Research Project

项目摘要：CRC的不成比例的负担仍然存在于种族-少数民族和其他医疗服务不足的人群中，尽管有益的筛查测试的可用性增加。为了解决这一差距，我们提出了一个创新的理论为基础的教育干预，在联邦合格的卫生中心和卫生部门诊所提供，以提高患者对结肠直肠癌筛查（CRCS）的认识，促进患者提供者对CRCS的讨论，并增加平均风险中CRCS的摄取。 个体我们建立在我们建立的社区-学术伙伴关系和社区参与式研究框架的基础上，作为一个两阶段项目的基础，该项目名为“结直肠癌意识，研究，教育和筛查”（CARES）。第1阶段（第1年）的目的是设计和制作一个CARES工具包，包括DVD和photonovella小册子、筛查准备卡和提醒明信片，用于各种医疗服务不足的人群。共有107人将参加 参与形成性研究，该研究使用卫生知识框架作为开发教育工具包的基础。在第11期（2-5年），前瞻性、纵向、随机、基于社区的干预研究的目的是：评估CARES工具包与标准手册干预（SI）对CRCS摄取的有效性;评估预防性健康模型变量是否介导干预效果;并检查成本效益。在该阶段，将招募共420名年龄在50-75岁之间的男性和女性，并随机分配至CARES条件或SI（每组210名）。作为干预措施的一部分，两组都将接受免费的免疫化学粪便潜血试验（1-FOBT）试剂盒。I-FOBT和总体（任何试验） 将在12个月时评价筛选摄取并在条件之间进行比较。预计CARES干预将与SI条件的更大筛查摄取（FOBT和其他筛查）和成本效益相关。多变量回归分析将用于评估与干预效果相关的因素。

Project Summary: The disproportionate burden of CRC persists among racial-ethnic minorities and other medically underserved populations despite increased availability of beneficial screening tests. To address this gap, we propose an innovative theory-based educational intervention delivered in federally qualified health centers and health department clinics to improve patient awareness about colorectal cancer screening (CRCS), facilitate patient-provider discussion of CRCS, and increase uptake of CRCS among average risk individuals. We build on our established community-academic partnerships and the community-based participatory research framework as the foundation for a two-phase project entitled "Colorectal Cancer Awareness, Research, Education and Screening" (CARES). The aim of Phase 1 (year 1) is to design and produce a CARES toolkit consisting of a DVD and photonovella booklet, screening readiness card, and reminder postcard intended for a diverse medically underserved population. A total of 107 individuals will take part in the formative research, which uses a health literacy framework as a basis for developing the educational tool kit. In Phase 11 (Years 2-5), the aims ofthe prospective, longitudinal, randomized communitybased intervention study are to: assess efficacy of CARES tool kit vs. a standard brochure intervention (SI) on CRCS uptake; assess whether Preventive Health Model variables mediate intervention effects; and examine cost-effectiveness. In this phase, a total of 420 men and women aged 50-75 years, will be recruited and randomized to either the CARES condition or SI (210 in each arm). Both groups will receive free immunochemical fecal occult blood test (1-FOBT) kits as part of the intervention. I-FOBT and overall (any test) screening uptake will be evaluated at 12 months and compared between conditions. It is expected that the CARES intervention will be associated with greater screening uptake (FOBT and other screening) and cost effectiveness that the SI condition. Multivariable regression analysis will be used to assess factors associated with intervention effects.