Increasing CRC Screening in Primary Care Settings

增加初级保健机构的结直肠癌筛查

• 批准号: 6730191
• 负责人: USHA MENON
• 金额: $ 4.16万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2004-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6730191
• 关键词: African American; behavior modification; behavioral /social science research tag; belief; cancer risk; caucasian American; clinical research; colorectal neoplasms; data collection methodology /evaluation; disease /disorder prevention /control; early diagnosis; health behavior; health care service utilization; health services research tag; human subject; interview; longitudinal human study; motivation; neoplasm /cancer diagnosis; patient care management; racial /ethnic difference

DESCRIPTION (provided by applicant): Regular screening reduces both morbidity and mortality from colorectal cancer (CRC). Screening rates, however, remain low suggesting the need for innovative research designed to increase screening behavior. The purpose of this study is to compare the effectiveness of two interventions (Tailored Health Communications [THC] and Motivational Interviewing [MI]) in increasing CRC screening behavior. Both interventions are based on a strong conceptual framework derived from the Health Belief Model (HBM) and Transtheoretical Model (TTM), allowing us to explore the underlying mechanisms through which these interventions impact behavior change. The primary aim of this study is to compare CRC screening test use among 804 participants randomly allocated to control or intervention conditions; 402 participants will be recruited from each site (Salt Lake City, UT and Nashville, TN). The three study groups will receive (1) standard care, (2) tailored health communication, and (3) motivational interviewing. Eligibility criteria for study participants includes being 50 years or older, not having CRC, and being of average or moderate risk for CRC. Study participants will be surveyed by telephone about CRC related beliefs pre-intervention (Time 1), one month post intervention (Time 2), and at 6 and 12 months (Times 3 and 4 respectively). Salt Like City participants will be primarily Caucasian and those from Nashville will be African American. Dichotomous behavioral outcomes (had screening test or not) and stages of CRC screening test adoption (based on the TTM) will be assessed, as well as sociodemographic and belief predictors of screening behavior. Binomial and multinomial logistic regression models will be used to evaluate screening test use and stage of test adoption. Sociodemographic and belief variables will be used as covariates, with intervention groups at the primary independent predictor. Descriptive statistics and ANOVA will be employed to assess between intervention differences in amenable beliefs. Path (mediation) analysis will be performed to further explore the underlying mechanisms through which THC and MI may differentially affect CRC screening behavior.

描述（由申请人提供）：定期筛查可降低结直肠癌（CRC）的发病率和死亡率。然而，筛查率仍然很低，这表明需要进行旨在增加筛查行为的创新研究。本研究的目的是比较两种干预措施（量身定制的健康沟通[THC]和动机性访谈[MI]）在增加CRC筛查行为方面的有效性。这两种干预措施都基于健康信念模型（HBM）和跨理论模型（TTM）衍生的强大概念框架，使我们能够探索这些干预措施影响行为改变的潜在机制。本研究的主要目的是比较随机分配到对照组或干预组的804名参与者的CRC筛查试验使用情况；将从每个站点（盐湖城，UT和纳什维尔，TN）招募402名参与者。三个研究组将接受(1)标准治疗，(2)量身定制的健康沟通，(3)动机性访谈。研究参与者的资格标准包括：年龄≥50岁，无结直肠癌，患结直肠癌的风险为中等或中等。研究参与者将在干预前（时间1）、干预后一个月（时间2）以及6个月和12个月（时间3和4分别）通过电话调查CRC相关信念。盐城的参与者将主要是高加索人，来自纳什维尔的参与者将是非洲裔美国人。将评估二分类行为结果（是否进行筛查试验）和采用CRC筛查试验的阶段（基于TTM），以及筛查行为的社会人口学和信念预测因子。二项和多项逻辑回归模型将用于评估筛选测试的使用和测试采用的阶段。社会人口学和信仰变量将被用作协变量，干预组是主要的独立预测因子。描述性统计和方差分析将用于评估干预之间的可服从信念的差异。路径（中介）分析将进一步探讨THC和MI可能差异影响CRC筛查行为的潜在机制。