ACCISS: Activating Collaborative CIS Support Services

描述(由申请者提供)：这项研究的长期目标是找到有效的方法来增加通过癌症信息服务(CIS)等现有资源提供的科学准确的癌症信息的使用和影响。使用形成性和实验性的研究方法，这项拟议的工作调查了如何将独联体与PAP测试异常的低收入城市非裔美国人和西班牙裔妇女联系起来。这项研究考察了在使用和转介他们的患者到独联体的过程中，让那些治疗服务不足的人的卫生保健提供者的效用。这项研究还评估了使用CIS服务对患者异常的PAP测试随访以及对提供者-患者关系质量的影响。对两家治疗服务不足的大型社区诊所的患者和提供者进行的初步形成性研究将检查对独联体的熟悉程度和看法，以及致电独联体寻求癌症预防和筛查信息的障碍和促进者。还将就计划纳入随机对照试验(RCT)的材料征求社区反馈。RCT将把大约500名刚刚在两家诊所接受阴道镜检查的妇女随机分为两种情况，涉及提供者的不同信件。普通护理参与者将收到一封普通信函，提醒他们后续预约。干预参与者将收到一封有针对性的信件，提醒他们后续预约，询问他们或他们指定的致电独联体的人，并建议询问问题。具体目的是检查有针对性的医生邮寄是否可以增加对独联体的呼叫，加强适当的医疗随访，并在后续医疗访问中提高对提供者与患者沟通的满意度。这项研究有可能确定一种可行、有效、可持续和对文化敏感的战略，以提高服务不足人口对独联体的认识和使用。癌症的负担主要落在低收入的非洲裔美国人和西班牙裔美国人身上，他们是研究人群。这项研究促使治疗服务不足的提供者将他们的患者与训练有素的癌症信息专家联系起来，这些专家可以通过电话联系到。这项研究考察了对医疗随访和提供者与患者沟通的影响。

DESCRIPTION (provided by applicant): The long-term objectives of this research are to find effective ways to increase the use and impact of scientifically accurate cancer information delivered through existing resources like the Cancer Information Service (CIS). Using formative and experimental research methodologies, the proposed work investigates how to connect the CIS to low-income urban African-American and Hispanic women with abnormal PAP tests. The research examines the utility of engaging health care providers who treat the underserved in using and referring their patients to the CIS. The study also evaluates the impact of accessing CIS services on patients' abnormal PAP test follow-up as well as on the quality of the provider-patient relationship. Initial formative research with patients and providers from two large community clinics that treat the underserved will examine familiarity with and views about the CIS, as well as barriers and facilitators of telephoning the CIS for information about cancer prevention and screening. Community feedback will also be sought on materials planned for inclusion in a randomized controlled trial (RCT). The RCT will randomize approximately 500 women just scheduled for colposcopy at the two clinics to two conditions involving different letters from the provider. Usual Care participants will receive a generic letter reminding them of their follow-up appointment. Intervention participants will receive a targeted letter reminding them of the follow-up appointment, asking them or someone they designate to call the CIS, and suggesting questions to ask. Specific aims are to examine whether a targeted physician mailing can increase calls to the CIS, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication at the follow-up medical visit. The study has the potential to identify a feasible, effective, sustainable, and culturally sensitive strategy to increase awareness and use of the CIS among an underserved population. The burden of cancer falls most heavily on low income African Americans and Hispanics, who are the study population. This research activates providers who treat the underserved to connect their patients to well- trained cancer information specialists who are accessible by telephone. The study examines the impact on medical follow-up and provider-patient communication.