Tailored Navigation in CRC Screening

我们建议进行一项为期四年的研究，其中包括六个以社区为基础的基层医疗机构， 特拉华州的克里斯蒂娜护理卫生系统（CCHS）。CRC筛查在实践中的使用是有限的，因为它是 在美国的其他地方。研究小组将确定符合条件的个人 进行CRC筛查，并将完成基线调查的知情参与者随机分配至 三个研究组：产科护理（对照）组、标准干预（SI）组或定制导航组 干预组。 对照组受试者将接受常规护理。圣莱科特国际集团参与者将接受标准干预 （一个通用的邮寄CRC筛查试剂盒）和邮寄提醒。TNI集团的参与者将获得一个量身定制的 导航干预（基于偏好的邮寄CRC筛查试剂盒和通过电话进行患者导航） 还有一封邮件提醒提供给TNI集团的CRC筛查工具包将反映参与者的 首选CRC筛查策略。“导航”指的是引导TNI集团参与者的过程 测试性能。研究的具体目标是： 确定干预对患者CRC筛查利用的影响。 确定干预对CRC筛查偏好的影响。 确定干预对患者对CRC筛查的知识和看法的影响。 我们假设TNI组将有显著更高的CRC筛查使用率， 对于CRC筛查，比SI组和对照组对CRC筛查更有利。 我们还预计这些结果在SI组中比对照组明显更明显。 从基线调查、终点调查和终点图表稽查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.