Tailored Navigation in CRC Screening

描述（由申请人提供）：拟议的项目代表了一个令人兴奋的机会，让老年城市非洲裔美国人参与增加CRC筛查方法的比较有效性研究。非裔美国人参与者仅占母研究参与者的25%左右。因此，我们将无法确定不同干预方法对这一高危人群的影响。确定如何在非裔美国人中增加CRC筛查将有助于减少疾病发病率和死亡率的差异。在这项竞争性修订中，研究的患者人群将来自费城的爱因斯坦卫生系统初级保健实践，主要服务于非洲裔美国人患者人群。使用两组随机设计，我们将完成基线电话调查的知情同意参与者（N=472）随机分配到标准干预（SI）组（N=236）或增强型定制导航干预（E-TNI）组（N=236）。圣莱科特国际集团的参与者将收到鼓励CRC筛查的一般邮寄干预措施。E-TNI集团的参与者将收到一封针对非裔美国人的文化干预邮件，电话联系和电子通信，旨在鼓励CRC筛查。本研究的具体目的（按优先顺序）是确定（1）E-TNI对CRC筛查利用的影响，（2）E-TNI对CRC筛查偏好的影响，以及（3）E-TNI对CRC筛查认知的影响。我们假设，E-TNI组将有显着更高的CRC筛查使用，增加对CRC筛查的偏好，以及对CRC筛查的更有利的看法比SI组。从终点调查和终点图表稽查中获得的数据将用于评估研究组差异。 公共卫生相关性：拟议的竞争性修订代表了一个令人兴奋的机会，让老年城市非洲裔美国人参与增加CRC筛查方法的比较有效性研究。确定如何在非裔美国人中增加CRC筛查将有助于减少疾病发病率和死亡率的差异。

DESCRIPTION (provided by applicant): The proposed project represents an exciting opportunity to engage older urban African Americans in a comparative effectiveness study of methods to increase CRC screening. African American participants represent only about 25% of study participants in the parent study. As a result, we will not be able to determine the impact of different intervention methods in this high-risk group. Determining how to increase CRC screening among African Americans will help to reduce disparities in disease incidence and mortality. In this competitive revision, the patient population for the study will be drawn from Einstein Health System primary care practices in Philadelphia that serve a predominantly African American patient population. Using a two-group randomized design, we will randomly assign consenting participants who complete a baseline telephone survey (N=472) to either a Standard Intervention (SI) Group (N=236) or an Enhanced Tailored Navigation Intervention (E-TNI) Group (N=236). SI Group participants will receive a generic mailed intervention that encourages CRC screening. E-TNI Group participants will receive a mailed intervention that is culturally-targeted to African Americans, telephone contacts, and electronic communications intended to encourage CRC screening. Specific aims of the study, in order of priority, are to determine (1) E-TNI impact on CRC screening utilization, (2) E-TNI impact on CRC screening preference, and (3) E-TNI impact on perceptions about CRC screening. We hypothesize that the E-TNI Group will have significantly higher CRC screening use, increased preference for CRC screening, and more favorable perceptions about CRC screening than the SI Group. Data obtained from an endpoint survey and an endpoint chart audit will be used to assess study group differences. PUBLIC HEALTH RELEVANCE: The proposed competitive revision represents an exciting opportunity to engage older urban African Americans in a comparative effectiveness study of methods to increase CRC screening. Determining how to increase CRC screening among African Americans will help to reduce disparities in disease incidence and mortality.