Increasing Colorectal and Breast Cancer Screnning in Women

描述（由申请人提供）：在50岁及以上的女性中进行适当的癌症筛查可以降低结直肠癌（CRC）和乳腺癌（BC）的死亡率，但坚持这两种筛查行为是不够的。本提案的目的是测试一种量身定制的互动干预措施，以增加51至75岁未坚持CRC但坚持BC （a组）或未坚持CRC和BC （B组）筛查的妇女的CRC和BC筛查。干预是基于理论模型，将同时解决一个以上的健康行为。我们将比较通过邮寄数字视频光盘（TIDVD）、癌症筛查电话（CSC）、TIDVD + CSC的组合以及在单点接触期间增加CRC和BC筛查的常规护理提供的定制互动计划。大约2616名妇女，谁是家庭护理实践网络的成员，并由Wellpoint保险将评估资格。符合条件的女性要么只接受结直肠癌（A组），要么同时接受结直肠癌和BC （B组）筛查。在资格评估和同意后，妇女将被纳入研究，并随机分配到TIDVD， CSC， TIDVD + CSC或常规护理组。TIDVD项目和CSC将根据接受者对CRC或CRC合并BC相关的风险、益处、障碍和自我效能的认知来定制信息。干预措施将鼓励在BC筛查成功的基础上进行结直肠癌筛查（A组），或者如果妇女不坚持任何一项筛查，将鼓励同时进行两项筛查（B组）。干预组的妇女将有能力通过电话安排BC或CRC筛查，而无需去诊所。所有干预武器都可以直接送到妇女家中。基线电话评估后一周，将提供干预措施。将通过电话访谈以及6个月时的索赔数据和医疗记录审计获得结果。干预后4周收集干预过程数据。如果发现其中一种或两种干预措施都有效，将计算两种干预措施的成本效益，以加快翻译实践。

DESCRIPTION (provided by applicant): Appropriate cancer screening in women 50 and older reduces both colorectal cancer (CRC) and breast cancer (BC) mortality, but adherence to both screening behaviors is inadequate. The purpose of this proposal is to test a tailored and interactive intervention to increase both CRC and BC screening in women 51 to 75 who are non-adherent to CRC but adherent to BC (Group A) or to a group which is non-adherent to both CRC and BC (Group B) screening. The intervention is based on theoretical modeling that will simultaneously address more than one health behavior. We will compare a tailored interactive program delivered via a mailed digital video disc (TIDVD), a cancer screening call (CSC), the combination of a TIDVD + CSC, and usual care to increase CRC and BC screening during a single point of contact. Approximately 2616 women, who are members of a family care practice network and insured by Wellpoint will be assessed for eligibility. Eligible women will be either non-adherent to CRC only (Group A) or non-adherent to both CRC and BC (Group B) screening. After eligibility assessment and consent, women will be enrolled in the study and randomly assigned to the TIDVD, CSC, TIDVD + CSC, or usual care. The TIDVD program and CSC will tailor messages to recipients' perceptions of risk, benefits, barriers, and self-efficacy associated with either CRC or with CRC and BC. Interventions will encourage either CRC screening building on their success with BC screening (Group A) or will encourage both screenings simultaneously (Group B) if the woman is non-adherent to either screening. Women in interventions groups will have the ability to schedule BC or CRC screening via telephone without a clinic visit. All intervention arms can be delivered directly to the women in their homes. One week after baseline telephone assessment, interventions will be delivered. Outcomes will be obtained by telephone interviews as well as through claims data and medical records audit at 6 months. Process data about the intervention will be collected at 4 weeks post intervention. Cost effectiveness will be computed for both interventions to speed translation to practice if either or both are found to be efficacious. PUBLIC HEALTH RELEVANCE: Detecting breast and colorectal cancer early through routine screening could dramatically reduce death from these cancers. This research will test a program that includes both breast and colorectal cancer screening interventions delivered through a DVD that is mailed directly to a woman's home, a cancer screening call, and a combination of the two strategies to increase breast and colorectal cancer. Women can schedule screening while on the phone. If found effective, these interventions could be easily incorporated into the health care system.