CORE--ADHERENCE CORE

结直肠癌仍然是#年癌症死亡的第二大原因。 美国。辅助治疗的最新进展只是 开始影响五年存活率。因此，早些时候 检测，特别是饮食和新的化学预防策略 代表着大幅降低死亡率的最大希望 治疗这种疾病。 坚持临床试验是一个越来越受关注的领域，因为 部分用于进行社区临床试验所涉及的成本。 人们越来越感兴趣的是确定那些可能 影响坚守和服从变化，以及发展 方法提高临床试验依从性。有证据表明 表明坚持长期临床试验是可以实现的。 然而，保持长期变化的复杂性，特别是 应该认识到饮食上的变化。 遵约核心是一种服务资源，它汇集了专业知识和 支持这三个项目的材料。这些临床上的受试者 研究对象年龄在40-80岁之间，有结直肠腺瘤病史 息肉。核心的目标是：1.监督和评估遵守情况 研究程序，2.为护士干预者提供 关于促进参与者遵守的指导方针、咨询和培训 研究协议，3.制定减少壁垒的策略 与临床试验中的依从性问题有关，4.开发和 制作材料(如时事通讯)和执行程序(如 一般遵守干预)，以提高参与者对 学习程序，5.开发、制作和分发各种书面文件 教育参与者有关潜在副作用和 管理他们的方法，6.优化主题招聘战略，以 减少磨损，7.开发工具来识别行为 可能影响/预测磨损和/或粘着的因素，以及8. 教育参与者关于癌症、其病因和预防的知识， 特别强调结肠癌。 核心成果包括促进遵守、评估 一般依从性增强干预措施的有效性 对非粘附者的问题解决补救干预，自然减员 预防干预，并生成有关问题的定性数据 在大型临床试验中参与者的经验，以及方法 来解决这些问题。

Colorectal cancer remains the second leading cause of cancer death in the United States. Recent advances in adjuvant therapy are just beginning to impact the 5-year survival rates. As a result, early detection and especially dietary and novel chemopreventive strategies represent the best hope to significantly decrease the mortality rates for this disease. Adherence to clinical trials is an area of increasing concern due in part to the cost involved in conducting community based clinical trials. There is increasing interest in identifying those factors that may affect adherence and are amenable to change, as well as developing methods to enhance adherence in clinical trials. There is evidence showing that adherence to long term clinical trials is achievable. However, the complexity of maintaining long term changes, particularly dietary changes should be recognized. The Adherence Core is a service resource which pools expertise and materials to support the three projects. Subjects in these clinical studies are 40-80 years old with a history of colorectal adenomatous polyps. The aims of the core are: 1. to monitor and evaluate adherence to study procedures, 2. to provide the nurse interveners with guidelines, consulting and training on promoting participant adherence to study protocols, 3. to develop strategies to reduce barriers associated with adherence problems in clinical trials, 4. to develop and produce materials (e.g. newsletters) and implement procedures (e.g. general adherence intervention) to enhance participant adherence to study procedures, 5. to develop, produce and distribute various written materials educating the participants about potential side effects and ways to manage them, 6. to optimize subject recruitment strategies to reduce attrition, 7. to develop instruments to identify behavioral factors that may influence/predict attrition and/or adherence, and 8. to educate participants about cancer, its etiology and prevention, with particular emphasis on colon cancer. Core outcomes include promotion of adherence, evaluation of the effectiveness of the General Adherence Enhancement intervention, the Problem-Solving remedial intervention for non-adherers, the Attrition Prevention intervention, and generation of qualitative data on problems experienced by participants in large clinical trials, as well as methods to solve them.