Prompting and Reminding at Encounters for Prevention

描述（由申请人提供） 预防相遇时的提醒和提醒（PREP）项目旨在评估为结直肠癌筛查提供提醒的特定方法的实施情况。它将研究在属于密歇根五大湖研究实践网络的12个社区实践中实施一个计算机化的提醒系统ClinfoTracker。该系统已开发并使用到目前为止，在密歇根大学附属社区的做法。我们建议在12个全州范围内的社区实践中评估其实施情况，这些社区实践具有不同的基础设施。 在一系列的评估中，我们将评估49个已经确定的，感兴趣的网络实践的能力，以实施结直肠癌筛查提醒系统，选择12个实践的实际实施。实施后，这些实践将随机分配到3种提醒模式之一：临床医生目标提醒、患者目标提醒以及临床医生和患者目标提醒。实践将在指定模式下使用提醒系统9个月，之后我们将深入评估结直肠癌筛查率以及临床医生，办公室工作人员和患者对提醒系统的态度和看法。在评估后阶段，我们将对提示患者进行基线和干预期图表审查，对临床医生、办公室工作人员和患者进行调查，并详细观察该系统如何融入常规实践。 在完成PREP后，我们将了解如何在各种实践中最好地实施提醒系统，我们将对三种提醒模式（临床医生提醒、患者提醒以及临床医生和患者提醒）中的每一种进行效应量估计。该信息将用于为计算机提醒的群集随机有效性试验提供方法和实践样本量计算信息，该试验具有足够的把握度，以确定提供结直肠癌筛查提醒的最佳模式。

DESCRIPTION (provided by applicant) The Prompting & Reminding at Encounters for Prevention (PREP) project is designed to evaluate the implementation of a specific method of delivering reminders for colorectal cancer screening. It will study the implementation of a computerized reminder system, ClinfoTracker, in 12 community practices belonging to the Michigan Great Lakes Research Into Practice Network (GRIN). This system has been developed and used to date in a group of University of Michigan affiliated community practices. We propose to evaluate its implementation in 12 statewide community practices with a varied set of infrastructures. In a series of assessments, we will evaluate 49 already identified, interested network practices on their ability to implement the colorectal cancer screening reminder system, selecting 12 practices for actual implementation. Following implementation, these practices will he randomized to one of 3 modes of reminding, clinician targeted reminders, patient targeted reminders, and both clinician and patient targeted reminders. The practices will use the reminder system in the assigned mode for 9 months, following which we will perform an in depth assessment of colorectal cancer screening rates and clinician, office staff and patient attitudes and perceptions regarding the reminder system. During this post-assessment phase we will perform baseline and intervention period chart reviews of prompted patients, conduct surveys of clinicians, office staff and patients, as well as detailed observations of how the system integrates into routine practice. At the completion of PREP we will understand how to best implement the reminder system into a variety of practices, we will have effect size estimates of each of the three reminding modes (clinician reminders, patient reminders and clinician and patient reminders). This information will be used to inform the methods and practice sample size calculations for a cluster-randomized effectiveness trial of computerized reminders with adequate power to determine the best mode of delivering reminders for colorectal cancer screening.