Preparing to Advance Colorectal Screening in Springfield

描述：结直肠癌（CRC）是第二大原因， 与癌症有关的死亡和第三个最常见的诊断癌症的两名男子 和美国的女性。1973-1995年期间， 美国男性和女性的这一比例有所增加，并超过了白人。非洲 美国男性的发病率最高。此外，尽管《儿童权利公约》 总人口死亡率下降了21%， 在65岁及以上的非洲裔美国男性中增加了26%， 16%的非洲裔美国男性不到65岁。非洲裔美国妇女 比任何其他种族/族裔群体的妇女更有可能死于CRC。 非裔美国人更有可能在晚期被诊断出来 比白人。1989年至1994年的五年生存率为64%， 白人和52%的非洲裔美国人。已知CRC筛查是 通过早期发现和通过去除癌前病变预防， 息肉，但未充分利用。 我们提出了一个形成性的可行性研究，将作为一个基础， 随后的随机试验测试创新策略的有效性 在社区卫生中心（CHC），以提高CRC筛查的参与， 非裔美国人在第一部分中，我们将描述临床和 参与机构现有的管理信息系统 社区健康中心和其他适当的场所（例如，内镜 评估干预计划、实施和 评价第二部分将探讨可行性和潜力 各种干预战略的有效性以及优先信息 在适合这一人群的策略中。需求 评估方法将包括病人和社区的焦点小组 成员，对保健中心提供者和工作人员中的关键知情人进行访谈 和胃肠病学家，审查医疗记录和试点病人调查。 收集的数据还将为抽样和应计预测提供信息， 为后续试验开发仪器。 本R2 1的产品包括a）一份关于以下因素的已发表报告： 非裔美国人中的CRC筛查; B）背景的系统分析， 护理过程; c）预先测试的工具和d）详细的建议 在随机试验中测试干预措施。

DESCRIPTION: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths and the third most commonly diagnosed cancer for both men and women in the United States. During 1973-1995, the incidence among African American men and women has increased and exceeds the rate among whites. African American men have the highest incidence rates. Furthermore, although the CRC mortality rate decreased 21 percent among the general population, mortality increased 26 percent among African American males aged 65 years and older, and 16 percent among African American males less than 65. African American women are more likely to die of CRC than are women of any other racial/ethnic group. African Americans are significantly more likely to be diagnosed at late-stage than Whites. Five-year survival rates for the period 1989-94 were 64 percent in whites and 52 percent in African Americans. CRC screening is known to be effective both by early detection and for prevention by removal of precancerous polyps but is underused. We propose a formative feasibility study that will serve as a basis for a subsequent randomized trial testing the effectiveness of innovative strategies in community health centers (CHCs) to improve CRC screening participation by African Americans. In the first component, we will profile the clinical and management information system(s) currently in place in the participating community health centers and other sites as appropriate (e.g., endoscopy clinics) to estimate capability for intervention planning, delivery and evaluation. The second component will explore the feasibility and the potential effectiveness of various intervention strategies, as well as priority messages within the strategies, which are appropriate for this population. The needs assessment approaches will include focus groups of patients and community members, interviews of key informants among health center providers and staff and gastroenterologists, review of medical records and pilot patient surveys. Data collected will also inform the sampling and accrual projections and instrument development of for the subsequent trial. The products of this R2 1 include a) a published report on factors related to CRC screening in African Americans; b) a systems analysis of the context and processes of care; c) pre-tested instruments and d) detailed recommendations for the interventions to be tested in a randomized trial.