STANDARD VS. INDIVIDUALIZED INTERVENTION FOR MAMMOGRAPHY

本提案描述了一项关于筛查主题的干预研究 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 一个大型HMO的部门 项目总工期为四年。 的 该项目的具体目标是： (1)探讨对女性患者的干预程度， 提高了乳腺X线摄影的比率， 仅初级保健提供者; (2)比较两种患者导向干预的效果 战略布局 一种干预措施是该组所有妇女的标准; 另一种将根据妇女目前的乳房X光检查阶段进行个性化治疗。 采用，并将由行为的跨理论模型指导 改变; (3)确定妇女和初级保健干预措施的哪些组成部分 供应商报告对于提示接收 乳房X光检查，以及如何影响持续或减少后， 干预被撤回。 调查将针对全方位的乳房X光检查情况， 包括：还没有生育的妇女（从预先考虑和 思考转化为行动）;第一次做乳房X光检查的妇女， 他们现在需要开始一个有规律的时间表（从行动转移到 维护）;目前在NCI/ACS计划中并且需要 维持一个定期的时间表（留在维修）;并帮助妇女， 计划外，应该开始再次进行乳房X光检查（“回收”） 从预先考虑和考虑到行动）。 采用随机三组设计：仅提供者干预， 提供者+标准患者干预和提供者+个性化 患者干预。 每个小组将招募480名妇女， 基线。 检验的第一个假设是，提供者+患者 干预措施将提高乳房X光检查的筛查率 与仅提供者条件相比。 第二个假设是， 提供者+个性化的效果会更好 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，并由其以较低的费用使用 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for prompting the receipt of mammography, and how the influence persists or lessens after the interventions are withdrawn.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.