Improving compliance with colorectal cancer screening in family medicine residenc

提高家庭住院医师结直肠癌筛查的依从性

• 批准号: 7429286
• 负责人: Robert D. Price
• 金额: $ 26.22万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-05 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7429286
• 关键词: Address; Adenomatous Polyps; Adherence; Adopted; Adoption; All Sites; American Cancer Society; Arkansas; Attitude; Behavior; Behavioral; Cancer Control; Cancer Etiology; Caring; Cessation of life; Clinic; Clinical; Colon Carcinoma; Colonoscopy; Colorectal Cancer; Communication; Community Hospitals; Computer software; Computerized Medical Record; Consultations; Data; Demographic Factors; Diffusion of Innovation; Discipline of Nursing; Disease; Education; Educational Grants; Educational Intervention; Educational Models; Educational workshop; Effectiveness; Electronics; Elements; Excision; Faculty; Family Practice; General Population; Goals; Guidelines; Healthy People 2010; Immersion Investigative Technique; Incidence; Information Technology; Insurance Carriers; Insurance Coverage; Interest Group; Internet; Intervention; Knowledge; Learning; Light; Malignant Neoplasms; Medical; Medical Technology; Modeling; Morbidity - disease rate; Neoplasm Metastasis; Office Nursing; Operative Surgical Procedures; Organizational Change; Patient Education; Patient-Centered Care; Patients; Performance; Physicians; Polyps; Population; Precancerous Polyp; Primary Health Care; Process; Program Evaluation; Publications; Rate; Readiness; Recommendation; Reporting; Research; Residencies; Risk; Role; Rural; Science; Screening for cancer; Screening procedure; Site; Social Marketing; Societies; Staging; Surveys; System; Telephone; Testing; Theoretical model; Time; Training; Universities; base; colorectal cancer screening; concept; follow-up; improved; innovation; interest; medical schools; member; mortality; motivational enhancement therapy; programs; repository; skills; symposium; theories

DESCRIPTION (provided by applicant): This educational dissemination project includes the following aims: 1) develop the multi-pronged practice immersion educational model to improve colorectal cancer (CRC) screening rates and prepare sites for implementation activities; 2) implement the educational model at four sites; 3) evaluate the educational model's impact on CRC screening rates; and 4) disseminate the educational model to other primary care residency educators and interested groups. The intervention is based on the Dissemination of Innovation theory. Family medicine residents (n = 96) from four rural Arkansas family medicine residency programs will receive training on how to optimize their patients' CRC screening rates. The educational approach involves residency clinic redesign, seminars on effective communications, augmentation of patient education and navigation, and adoption of advanced electronic medical record (EMR) software that includes prompts and reminders and quality improvement reports. Each residency's clinic management team will receive guidance from the grant educational support team on how to improve adherence with the American Cancer Society CRC screening guidelines, and will attend a training workshop in Little Rock to assist them in implementing the intervention. There will be a post-intervention dissemination effort that will use a social marketing approach aimed primarily at primary care residency program faculty, and will be delivered via an annual workshop, electronic-based communications (knowledge repositories and Web-CT conferences), publications, seminars at primary care education meetings, and consultation with the educational team via Internet and phone. Hierarchical analysis will be used to shed light on the influence of different factors that may impact on resident learning and performance. These factors will include organizational parameters such as organizational capacity and management's readiness to adopt the educational intervention; resident factors such as years of residency training and readiness to adopt innovations, and patient factors (demographics, insurance status, and readiness to change). We will evaluate the value of the educational strategy through multiple program evaluations using surveys of trainees and staff focusing on each element of the educational program, and changes in residents' attitudes, knowledge, and skills related to improving CRC screening (pre/post intervention). The dissemination will be evaluated using the RE-AIM strategy, which assesses the reach of the program through presentations and publications, as well as its long-term adoption.

项目描述（申请人提供）：本教育传播项目旨在：1)发展多管齐下的实践浸入式教育模式，提高结直肠癌（CRC）筛查率，并为实施活动准备场地；2)在四个站点实施教学模式；3)评估教育模式对结直肠癌筛查率的影响；4)向其他基层住院医师教育工作者和感兴趣的群体推广该教育模式。干预是基于创新传播理论。来自阿肯色州四个农村家庭医学住院医师项目的家庭医学住院医师（n = 96）将接受如何优化患者CRC筛查率的培训。教育方法包括重新设计住院医师诊所、举办有效沟通研讨会、加强患者教育和指导、采用先进的电子病历（EMR）软件，其中包括提示和提醒以及质量改进报告。每个住院医师的诊所管理团队将接受资助教育支持团队的指导，了解如何提高对美国癌症协会CRC筛查指南的依从性，并将参加小石城的培训研讨会，以帮助他们实施干预措施。干预后的传播工作将采用社会营销方法，主要针对初级保健住院医师项目的教员，并将通过年度研讨会、电子通信（知识库和网络ct会议）、出版物、初级保健教育会议研讨会以及通过互联网和电话与教育团队进行咨询来进行。本研究将运用层次分析法，探讨不同因素对住院医师学习及表现的影响。这些因素将包括组织参数，如组织能力和管理层采取教育干预的准备程度；居民因素，如住院医师培训的年数和采用创新的准备程度，以及患者因素（人口统计、保险状况和改变的准备程度）。我们将通过对培训生和工作人员的调查来评估教育策略的价值，这些调查侧重于教育计划的每个要素，以及居民对改善CRC筛查（干预前/干预后）的态度、知识和技能的变化。将利用再目标战略对传播情况进行评价，该战略通过介绍和出版物评估方案的影响范围以及方案的长期采用情况。