Colorectal Cancer Screening Behavior in VA Population

VA 人群的结直肠癌筛查行为

• 批准号: 6863573
• 负责人: Deborah A Fisher
• 金额: $ 16.51万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-01-15 至 2006-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6863573
• 关键词: behavior prediction; behavioral /social science research tag; cancer risk; clinical research; colorectal neoplasms; health behavior; health care service utilization; health services research tag; human middle age (35-64); human old age (65+); human subject; mass screening; neoplasm /cancer diagnosis; psychometrics; questionnaires; veterans

DESCRIPTION (provided by applicant): Background:Colorectal cancer is the second leading cause of Cancer death in the United States. In spite of demonstrated efficacy and guideline recommendations, colorectal cancer screening rates are low. Purpose: This study is the next step in development and validation of new instrument, the Colorectal Cancer Screening Behavior Questionnaire (CRCSBQ) to measure colorectal cancer screening participation. The long- term goal of this study is to contribute to the development of a resource of cancer screening measures with known validity across multiple settings and populations. Methods: Phase 1: The CRCSBQ will undergo cognitive testing in a sample of patients (32 total) at two geographically diverse Veterans Affairs (VA) facilities. Patients will be from the primary care clinics, over age 50 and include Caucasians and African-Americans of both genders. Phase 2: The CRCSBQ and a demographics questionnaire will be administered to 200 (total) primary care patients at the 2 sites. In addition, medical record data will abstracted from the VA electronic medical record, non-VA medical records and Medicare claims data (patients older than 65). The questionnaire responses will be compared to the medical record data. We will calculate point estimates and 95% confidence intervals for the concordance, relative sensitivity, specificity and report-to-records ratio of the CRCSBQ to detect current colorectal cancer screening status by the American Cancer Society guidelines compared to the medical record review. We will use logistic regression analysis to explore patient factors that may be associated with agreement between self-report and medical records for colorectal cancer screening. Importance: Accurate measurement of colorectal cancer screening behavior is the essential first step in studying the problem of low screening rates. Veterans followed at VA primary care clinics represent the ideal population in which to validate the new instrument. The VA health care system is the largest integrated healthcare system in the United States. There is a comprehensive electronic record which includes all inpatient and outpatient care at any VA medical center. The VA population is diverse and includes representation from a range of age groups, racial and ethnic minorities and a substantial proportion of individuals from lower socioeconomic backgrounds and lower educational levels.

背景：结直肠癌是美国癌症死亡的第二大原因。尽管已经证明了有效性和指南建议，但结直肠癌筛查率仍然很低。 目的：这项研究是开发和验证新工具的下一步，即结直肠癌筛查行为问卷（CRCSBQ），以衡量结直肠癌筛查参与情况。这项研究的长期目标是促进开发一种在多个环境和人群中具有已知有效性的癌症筛查措施资源。 研究方法：第一阶段：CRCSBQ将在两个地理位置不同的退伍军人事务部（VA）设施的患者样本（共32名）中进行认知测试。患者将来自初级保健诊所，年龄在50岁以上，包括白人和非洲裔美国人的两种性别。II期：将对2个研究中心的200例（总计）初级保健患者进行CRCSBQ和人口统计学问卷调查。此外，将从VA电子病历、非VA病历和Medicare索赔数据（65岁以上患者）中提取病历数据。将问卷回答与病历数据进行比较。我们将计算CRCSBQ的一致性、相对敏感性、特异性和报告与记录比率的点估计值和95%置信区间，以检测美国癌症协会指南与病历审查相比的当前结直肠癌筛查状态。我们将使用逻辑回归分析来探讨可能与结直肠癌筛查的自我报告和医疗记录之间的一致性相关的患者因素。 重要性：准确测量结直肠癌筛查行为是研究低筛查率问题的重要第一步。在VA初级保健诊所随访的退伍军人代表了验证新仪器的理想人群。VA医疗保健系统是美国最大的综合医疗保健系统。有一个全面的电子记录，其中包括所有住院和门诊护理在任何VA医疗中心。VA人口是多样化的，包括来自一系列年龄组，种族和少数民族的代表，以及来自较低社会经济背景和较低教育水平的相当大比例的个人。