内窥镜检查 诊所)评估干预计划、实施和 评估。第二部分将探讨其可行性和潜力。 各种干预战略的有效性以及优先信息 在适合这一人群的战略范围内。需求 评估方法将包括重点患者群体和社区 成员，采访卫生中心提供者和工作人员中的关键线人 和胃肠病专家，审查医疗记录和试点患者调查。 收集的数据也将为抽样和应计预测提供信息，并 为后续试验研制的仪器。 本R2 1的产品包括a)与以下因素相关的已发表报告 对非裔美国人进行结直肠癌筛查；b)背景和系统分析 护理程序；c)预先测试的文书和d)详细建议 这些干预措施将在随机试验中进行测试。

DESCRIPTION: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths and the third most commonly diagnosed cancer for both men and women in the United States. During 1973-1995, the incidence among African American men and women has increased and exceeds the rate among whites. African American men have the highest incidence rates. Furthermore, although the CRC mortality rate decreased 21 percent among the general population, mortality increased 26 percent among African American males aged 65 years and older, and 16 percent among African American males less than 65. African American women are more likely to die of CRC than are women of any other racial/ethnic group. African Americans are significantly more likely to be diagnosed at late-stage than Whites. Five-year survival rates for the period 1989-94 were 64 percent in whites and 52 percent in African Americans. CRC screening is known to be effective both by early detection and for prevention by removal of precancerous polyps but is underused. We propose a formative feasibility study that will serve as a basis for a subsequent randomized trial testing the effectiveness of innovative strategies in community health centers (CHCs) to improve CRC screening participation by African Americans. In the first component, we will profile the clinical and management information system(s) currently in place in the participating community health centers and other sites as appropriate (e.g., endoscopy clinics) to estimate capability for intervention planning, delivery and evaluation. The second component will explore the feasibility and the potential effectiveness of various intervention strategies, as well as priority messages within the strategies, which are appropriate for this population. The needs assessment approaches will include focus groups of patients and community members, interviews of key informants among health center providers and staff and gastroenterologists, review of medical records and pilot patient surveys. Data collected will also inform the sampling and accrual projections and instrument development of for the subsequent trial. The products of this R2 1 include a) a published report on factors related to CRC screening in African Americans; b) a systems analysis of the context and processes of care; c) pre-tested instruments and d) detailed recommendations for the interventions to be tested in a randomized trial.