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Comparative Effectiveness of Interventions to Improve Screening Among Rural Women

改善农村妇女筛查干预措施的比较有效性

基本信息

批准号：
9310329
负责人：
Victoria Lee Champion
金额：
$ 63.39万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-08-13 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9310329
关键词：
Address Adherence Age Appalachian Region Area Behavior Behavioral Risk Factor Surveillance System Breast Cancer Burden Cancer Intervention Cervical Classification Colonoscopy Colorectal Colorectal Cancer Communities County Depressed mood Diagnosis Effectiveness Effectiveness of Interventions Environment Fecal occult blood Female Goals Guideline Adherence Guidelines Health Health behavior Health behavior change Indiana Individual Intervention Malignant Neoplasms Malignant neoplasm of cervix uteri Mammography Maps Medical Records Modeling Ohio Outcome Pap smear Patients Population Group Prevalence Preventive Randomized Research Resources Rural Rural Population Screening for cancer Site Source Surveys Telephone Testing Underserved Population United States Woman Work base behavior test cancer health disparity colorectal cancer screening comparative comparative effectiveness compare effectiveness computer program cost effective cost effectiveness experience group intervention health disparity improved innovation malignant breast neoplasm mortality older women public health relevance rural counties rural underserved screening social socioeconomics theories treatment as usual

项目摘要

DESCRIPTION (provided by applicant): In 2014 approximately 310,030 women in the United States (U.S.) will be diagnosed with breast cancer (BC), cervical cancer (CC), or colorectal cancer (CRC), and 68,060 women will die from these cancers. These three cancers account for 39% of the cancer burden and 25% of the cancer mortality among women in the U.S. Although effective screening tests are widely available for all three cancers, many women do not adhere to screening guidelines. Furthermore, the burden of these cancers is higher among some population groups and regions. Thirty-two rural counties in northwest Ohio and northeast Indiana share similar socioeconomically underserved populations of predominately (96.2%) white women who have elevated BC, CRC, and CC mortality rates, and lower screening rates with mammography, Pap tests, and fecal occult blood testing or colonoscopy. No known intervention has addressed improving screening rates for these three main female cancers simultaneously, even though multiple health behavior change research is emerging as a new model to change the way in which interventions can be packaged. The proposed project uses an overall theoretical framework to understand health disparities which includes individual, social and community level variables, and a conceptual model for the intervention which uses a multiple behavior theoretical approach, all of which have demonstrated efficacy in improving adherence to single screening test behaviors, as well as other preventive health behaviors. The goal of this proposal is to test the comparative effectiveness of a tailored interactive computer program delivered via DVD (TIDVD) vs. a TIDVD + telephone-based patient navigation (PN) intervention (TNI) vs. Usual Care (UC) to increase guideline-based screening rates for BC, CC, and CRC among women age 50 to 74 living in these rural counties of Ohio and Indiana. Specific aims are to: 1) compare the effectiveness of a tailored and interactive DVD (TIDVD) vs. TIDVD + telephone-based PN intervention (TNI) vs. UC, to increase guideline-based cancer screening rates at 12 months post randomization for BC, CC, and CRC among 1058 women age 50 to 74 living in rural northwest Ohio and northeast Indiana; and 2) compare the cost effectiveness of the TIDVD and the TIDVD + TNI intervention vs. UC, for adherence to each screening outcome or combination of screening tests. As an Exploratory Aim, we will identify associations between theoretical variables (community, social, and individual) and screening outcomes, including interactions with the interventions. If found to be cost effective, either or both interventions hae the potential to be immediately disseminated to increase BC, CC, and CRC screening rates and ultimately reduce cancer disparities for underserved rural women.