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: 8132459
• 负责人: GEOFFREY A GOLDSMITH
• 金额: $ 16.41万
• 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 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8132459
• 关键词: Address; Adenomatous Polyps; Adherence; Adopted; Adoption; American Cancer Society; Arkansas; Attitude; Behavior; Behavioral; Cancer Control; Cancer Etiology; Caring; 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; 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; 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; improved; innovation; interest; medical schools; meetings; member; mortality; motivational enhancement therapy; post intervention; 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.

描述（申请人提供）：该教育传播项目包括以下目标：1）开发多管齐下的实践浸入式教育模式，以提高结直肠癌（CRC）筛查率，并为实施活动做好准备; 2）在四个地点实施教育模式; 3）评估教育模式对CRC筛查率的影响;及4）向其他基层护理住院医生教育者及关注团体推广教育模式。这种干预是基于创新传播理论。来自四个农村阿肯色州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，加强患者教育和导航，并采用先进的电子病历（EMR）软件，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赠款教育支持团队的指导，指导他们如何提高美国癌症协会CRC筛查指南的依从性，并将参加在小石城举行的培训研讨会，以帮助他们实施干预措施。将有一个干预后的传播工作，将使用主要针对初级保健住院医师计划教师的社会营销方法，并将通过年度研讨会，基于电子的通信（知识库和Web-CT会议），出版物，初级保健教育会议研讨会，并通过互联网和电话与教育团队进行咨询。层级分析将用于阐明可能影响住院医师学习和绩效的不同因素的影响。这些因素将包括组织参数，如组织能力和管理的准备采取教育干预;居民因素，如多年的住院医师培训和准备采取创新，和病人的因素（人口统计，保险状况，并准备改变）。我们将通过多个项目评估来评估教育策略的价值，这些项目评估使用了对培训生和工作人员的调查，重点关注教育项目的每个要素，以及居民态度、知识和技能的变化，这些变化与改善CRC筛查（干预前/后）有关。传播将使用RE-AIM战略进行评估，该战略通过演示文稿和出版物评估该计划的覆盖范围及其长期采用情况。