Colorectal Cancer Screening Preferences in Primary Care

描述（由申请人提供） 该项目将使用联合分析（CA）评估不同种族初级保健患者对结直肠癌筛查（CRCS）选项的偏好。低筛查率和有限的干预措施的有效性，以改善他们最近的注意力集中在了解更多关于一个CRCS测试比另一个偏好的变化。关于不同种族/民族的患者如何看待CRCS，或者某些测试对不同少数群体的个体是否更有吸引力或不太理想的信息很少。本研究的具体目的是：1）开发一个教育模块和相应的评估工具，以了解使用CA的不同患者人群对CRCS的偏好; 2）评估使用CA的CRCS选项的偏好差异，并以大型城市实践为基础的研究网络作为实验室;和3）确定种族/民族（性别和年龄）对CRCS测试属性的偏好差异，其可用于开发未来的干预措施。联合分析是一种偏好评估技术，其根源在于市场研究，最近应用于确定健康服务偏好。联合分析在评估不同人群对结直肠癌筛查的偏好方面有3个优势：1）当某些产品属性必须相互权衡时，它是最好的方法，例如将测试准确性与侵入性进行权衡; 2）潜在的“如果”情况，例如更准确的粪便潜血测试或虚拟结肠镜检查，可以使用CA轻松评估;以及3）所述方法识别或多或少可能偏好特定服务或测试的群体特征，例如种族/民族、性别和/或年龄。拟议研究的第一部分将开发使用CA评估CRCS偏好所需的教育模块，而实施阶段将使用这些材料评估225名白色、非洲裔美国人和西班牙裔初级保健患者（每组75名）的偏好。结果评价将揭示最优选的CRCS测试属性（例如，准确性、侵入性），这些偏好是否根据患者特征而变化。拟议的研究将为更大规模的研究提供基础，该研究将在更大的人群中复制CA方法，并利用结果开发和测试基于偏好的干预措施或决策辅助，以提高少数族裔人群对CRCS的依从性。

DESCRIPTION (provided by applicant) This project will assess preferences for colorectal cancer screening (CRCS) options among ethnically-diverse primary care patients using conjoint analysis (CA). Low screening rates and limited effectiveness of interventions to improve them has focused recent attention on understanding more about variation in preferences for one CRCS test over another. Little information exists about how racial/ethnically diverse patients regard CRCS, or whether certain tests are more appealing or less desirable to individuals of different minority groups. The specific aims of this 3-part study are to: 1) develop an educational module and accompanying assessment instrument to elicit preferences for CRCS among diverse patient populations using CA; 2) assess differences in preferences for CRCS options using CA with a large, urban practice-based research network serving as the laboratory; and 3) determine racial/ethnic (gender and age) differences in preferences for CRCS test attributes that can be used in development of future interventions. Conjoint analysis is a preference assessment technique with its roots in marketing research and more recent applications in determination of preferences for health services. Conjoint analysis has 3 strengths for assessment of preferences for colorectal cancer screening in a diverse population: 1) it is the best method when certain product attributes have to be traded off against one another, such as trading test accuracy for invasiveness; 2) potential "what if' situations, such as a more accurate fecal occult blood test or virtual colonoscopy, can be easily evaluated using CA; and 3) the approach identifies characteristics of populations, such as race/ethnicity, gender and/or age, that are more or less likely to prefer a particular service, or test. The first part of the proposed study will develop the educational modules needed to assess CRCS preferences using CA, while the implementation phase will use these materials to assess preferences among 225 white, African American and Hispanic primary care patients (75 per group). The evaluation of the results will reveal the most preferred CRCS test attributes (e.g., accuracy, invasiveness) whether these preferences vary according to patient characteristics. The proposed study will provide the groundwork for a larger study that will replicate the CA methods in a larger population, and use the results to develop and test a preference-based intervention, or decision aid, to improve compliance with CRCS among minority populations.