Supplement to Tailored Interactive CRCS Intervention

描述（由申请人提供）：本补充旨在通过探索参与目前资助的旨在增加结直肠癌筛查的干预试验的更多中间结果来填补父母资助的空白，因为它们特别与医患沟通有关。补充研究将与父母研究同时进行，补充研究的参与者被随机分配到与父母资助相同的互动干预、通用信息或标准护理控制条件。与父母补助的参与者类似，补充研究的参与者将完成基线和六个月的随访电话调查，并允许检查他们的医疗图表以验证CRCS。补充研究将包括额外的预约前和预约后定量评估，健康访问期间医患互动的录音，以及访问后对患者的定性访谈。通过使用观察性和定性研究方法，该补充将利用并增加家长补助金，以提供有关患者与提供者讨论CRCS（或缺乏CRCS）的内容和过程的详细信息。更好地了解针对癌症筛查行为的干预措施的更多中间结果，如患者-医生CRCS讨论及其对患者CRCS决策的影响，将为父母资助的具体目标3提供有关CRCS干预效果评估的信息，并指导未来的干预设计。此外，将现有的创新（如录音医患互动）应用于癌症筛查等新的研究领域，将填补癌症预防研究的空白。

DESCRIPTION (provided by applicant): This supplement seeks to fill a gap in the parent grant by exploring the more intermediate outcomes of participating in the currently funded intervention trial designed to increase colorectal cancer screening, as they specifically relate to doctor-patient communication. The supplemental study will be conducted in parallel to the parent study, with participants in the supplement being randomized to the same interactive intervention, generic information or standard care control conditions as those in the parent grant. Similar to participants in the parent grant, participants in the supplemental study will complete baseline and six month follow-up phone surveys and allow for their medical chart to be examined for verification of CRCS. The supplemental study will involve additional pre- and post-appointment quantitative assessments, an audio-recording of the doctor-patient interaction during a wellness visit, and a post-visit qualitative interview with patients. The supplement will capitalize on and augment the parent grant by using observational and qualitative research methods to provide detailed information about the content and process of patient-provider discussions of CRCS (or lack thereof). Better understanding of the more intermediate outcomes of interventions targeting cancer screening behaviors, such as patient-physician CRCS discussions and their effects on patients' CRCS decision making, will inform Specific Aim 3 from the parent grant concerning evaluation of intervention effects on CRCS, as well as direct future intervention design. Additionally, the application of existing innovations, such as audio-recorded doctor-patient interactions, to new areas of inquiry, such as cancer screening, will fill gaps in cancer prevention research.