ACCISS: Activating Collaborative CIS Support Services

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，拟议的工作调查如何连接CIS到低收入的城市非洲裔美国人和西班牙裔妇女与异常的PAP测试。该研究探讨了参与医疗保健提供者的效用，这些医疗保健提供者在使用CIS和将患者转诊到CIS时治疗服务不足的患者。该研究还评估了访问CIS服务对患者异常PAP测试随访以及医患关系质量的影响。与来自两个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CIS的熟悉程度和看法，以及致电CIS获取有关癌症预防和筛查信息的障碍和促进因素。还将征求社区对计划纳入随机对照试验（RCT）的材料的反馈。随机对照试验将在两个诊所随机安排大约500名妇女进行阴道镜检查，两种情况涉及提供者的不同信件。医疗护理参与者将收到一封普通信件，提醒他们随访预约。干预参与者将收到一封有针对性的信件，提醒他们随访预约，要求他们或他们指定的人致电CIS，并建议要问的问题。具体目标是检查是否有针对性的医生邮件可以增加呼叫CIS，加强适当的医疗后续行动，并提高满意度与提供者-患者在后续医疗访问的沟通。这项研究有可能确定一个可行的，有效的，可持续的，文化上敏感的战略，以提高认识和使用独联体服务不足的人口。癌症的负担福尔斯最沉重地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。这项研究激活了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。该研究探讨了对医疗随访和医患沟通的影响。

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.