Tailored Navigation in CRC Screening

描述(由申请者提供)：我们建议进行一项为期4年的研究，研究对象是特拉华州克里斯蒂安娜保健保健系统(CCHS)的6个社区初级保健实践。CRC筛查在实践中的使用是有限的，就像在美国其他地方一样。研究小组将确定实践中有资格进行CRC筛查的个人，并将同意完成基线调查的参与者随机分配到3个研究组中的一个：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组参与者将收到标准干预(普通邮寄的CRC筛查试剂盒)和邮寄的提醒。TNI组参与者将收到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)和邮寄提醒。提供给TNI小组的结直肠癌筛查工具包将反映参与者首选的结直肠癌筛查战略。“导航”指的是引导TNI组参与者进行测试的过程。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，与SI组和对照组相比，TNI组的结直肠癌筛查使用率明显更高，对结直肠癌筛查的偏好更高，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组的差异。最后，将进行分析，以确定与CRC筛查利用相关的干预成本效益。

DESCRIPTION (provided by applicant): We propose to conduct a 4-year study with 6 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 1 of 3 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 guiding the 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.