STANDARD & INDIVIDUALIZED INTERVENTION FOR MAMMOGRAPHY

本提案描述了一项关于筛查主题的干预性研究 乳房X光检查。目标群体是40-74岁的妇女和初级保健 来自家庭诊所、妇产科和内科的提供者 一家大型医疗保健组织的部门。项目总工期为四年。这个 该项目的具体目标是： (1)调查对女性患者的干预程度 提高使用时观察到的乳房X光检查的速度 仅初级保健提供者； (2)比较两种患者指导性干预的效果 战略。一种干预是该小组中所有女性的标准干预； 其他人将根据妇女目前的乳房X光检查阶段进行个性化检查 采用，并将以跨理论行为模式为指导 改变； (3)确定干预妇女和初级保健的哪些组成部分 供应商报告是提示收到的最重要的 乳房X光检查，以及这种影响在治疗后如何持续或减弱 干预措施被撤回。 调查将针对全面的乳房X光检查情况， 包括：还没有生育的妇女(从预想和 将思考转化为行动)；接受了第一次乳房X光检查的妇女，以及 谁现在需要开始定期计划(从操作移动到 维护)；目前在NCI/ACS计划中并需要 保持有规律的时间表(维持维护期)；以及，帮助那些 不在计划之内，应该重新开始做乳房X光检查(“回收” 从预想和沉思回到行动)。 采用了随机的三组设计：仅提供者干预， 提供商+标准患者干预，提供商+个性化 病人干预。每组将有480名女性在 基线。检验的第一个假设是提供者+患者 干预措施将导致筛查乳房X光检查的比率提高 与仅提供程序的情况相比。第二个假设是 对提供者+个性化会有更大的影响 干预条件，与提供者+标准干预相比 条件。预计本项目中使用的干预措施 可以传播给其他群体，并以相对较低的成本由其他群体使用 练习设置。

This proposal describes an intervention study on the topic of screening mammography. The target groups are women aged 40-74 and primary care providers from the Family Practice, OB/GYN, and Internal Medicine departments of a large HMO. The total project period is four years. The specific aims of the project are: (1) To investigate the degree to which intervening with women patients augments the rates of mammography that are observed when working with primary care providers only; (2) To compare the effects of two patient-directed intervention strategies. One intervention is standard for all women in the group; the other will be individualized to the woman's current stage of mammography adoption, and will be guided by the Transtheoretical Model of behavior change; (3) To identify which components of intervention women and primary care providers report are most important for prompting the receipt of mammography, and how the influence persists or lessens after the interventions are withdrawn. The investigation will target a full range of mammography situations, including: women who have not yet had one (move from Precontemplation and Contemplation into Action); women who have had their first mammogram, and who now need to start a regular schedule (move from Action to Maintenance); women who are currently on the NCI/ACS schedule and need to sustain a regular schedule (stay in Maintenance); and, to help women who are off-schedule and should begin having mammograms again ("recycling" back from Precontemplation and Contemplation to Action). A randomized, three-group design is employed: Provider Intervention Only, Provider + Standard Patient Intervention, and Provider + Individualized Patient Intervention. Each group will have 480 women recruited at baseline. The first hypothesis tested is that both Provider + Patient interventions will result in an increased rate of screening mammography compared to the Provider Only condition. The second hypothesis is that there will be a greater effect for The Provider + Individualized intervention condition, compared to the Provider + Standard intervention condition. It is expected that the interventions used in this project could be disseminated to, and used at relatively low cost by, other group practice settings.