Tailored Interactive Multimedia to Reduce Colorectal CA Screening Disparities

背景：交互式多媒体计算机程序(IMCP)作为一种交付方式显示出希望 个人定制(PT)信息，以增强健康行为的认知中介并改善患者 结果。然而，目前尚不清楚初级保健办公室是否可以部署PT IMCP以增加 癌症筛查摄取和消除种族差异摄取通过提供每个用户的PT信息 首选语言。目标/假设：我们将比较结直肠癌筛查认知介体的变化(自我 效率、感知障碍和就绪性)和采用IMCP PT，以增强关键 认知介体和针对患者自我认同的种族-变化导致的非 量身定做的“电子传单”控制IMCP。实验和对照IMCP将分别以英语提供 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，或两者兼而有之)：(1)英文版PT IMCP将增强以下认知调节因素 对讲英语的拉美裔和非拉美裔的CRC筛查行为；(2)将有类似的优惠 使用西班牙文版PT IMCP的西班牙裔调解人的变化；(3)PT的部署 IMCP将提供证据，证明西班牙裔和非西班牙裔在结直肠癌筛查中消除了差异 受试者通过其对这些群体中的认知中介的相对影响；以及(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(考虑)的结直肠癌筛查接受率 另外)通过认知介体的变化。方法：2组随机对照试验， 英语和西班牙语提供的PT(与认知介体)CRC筛查IMCP的比较 版本，并在初级保健办公室就诊前部署，使用非定制的电子小册子进行结直肠癌筛查 IMCP(控制)还提供英语和西班牙语两种版本。筛查方法将针对粪便潜血 检查、柔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吸收，自我 有效性、感知障碍和就绪性。含义：我们的发现将决定IMCP是否是 PT到筛查行为的认知介体，并在之前部署在初级保健办公室 定期就诊可以激活不同种族的患者接受结直肠癌筛查。他们还可能建议 一种前景看好的便携式方法，可以减少西班牙裔之间结直肠癌(和其他)筛查的差异 和非西班牙裔个人。项目描述：我们的发现将决定一个交互式多媒体计算机程序是否 亲自为筛查行为的认知调解人量身定做，并在初级保健办公室之前部署 先前安排的就诊可以激活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希望的、便携的方法来减少结直肠癌(和其他疾病)的差异。 在西班牙裔和非西班牙裔个体之间进行筛查。

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.