A patient-centered intervention using virtual technology to reduce colorectal cancer disparities in primary care

项目摘要 结直肠癌(CRC)是美国癌症死亡的第二大原因。不幸的是，在那里 是否存在显著的结直肠癌筛查差异，从而导致结直肠癌相关发病率和死亡率较高 少数民族和农村患者群体，特别是在美国南部。的发展。 利用通信、信息学和计算机科学的进步进行干预有很大的好处 承诺解决与CRC筛查决策相关的理论和实践问题。这个 本提案的目的是测试以患者为中心的、量身定制的信息干预的有效性 在指导方针内增加少数民族和农村地区结直肠癌筛查的虚拟技术 病人。我们假设，暴露于通过VHT提供的最低限度定制的结直肠癌筛查干预 将导致改善干预的认知过程，并增加对初始和重复干预的坚持 与完全量身定制的纯文本干预相比，每年完成FIT筛查。这一假设将是 通过两个特定的目标进行了测试。在具体目标1中，我们将进行焦点小组和大声思考的采访 按地理、性别和种族/民族背景分层，以扩展和试点使用 将虚拟人作为CRC筛查信息的传递机制。在特定目标2中，患者(N= 3,000人)将通过初级保健诊所和安全的临床数据仓库招募，以完成患者- 促进初始和重复匹配测试的干预效果的随机测试。依赖 将通过患者自我报告和图表审查来评估措施。这项拟议的研究将降低健康 通过增加种族/民族之间的筛查，结直肠癌的差异和相关的发病率和死亡率 少数民族和农村人口。

PROJECT ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Unfortunately, there are significant CRC screening disparities that result in higher rates of CRC-related morbidity and mortality for minority and rural patient populations, particularly in the southern United States. The development of interventions that capitalize on advances in communication, informatics, and computer science have great promise for resolving theoretical and practical problems associated with CRC screening decision-making. The purpose of this proposal is to test the efficacy of a patient-centered, tailored message intervention delivered via virtual technology for increasing CRC screening within guidelines among racial/ethnic minority and rural patients. We hypothesize that exposure to a minimally tailored CRC screening intervention delivered via VHT will lead to improved cognitive processing of the intervention and increased adherence with initial and repeated annual FIT screening completion as compared to a fully tailored, text-only intervention. This hypothesis will be tested through two specific aims. In Specific Aim 1, we will conduct focus groups and think-aloud interviews stratified by geography, gender, and racial/ethnic background to expand and pilot test an intervention that uses a virtual human as a delivery mechanism for CRC screening information. In Specific Aim 2, patients (N = 3,000) will be recruited via primary care clinics and a secure, clinical data warehouse to complete a patient- randomized test of the efficacy of the intervention for promoting initial and repeat FIT testing. Dependent measures will be assessed via patient self-report and chart review. The proposed study will reduce health disparities and associated morbidity and mortality due to CRC via increasing screening among racial/ethnic minority and rural populations.