Tailored Interactive Multimedia to Reduce Colorectal CA Screening Disparities

定制交互式多媒体以减少结直肠 CA 筛查差异

• 批准号: 7516671
• 负责人: ANTHONY FRANCIS JERANT
• 金额: $ 49.8万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-12 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7516671
• 关键词: Address; Behavior; Caring; Clinical; Cognitive; Colonoscopy; Colorectal; Colorectal Cancer; Communities; Computers; Condition; Control Groups; Electronics; English Language; Ethnic Origin; Failure; Fecal occult blood; Flexible fiberoptic sigmoidoscopy; Health; Health behavior; Health behavior change; Hispanics; Home environment; Individual; Internet; Intervention; Knowledge; Language; Mediating; Mediator of activation protein; Methods; Not Hispanic or Latino; Office Visits; Outcome; Patient Preferences; Patients; Performance; Physicians' Offices; Primary Health Care; Printing; Process; Public Health; Randomized Controlled Trials; Readiness; Relative (related person); Schedule; Screening for cancer; Screening procedure; Self Efficacy; Staging; Testing; Training; Visit; Work; base; colorectal cancer screening; computer program; improved; interactive multimedia; laptop; preference; size; trend; uptake

DESCRIPTION (provided by applicant): Interactive multimedia computer programs (IMCPs) show promise as a way of delivering personally tailored (PT) information to enhance cognitive mediators of health behavior and improve patient outcomes. However, it is unclear whether PT IMCPs can be deployed in primary care offices to increase cancer screening uptake and eliminate ethnic disparities in uptake by providing PT information in each user's preferred language. Aims/Hypotheses: We will compare changes in CRC screening cognitive mediators (self- efficacy, perceived barriers, and readiness) and uptake resulting from an IMCP PT to enhance the key cognitive mediators and targeted to patients' self-identified ethnicity - with changes resulting from a non- tailored "electronic leaflet" control IMCP. The experimental and control IMCPs will each be offered in English and Spanish versions. We hypothesize that, compared with the appropriate control condition (English, Spanish, or both combined): (1) the English version of the PT IMCP will enhance the cognitive mediators of CRC screening behavior for English-speaking Hispanics and non-Hispanics; (2) there will be similarly favorable changes in these mediators for Hispanics using the Spanish version of the PT IMCP; (3) deployment of the PT IMCP will provide evidence of elimination of disparities in CRC screening between Hispanic and non-Hispanic subjects via its relative impact on the cognitive mediators in these groups; and (4) the PT IMCP (English and Spanish combined) will increase CRC screening uptake in Hispanics and non-Hispanics (considered separately) via changes in the cognitive mediators. Methods: Randomized controlled trial of 2 groups, comparing a PT (to the cognitive mediators) CRC screening IMCP offered in both English and Spanish versions and deployed before a primary care office visit with a non-tailored "electronic leaflet" CRC screening IMCP (control) also offered in both English and Spanish. Screening methods targeted will be fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. Primary outcomes will be CRC screening uptake, self- efficacy, perceived barriers, and readiness. Implications: Our findings will determine whether an IMCP that is PT to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo CRC screening. They may also suggest a promising, portable method of reducing disparities in CRC (and other) screening uptake between Hispanic and non-Hispanic individuals. PUBLIC HEALTH RELEVANCE: Our findings will determine whether an interactive multimedia computer program that is personally-tailored to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo colorectal cancer screening. They may also suggest a promising, portable method of reducing disparities in colorectal cancer (and other) screening uptake between Hispanic and non-Hispanic individuals.

描述（由申请人提供）：交互式多媒体计算机程序（IMCP）有望成为提供个人定制（PT）信息的一种方式，以增强健康行为的认知调节因素并改善患者的治疗结果。然而，尚不清楚是否可以在初级保健办公室部署 PT IMCP，以通过以每个用户的首选语言提供 PT 信息来提高癌症筛查的采用率并消除采用率的种族差异。目的/假设：我们将比较 CRC 筛查认知中介因素（自我效能、感知障碍和准备情况）的变化以及由 IMCP PT 引起的变化，以增强关键认知中介因素并针对患者的自我识别种族，与非定制的“电子传单”控制 IMCP 引起的变化。实验版和对照版 IMCP 将分别提供英语和西班牙语版本。我们假设，与适当的控制条件（英语、西班牙语或两者结合）相比：（1）英语版 PT IMCP 将增强讲英语的西班牙裔和非西班牙裔的 CRC 筛查行为的认知中介； (2) 使用西班牙语版本的 PT IMCP，这些调解员也会对西班牙裔人产生类似的有利变化； (3) PT IMCP 的部署将通过其对西班牙裔和非西班牙裔受试者认知调节因子的相对影响，提供消除西班牙裔和非西班牙裔受试者之间 CRC 筛查差异的证据； (4) PT IMCP（英语和西班牙语合并）将通过改变认知调节因素来增加西班牙裔和非西班牙裔（单独考虑）的 CRC 筛查率。方法：对 2 组进行随机对照试验，比较以英语和西班牙语版本提供并在初级保健办公室就诊之前部署的 PT（认知调节剂）CRC 筛查 IMCP 与同样以英语和西班牙语提供的非定制“电子传单”CRC 筛查 IMCP（对照）。针对性的筛查方法包括粪便潜血检测、柔性乙状结肠镜检查和结肠镜检查。主要结果将是 CRC 筛查率、自我效能、感知障碍和准备情况。意义：我们的研究结果将确定 IMCP（对筛查行为的认知调节因素进行 PT 并在先前安排的就诊之前部署在初级保健办公室）是否可以激活不同种族的患者接受 CRC 筛查。他们还可能提出一种有前途的、可移植的方法来减少西班牙裔和非西班牙裔个体之间 CRC（和其他）筛查的差异。公共卫生相关性：我们的研究结果将确定，针对筛查行为的认知中介因素量身定制并在先前安排的就诊之前部署在初级保健办公室的交互式多媒体计算机程序是否可以激活不同种族的患者接受结直肠癌筛查。他们还可能提出一种有前途的、便携式的方法来减少西班牙裔和非西班牙裔个体之间结直肠癌（和其他）筛查的差异。