Tailored Touchscreen Colorectal Cancer Prevention in American Indian Communities

描述（由申请人提供）：结直肠癌（CRC）死亡率不成比例地影响少数民族。 很少有研究涉及特定少数民族人群，如美国印第安人（AI）的筛查。 本研究将评估一种新的定制的触摸屏计算机干预的有效性的基础上创新的整合的预防采用过程模型（PAPM）和“实施意图”的概念，最近阐述的理论计划行为。 大多数干预措施将在部落诊所和初级保健机构通过低成本触摸屏电脑通过多媒体音频叙述和视频信息提供。 研究还没有测试针对特定文化的沟通的有效性，以改善这一群体的CRC筛查的“实施意图”。 随机设计将测试通用信息与多媒体定制干预的比较条件，该多媒体定制干预具体解决每个参与者的筛选测试模式偏好、当前CRC筛选决策阶段（PAPM）和CRC筛选“实施意图”（筛选的“何时”、“何地”和“如何”细节）。 行为干预材料将在文化专家的帮助下开发，试点测试，并从之前的焦点小组研究中收集的数据中，我们用来评估对CRC筛查AI的关键影响。 该研究将在460名符合CRC筛查条件的AI患者中进行，并在部落或地区安全网诊所接受护理时招募。 所有参与者将接受基线触摸屏管理评估，并根据所述偏好，提供免疫化学粪便潜血试验（iFOBT-InSure TM）或结肠镜检查。 参与者将被随机分配到C组（对照组-计算机提供的通用CRC信息）或AI 2组（主动干预-计算机提供的基于个体PAPM阶段、行为结构和“实施意图”的文化定制消息）。 一个简短的办公室退出调查将评估患者提供者讨论CRC筛查和满意度与计算机化的消息材料。

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) mortality disproportionately impacts minorities. Few studies have addressed screening among specific minority populations such as American Indians (AI). This study will assess the efficacy of a novel tailored touch screen computer intervention based on an innovative integration of the Precaution Adoption Process Model (PAPM) and the concept of "implementation intentions," a recent elaboration of the Theory of Planned Behavior. The majority of the intervention will be delivered in tribal clinics and primary care settings on low-cost touch screen computers through multimedia audio-narrative and video messages. Studies have not tested the effectiveness of culturally tailored communications specified to stated "implementation intentions" for improving CRC screening in this group. A randomized design will test a comparison condition of generic information versus a multimedia tailored intervention that specifically addresses each participant's screening test modality preference, current CRC screening decisional stage (PAPM), and CRC screening "implementation intentions" (the "when", "where" and "how" details of screening). Behavioral intervention materials will be developed with the help of cultural experts, a pilot test, and from data gathered in a prior focus group study we used to assess key influences on CRC screening for AIs. The study will be conducted with 460 AI patients eligible for CRC screening and recruited while presenting for care in tribal or regional safety-net clinics. All participants will receive a baseline touch screen administered assessment and, depending on stated preference, be offered either an immunochemical fecal occult blood test (iFOBT-InSure TM) or colonoscopy. Participants will be randomized to either C (comparison group-computer delivered generic CRC information) or AI2 (active intervention-computer delivered culturally tailored messaging based on individual PAPM stage, behavior constructs, and "Implementation Intentions"). A brief office exit survey will assess patient-provider discussions of CRC screening and satisfaction with computerized message materials.