Couple-Based Intervention for Colorectal Cancer Screening

描述（由研究者提供）：虽然结肠直肠癌筛查（CRCS）的接受率一直在增加，但筛查的参与率仍然相对较低。需要开发改进CRCS的新方法。针对不遵守CRCS的个人，已经开发了许多以个人为重点的干预措施。尽管其中一些干预措施已报道对CRCS有显著影响，但其他研究未报道显著影响。个人层面干预的一个可能的限制是，它们没有利用大多数健康行为发生的社会背景。婚姻关系是社会背景因素的一个例子，而社会背景因素并没有被纳入红十字会的干预工作。在拟议的研究中，我们寻求开发一种创新的，基于夫妻的干预（CBI），其目标是增加夫妻双方都没有按时接受CRCS的夫妇对CRCS的吸收。我们将发展CBI，并开展试点和可行性研究。我们的干预主要基于相互依赖模型，这是一个双层面的社会心理学理论，提出伴侣影响自己和伴侣的行为，并且将健康行为改变的动机转化为关系的意义的干预措施应该比仅为自己的改变赋予意义的干预措施更成功。CBI的目标是提高夫妻建设性地讨论CRCS的程度，以及夫妻认为CRCS对他们的关系很重要的程度。最终目标是增加参与者对CRCS的吸收。我们将通过进行两项研究来实现这一目标。研究1的目标是通过对接受筛查和未接受筛查的夫妇进行访谈，以收集有关婚姻关系在结肠癌筛查中的作用的信息，并通过对未接受筛查的夫妇样本评估我们开发的临时CBI材料，来完善CBI。研究2的目标是进行一项小规模的试点研究，通过将CBI与广泛使用的关于CRCS的小册子进行比较，提供有关CBI影响的初步信息。本研究的主要目的是发展CBI，并评估其可行性和可接受性。次要目的是收集关于CBI与最低护理（MC）对CRCS和CRCS意图的影响的初步信息，以及收集关于CBI与MC对可能的变化机制的影响的初步信息。公共卫生相关性：虽然大肠癌筛查的接受率一直在增加，但参与筛查的人数仍然相对较低，特别是与其他癌症相比，考虑到《2010年健康人》提出的预防目标。需要开发改进CRCS的新方法。在拟议的研究中，我们寻求开发和试点测试一种创新的、理论指导的、基于夫妻的干预措施，其目标是鼓励夫妻建设性地讨论进行CRCS，最终目标是在双方都没有按时进行CRCS的夫妇中增加对CRCS的吸收。

DESCRIPTION (provided by investigator): While uptake rates for colorectal cancer screening (CRCS) have been increasing, participation in screening remains relatively low. Novel approaches for improving CRCS need to be developed. A number of individually-focused interventions have been developed for individuals who are not compliant with CRCS. Although some of these interventions have reported significant effects upon CRCS, other studies have not reported significant effects. One possible limitation of individual-level interventions is that they do not take advantage of the social context in which most health behavior occurs. The marital relationship is an example of a social context factor that has not been incorporated into CRCS intervention efforts. In the proposed study, we seek to develop an innovative, couple-based intervention (CBI) whose goal is to increase uptake of CRCS among couples in which neither partner is on-schedule with regard to CRCS. We will develop CBI and conduct a pilot and feasibility study. Our intervention is based primarily on the Interdependence Model, which is a dyad-level social psychological theory proposes that partners influence both their own as well as their partner's behavior and that interventions which transform the motivation for health behavior change to ascribe meaning for the relationship should be more successful than interventions that ascribe meaning for the change only for oneself. The goal of CBI is to increase the degree to which couples constructively discuss CRCS and the degree to which couples think about CRCS as important to their relationship. The ultimate goal is to increase participants' uptake of CRCS. We will achieve this goal by conducting two studies. The goal of Study 1 is to refine CBI by conducting interviews with screened and unscreened couples to gather information regarding the role of the marital relationship in colon cancer screening and by having a sample of unscreened couples evaluate the provisional CBI materials we have developed. The goal of Study 2 is to conduct a small-scale pilot study to provide preliminary information regarding the impact of CBI by comparing it with a widely-available pamphlet about CRCS. The primary aim of this study is to develop CBI and evaluate its feasibility and acceptability. The secondary aims are to gather preliminary information regarding the impact of CBI versus Minimal Care (MC) on CRCS and CRCS intentions and to gather preliminary information regarding the impact of CBI versus MC on possible mechanisms of change. PUBLIC HEALTH RELEVANCE: While uptake rates for colorectal cancer screening have been increasing, participation in screening remains relatively low, particularly in comparison with other cancers and when considering prevention objectives set forth in Healthy People 2010. Novel approaches for improving CRCS need to be developed. In the proposed study, we seek to develop and pilot test an innovative, theoretically-guided, couple-based intervention whose goal is to encourage couples to constructively discuss having CRCS, with the ultimate goal of increasing the uptake of CRCS among couples in which neither partner is on-schedule with regard to CRCS.