REDUCING BARRIERS TO THE USE OF COLON CANCER SCREENING

纽约州立大学石溪分校(SUNYSB)提交的这项拟议研究的长期目标是提高50岁及以上女性和男性的结直肠癌筛查(CRC)率。这项研究的具体目的是测试有针对性的电话咨询(TTC)和个性化继续医学教育在增加研究对象男女结直肠癌筛查方面的有效性。还将评估这些干预措施的成本效益。SUNYSB项目将以50-75岁的社区妇女和男子为对象，他们是通过人口抽样电话调查确定的。女性和男性的样本将从长岛的五个研究社区中抽取。个性化继续医学教育(CME)干预将仅限于研究人群中男女的初级保健医生。SUNYSB项目将测试有针对性的电话咨询(TTC)，目的是针对个人准备采用CRC筛查的阶段以及他们利用筛查的障碍。针对他们的医生的个性化继续医学教育干预将包括邮寄材料、电话和办公室干预。办公室干预旨在改善办公室系统、医生沟通和行为咨询的使用，并培养办公室工作人员在FOBT说明、阅读和跟踪方面的技能。这些主要组成部分的附件还将解决CRC风险沟通问题，并在FOBT呈阳性后完成诊断评估。这项研究涉及析因设计，以测试TTC和CME在单独应用和联合应用时对增加CRC使用的相对效果。在每个有正规医生的研究城镇中，女性和男性将被随机分配到TTC或对照条件下，并根据他们是否居住在CME干预VS对照县而被分配到CME干预或对照组。干预前和干预后的电话调查将评估妇女和男子关于CRC筛查的知识、信念和做法的变化。还将对医生进行干预前和干预后的调查以及图表审计，以评估与结直肠癌筛查相关的医生知识、信念和做法的变化。本研究聚焦于如何激励人们参与结直肠癌筛查这一重要问题。

The long-term objective of the proposed research submitted by the State University of New York at Stony Brook (SUNYSB) is to increase the rates of colorectal cancer screening (CRC) among women and men aged 50 and older. The specific aims of the research are to test the effectiveness of Targeted Telephone Counseling (TTC) and individualized Continuing Medical Education in increasing CRC screening among study women and men. The cost- effectiveness of these interventions will also be assessed. The SUNYSB project will target community women and men aged 50-75 who are identified through population sample telephone surveys. The samples of women and men will be drawn from five study communities on Long Island. The individualized Continuing Medical Education (CME) intervention will be limited to the primary care physicians of women and men in the study population. The SUNYSB project will test Targeted Telephone Counseling (TTC) aimed at the individual's stage of readiness to adopt CRC screening and barriers to their utilization of screening. The individualized CME intervention aimed at their physicians will involve mailed materials, telephone and in-office interventions. The in-office intervention is designed to improve the use of office systems, physician communication and behavioral counseling, and to develop skills of office staff in FOBT instructions, readings and tracking. Adjuncts to these major components will also address CRC risk communication and complete diagnostic evaluation following a positive FOBT. The research involves a factorial design to test the relative effects of TTC and of CME when applied alone and in combination on increasing CRC use. Women and men in each study town with regular physicians will be randomized to the TTC or control condition, and assigned to a CME intervention or control group by virtue of whether or not they reside in a CME intervention vs control County. Pre-and post-intervention telephone surveys will assess changes in women's and men's knowledge, beliefs and practices relating to CRC screening. Pre-and post-intervention surveys of physicians and chart audits will also be conducted to evaluate changes in physician knowledge, beliefs and practices related to CRC screening. The research focuses on the important question of how to motivate participation in CRC screening.