Increasing Colorectal and Breast Cancer Screnning in Women

描述(申请人提供)：在50岁及以上的女性中进行适当的癌症筛查可以降低结直肠癌(CRC)和乳腺癌(BC)的死亡率，但对这两种筛查行为的坚持是不够的。这项建议的目的是测试一种量身定制的互动干预措施，以增加51至75岁不遵守儿童权利公约但遵守BC的妇女(A组)或不同时接受儿童权利公约和BC筛查的妇女(B组)的CRC和BC筛查。该干预基于理论建模，将同时处理不止一种健康行为。我们将比较通过邮寄数字视频光盘(TIDVD)、癌症筛查电话(CSC)、TIDVD+CSC的组合以及在单点接触期间增加CRC和BC筛查的常规护理提供的量身定制的互动节目。约2616名妇女将接受资格评估，她们是家庭护理实践网络的成员，并由Wellpoint投保。符合资格的妇女将不遵守儿童权利公约(A组)，或不遵守儿童权利公约和BC筛查(B组)。在资格评估和同意后，妇女将被纳入研究并随机分配到TIDVD、CSC、TIDVD+CSC或常规护理。TIDVD计划和CSC将根据接受者对与CRC或CRC和BC相关的风险、好处、障碍和自我效能的看法来定制消息。干预措施将鼓励在结直肠癌筛查成功的基础上进行结直肠癌筛查(A组)，或者如果妇女不遵守任何一项筛查，将鼓励同时进行两项筛查(B组)。干预组的妇女将能够通过电话安排BC或CRC筛查，而无需去诊所就诊。所有干预武器都可以直接送到妇女家中。基线电话评估一周后，将提供干预措施。结果将通过电话访谈以及在6个月后通过索赔数据和医疗记录审计获得。有关干预的过程数据将在干预后4周收集。如果发现其中一种或两种都有效，将计算两种干预措施的成本效益，以加快翻译到实践的速度。

DESCRIPTION (provided by applicant): Appropriate cancer screening in women 50 and older reduces both colorectal cancer (CRC) and breast cancer (BC) mortality, but adherence to both screening behaviors is inadequate. The purpose of this proposal is to test a tailored and interactive intervention to increase both CRC and BC screening in women 51 to 75 who are non-adherent to CRC but adherent to BC (Group A) or to a group which is non-adherent to both CRC and BC (Group B) screening. The intervention is based on theoretical modeling that will simultaneously address more than one health behavior. We will compare a tailored interactive program delivered via a mailed digital video disc (TIDVD), a cancer screening call (CSC), the combination of a TIDVD + CSC, and usual care to increase CRC and BC screening during a single point of contact. Approximately 2616 women, who are members of a family care practice network and insured by Wellpoint will be assessed for eligibility. Eligible women will be either non-adherent to CRC only (Group A) or non-adherent to both CRC and BC (Group B) screening. After eligibility assessment and consent, women will be enrolled in the study and randomly assigned to the TIDVD, CSC, TIDVD + CSC, or usual care. The TIDVD program and CSC will tailor messages to recipients' perceptions of risk, benefits, barriers, and self-efficacy associated with either CRC or with CRC and BC. Interventions will encourage either CRC screening building on their success with BC screening (Group A) or will encourage both screenings simultaneously (Group B) if the woman is non-adherent to either screening. Women in interventions groups will have the ability to schedule BC or CRC screening via telephone without a clinic visit. All intervention arms can be delivered directly to the women in their homes. One week after baseline telephone assessment, interventions will be delivered. Outcomes will be obtained by telephone interviews as well as through claims data and medical records audit at 6 months. Process data about the intervention will be collected at 4 weeks post intervention. Cost effectiveness will be computed for both interventions to speed translation to practice if either or both are found to be efficacious.