Colorectal Cancer Screening Patient Navigation for African Americans

描述(申请人提供)：与非西班牙裔白人相比，非洲裔美国人患结直肠癌的发病率和死亡率更高。为了缩小这一差距，需要采取干预措施，提高这一人群的结直肠癌筛查率。定期筛查可以降低结直肠癌的发病率和死亡率，并提供早期发现和预防的可能性。这项研究的主要建议是开发和测试基于同伴的导航器干预的可行性，以提高非裔美国人的结直肠癌筛查率，涉及到一种免费的筛查计划。从筛查计划收集的初步数据显示，在被转介到该计划的非裔美国人中，82%未能完成结直肠癌筛查。这项研究的第一个目的是为参加这项免费筛查计划的参与者确定结直肠癌筛查的决定因素。将进行半结构化访谈和焦点小组，以确定影响是否参与结直肠癌筛查的决定因素。定性研究将在PEN-3框架的指导下进行，并将探索文化背景及其与结直肠癌筛查的关系。这项研究的第二个目的是开发和试点测试一种基于同伴的导航员干预措施，以提高筛查率。定性研究的结果将有助于开发基于同伴的导航员干预。为了测试干预的效果，200名符合免费项目资格要求的非裔美国男性和女性将被随机分配到对照(标准护理)和基于同伴的导航员条件中。那些处于干预状态的人将得到一名基于同伴的导航员，他将提供社会支持，并帮助参与者克服潜在的障碍。结果评估将基于最初基线调查后3个月进行的后续电话调查以及自我报告的结肠镜筛查的付款记录核实。到这个项目完成时，我们将测试基于同行的导航器干预的可行性，并收集数据以计划一项更大规模的干预试验，以增加对非裔美国人的结直肠癌筛查。

DESCRIPTION (provided by applicant): African Americans experience higher incidence and greater mortality from colorectal cancer in comparison to non-Hispanic whites. To reduce this disparity, interventions are needed that will increase rates of colorectal cancer screening by this population. Regular screening can reduce both morbidity and mortality from colorectal cancer and offers the possibility of early detection and prevention. The primary propose of this study is to develop and test the feasibility of a peer-based navigator intervention for increasing colorectal cancer screening rates for African Americans referred to a no-cost screening program. Initial data collected from the screening program show that 82% of African Americans who were referred to the program failed to complete colorectal cancer screening. The first aim of this study is to identify determinants of colorectal cancer screening for participants referred to this no-cost screening program. Semi-structured interviews and focus groups will be conducted to identify determinants that influence the decision to, or failure to, participate in colorectal cancer screening. Qualitative research will be guided by the PEN-3 framework and will explore cultural context and its relationship to colorectal cancer screening. The second aim of this study is to develop and pilot test a peer-based navigator intervention to increase screening rates. Findings from the qualitative studies will help inform the development of a peer-based navigator intervention. To test the efficacy of the intervention, two hundred African American men and women meeting the eligibility requirements of the no- cost program will be randomly assigned to the control (standard care) and peer-based navigator conditions. Those in the intervention condition will receive a peer-based navigator who will provide social support and assist participants in overcoming potential barriers. Outcome evaluation will be based on a follow-up telephone survey conducted 3-months after the initial baseline survey as well as payment record verification of self-reported colonoscopy screening. By the completion of this project, we will have tested the feasibility of a peer-based navigator intervention and collected data to plan a larger intervention trial to increase colorectal cancer screening among African Americans.