Tailored Interactive Multimedia to Reduce Colorectal CA Screening Disparities

定制交互式多媒体以减少结直肠 CA 筛查差异

• 批准号: 7911260
• 负责人: ANTHONY FRANCIS JERANT
• 金额: $ 52.9万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7911260
• 关键词: Address; Behavior; Caring; Clinical; Cognitive; Colonoscopy; Colorectal; Colorectal Cancer; Communities; Computers; Control Groups; Electronics; English Language; Ethnic Origin; Failure; Fecal occult blood; Flexible fiberoptic sigmoidoscopy; Health; Health behavior; Health behavior change; Hispanics; Home environment; Individual; Internet; Intervention; Knowledge; Language; Mediating; Mediator of activation protein; Methods; Not Hispanic or Latino; Office Visits; Outcome; Patient Preferences; Patients; Performance; Physicians' Offices; Primary Health Care; Printing; Process; Randomized Controlled Trials; Readiness; Relative (related person); Schedule; Screening for cancer; Screening procedure; Self Efficacy; Staging; Testing; Training; Visit; Work; base; colorectal cancer screening; computer program; improved; interactive multimedia; laptop; preference; primary outcome; trend; uptake

Background: Interactive multimedia computer programs (IMCPs) show promise as a way of delivering personally tailored (PT) information to enhance cognitive mediators of health behavior and improve patient outcomes. However, it is unclear whether PT IMCPs can be deployed in primary care offices to increase cancer screening uptake and eliminate ethnic disparities in uptake by providing PT information in each user's preferred language. Aims/Hypotheses: We will compare changes in CRC screening cognitive mediators (self- efficacy, perceived barriers, and readiness) and uptake resulting from an IMCP  PT to enhance the key cognitive mediators and targeted to patients' self-identified ethnicity - with changes resulting from a non- tailored "electronic leaflet" control IMCP. The experimental and control IMCPs will each be offered in English and Spanish versions. We hypothesize that, compared with the appropriate control condition (English, Spanish, or both combined): (1) the English version of the PT IMCP will enhance the cognitive mediators of CRC screening behavior for English-speaking Hispanics and non-Hispanics; (2) there will be similarly favorable changes in these mediators for Hispanics using the Spanish version of the PT IMCP; (3) deployment of the PT IMCP will provide evidence of elimination of disparities in CRC screening between Hispanic and non-Hispanic subjects via its relative impact on the cognitive mediators in these groups; and (4) the PT IMCP (English and Spanish combined) will increase CRC screening uptake in Hispanics and non-Hispanics (considered separately) via changes in the cognitive mediators. Methods: Randomized controlled trial of 2 groups, comparing a PT (to the cognitive mediators) CRC screening IMCP offered in both English and Spanish versions and deployed before a primary care office visit with a non-tailored "electronic leaflet" CRC screening IMCP (control) also offered in both English and Spanish. Screening methods targeted will be fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. Primary outcomes will be CRC screening uptake, self- efficacy, perceived barriers, and readiness. Implications: Our findings will determine whether an IMCP that is PT to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo CRC screening. They may also suggest a promising, portable method of reducing disparities in CRC (and other) screening uptake between Hispanic and non-Hispanic individuals. Project Narrative: Our findings will determine whether an interactive multimedia computer program that is personally-tailored to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo colorectal cancer screening. They may also suggest a promising, portable method of reducing disparities in colorectal cancer (and other) screening uptake between Hispanic and non-Hispanic individuals.

背景：交互式多媒体计算机程序 (IMCP) 作为一种交付方式展现出前景 个人定制 (PT) 信息，以增强健康行为的认知调节因素并改善患者的健康状况 结果。然而，尚不清楚 PT IMCP 是否可以部署在初级保健办公室以增加 通过在每个用户的信息中提供 PT 信息，提高癌症筛查的采用率并消除采用率的种族差异 首选语言。目标/假设：我们将比较 CRC 筛查认知中介变量（自我认知）的变化 IMCP PT 的效果、感知障碍和准备情况）和吸收，以增强关键 认知调节因素并针对患者的自我认同种族 - 其变化源于非 量身定制“电子传单”控制IMCP。实验 IMCP 和对照 IMCP 均以英语提供 和西班牙语版本。我们假设，与适当的控制条件（英语， 西班牙语，或两者结合）：（1）英语版的 PT IMCP 将增强认知中介 讲英语的西班牙裔和非西班牙裔的 CRC 筛查行为； (2) 将会有类似的优惠 使用西班牙语版本的 PT IMCP 对西班牙裔调解员进行了更改； (3) PT的部署 IMCP 将提供消除西班牙裔和非西班牙裔之间 CRC 筛查差异的证据 受试者通过其对这些群体中认知中介的相对影响； (4) PT IMCP（英语和 西班牙语合并）将增加西班牙裔和非西班牙裔的 CRC 筛查率（考虑 分别）通过认知中介的变化。方法：2组随机对照试验， 比较 PT（与认知中介）CRC 筛查 IMCP 以英语和西班牙语提供 版本并在初级保健办公室就诊之前使用非定制的“电子传单”CRC 筛查进行部署 IMCP（控制）还提供英语和西班牙语版本。筛查方法有针对性的是粪便潜血 测试、可屈性乙状结肠镜检查和结肠镜检查。主要结果将是结直肠癌筛查率、自我筛查率 功效、感知障碍和准备情况。启示：我们的研究结果将决定 IMCP 是否是 PT 是筛查行为的认知中介，并在之前部署在初级保健办公室 定期就诊可以激励不同种族的患者接受结直肠癌筛查。他们也可能会建议 一种有前景、可移植的方法，可减少西班牙裔之间 CRC（和其他）筛查的差异 和非西班牙裔个人。项目叙述：我们的研究结果将决定交互式多媒体计算机程序是否是 为筛查行为的认知中介量身定制，并在筛查之前部署在初级保健办公室 预先安排的就诊可以激励不同种族的患者接受结直肠癌筛查。 他们还可能提出一种有前途的、便携式的方法来减少结直肠癌（和其他癌症）的差异 筛选西班牙裔和非西班牙裔个人的吸收情况。