Tailored Navigation in CRC Screening

我们建议进行一项为期四年的研究，其中包括六项以社区为基础的初级保健做法，这些做法是 特拉华州的克里斯蒂娜医疗保健系统(CCHS)。CRC筛查在实践中的使用是有限的，因为它 在美国的其他地方。研究小组将确定实践中符合条件的个人 用于CRC筛查，并将随机分配完成基线调查的同意参与者之一 三个研究组：常规护理(对照)组、标准干预(SI)组或定制导航 干预(TNI)组。 对照组参与者将接受常规护理。SI组参与者将接受标准干预 (普通邮寄的CRC筛查试剂盒)和邮寄的提醒。TNI小组参与者将获得量身定做的 导航干预(基于偏好的邮寄CRC筛查试剂盒和电话导航) 还有一份邮寄的提醒。提供给TNI小组的CRC筛查试剂盒将反映参与者的 首选的CRC筛查策略。导航是指对TNI小组参与者进行引导的过程 向测试性能迈进。这项研究的具体目的是： 确定干预对患者结直肠癌筛查利用率的影响。 确定干预对结直肠癌筛查偏好的影响。 确定干预措施对患者对结直肠癌筛查知识和认知的影响。 我们假设TNI组将有显著更高的结直肠癌筛查使用率、更高的偏好 对于结直肠癌筛查，与SI组和对照组相比，对结直肠癌筛查的看法更好。 我们还预计，SI组的这些结果将比对照组明显得多。 从基线调查、终点调查和终点图表审计中获得的数据将用于评估研究 群体差异。最后，将进行分析，以确定与以下方面相关的干预成本效益 CRC筛查利用率。

We propose to conduct a four-year study with six community-based primary care practices that are part of the Christiana Care Health System (CCHS) in Delaware. CRC screening use in the practices is limited,as it is elsewhere in the United States. The research team will identify individuals in the practices who are eligible for CRC screening and will randomly assign consenting participants who complete a baseline survey to one of three study groups: a Usual Care (Control) Group, Standard Intervention (SI)Group, or Tailored Navigation Intervention (TNI) Group. Control Group participants will receive usual care. SI Group participants will receive a standard intervention (a generic mailed CRC screening kit) and a mailed reminder. TNI Group participants will receive a tailored navigation intervention (a preference-based mailed CRC screening kit and patient navigation by telephone) and a mailed reminder. The CRC screening kit provided to the TNI Group will reflect the participant's preferred CRC screening strategy. "Navigation" refers to the process of guidingthe TNI Group participant towards test performance. Specific aims of the study are to: Determine intervention impact on patient CRC screening utilization. Determine intervention impact on CRC screening preference. Determine intervention impact on patient knowledge and perceptions about CRC screening. We hypothesize that the TNI Group will have significantly higher CRC screening use, increased preference for CRC screening, and more favorable perceptions about CRC screening than the SI and Control Groups. We also expect these outcomes to be significantly more pronounced in the SI Group than the Control Group. Data obtained from baseline survey, endpoint survey, and an endpoint chart audit will be used to assess study group differences. Finally, analyses will be performed to determine intervention cost-effectiveness related to CRC screening utilization.