Developing a Young Adult-Mediated Intervention to Increase Colorectal Cancer Screening among Rural Screening Age-Eligible Adults

项目摘要 结直肠癌（CRC）仍然是美国癌症相关死亡的第二大原因。最近 研究强调了几个地理上的，主要是农村的，CRC发病率和死亡率过高的“热点”。 农村和非农村人口之间的这些差异的一个驱动因素是农村地区CRC筛查率低。 因此，需要用于改善这些领域中的筛查和早期检测的新方法。长期 本研究的目的是开发一种利用“向上沟通”的干预措施，以改善CRC 在农村人口中进行筛查。建议的R 03具体目标将有助于实现这一目标， 收集所需的初步信息，以开发一种年轻的成人介导的干预措施， 教导家庭成员鼓励他们的年长家庭成员参与CRC筛查。这样的 干预不仅可以提高符合年龄条件的成年人的筛查率， 在生活在农村环境中的年轻人中筛查知识、意识和准备情况。的 ORBIT模型将指导审慎制定和优化干预方法的过程。旨在 1和2将使用混合方法收集形成性数据，以确定关键干预组件。完成 目标1，来自n=150名年轻（25-44岁）和n=150名老年（45-75岁）农村成年人的调查数据 社区将被收集。在目标2中，我们将制定和评估干预措施， 使用n=9个焦点小组进行关于CRC预防和筛查的有效向上沟通。我们将 并根据焦点小组的反馈修改干预措施。目标1和2的结果将指导 完善干预内容和设计。新干预措施的影响将通过一个单一的- 组，目标3中的预测试后测试试验设计（n=15个成人儿童/父母二人组）。利用和利用家庭 成员可能是农村地区文化上适当的癌症传播的一个特别突出的渠道。 这可能有助于解决CRC热点居民未满足的需求。总体而言，拟议的 研究将产生一个向上的沟通干预，有可能改善CRC的健康 在农村地区开展扫盲和筛查。

PROJECT SUMMARY Colorectal cancer (CRC) remains the second leading cause of cancer-related death in the United States. Recent studies have highlighted several geographic, primarily rural, “hotspots” for excess CRC incidence and mortality. One driver of these disparities between rural and non-rural populations is low CRC screening rates in rural areas. Thus, novel methods for improving screening and early detection in these areas are needed. The long-term objective of this research is to develop an intervention leveraging “upward communications” to improve CRC screening uptake in rural populations. The proposed R03 specific aims will help achieve this objective by garnering the preliminary information needed to develop a young adult-mediated intervention whereby a younger family member is taught to encourage their older family member to engage in CRC screening. Such an intervention could not only improve screening uptake among age-eligible adults, but could also improve cancer screening knowledge, awareness, and readiness among young adults themselves living in rural settings. The ORBIT model will guide the process of deliberatively developing and optimizing the intervention approach. Aims 1 and 2 will use mixed methods to collect formative data to identify critical intervention components. To complete Aim 1, survey data from n=150 younger (25-44 years old) and n=150 older (45-75 years old) adults living in rural communities will be collected. In Aim 2, we will develop and evaluate intervention components to facilitate effective upward communications about CRC prevention and screening using n=9 focus groups. We will iterate and modify intervention components based on focus group feedback. The results from Aims 1 and 2 will guide the refinement of intervention content and design. The impact of the novel intervention will be assessed via a single- arm, pre-test post-test trial design (n=15 adult child/parent dyads) in Aim 3. Tapping into and leveraging family members may be a particularly salient channel for culturally appropriate cancer communications in rural populations and may help address the unmet needs of CRC hotspot residents. Collectively, the proposed research will produce an upward communications intervention that has the potential to improve CRC health literacy and screening uptake in rural settings.