PRE-VIEW An Interactive Video Doctor to Encourage Cancer Screening

描述（由申请人提供）：通过R21机制从NCI的资金，我们已经开发了预览（预防视频教育等候室计划）。这一创新工具旨在提高推荐的癌症筛查率和有关癌症筛查的讨论。PRE-VIEW是一种多媒体干预，评估每种癌症筛查的变化阶段，使用交互式视频医生，针对每种癌症的变化阶段和个体障碍提供可行，有效的信息，并生成个性化的提供者警报。PRE-VIEW是新颖的，因为它1）专注于针对特定个体的所有推荐癌症筛查，2）针对个体的变化阶段和他/她对每种特定癌症筛查的障碍进行定制，以及3）已经过可行性的试点测试。我们的第一个目标是在一项随机对照试验（RCT）中确定，在看医生之前使用PRE-VIEW的患者是否比接受常规护理的患者更有可能证明乳腺X射线摄影筛查乳腺癌的比率增加;宫颈癌的巴氏试验;或结肠直肠癌，粪便潜血试验，粪便免疫化学试验，乙状结肠镜检查或结肠镜检查，并参与共同决策与初级保健医生对前列腺癌筛查与前列腺特异性抗原检测（PSA）时，指示。根据RCT的结果，我们的第二个目标是定制和修改PRE-VIEW，以促进参与RCT的研究中心的持续采用、实施和维护。我们的第三个目标是制定一个传播和促进工具包，并制定一个计划，以便将PRE-VIEW更广泛地传播到新的初级保健诊所，并衡量传播在采用、吸收和持续使用方面的成功程度。我们的最终目标是为将来的提案做准备，开始以两种方式调整PRE-VIEW：1）适应新的语言（西班牙语），2）与不同的用户界面（如互联网、手机或平板电脑）一起使用，同时仍然促进患者与医生的讨论。 公共卫生相关性：癌症筛查可降低死亡率，多个组织建议对50至70岁的男性和女性进行几种癌症的常规筛查。我们开发了PRE-VIEW（候诊室预防性视频教育计划），这是一种多媒体癌症预防干预措施，可用于初级保健诊所环境，使用交互式视频医生，专注于为特定个体推荐的所有癌症筛查，针对每种癌症的个体变化阶段和个体障碍提供可行，有效的信息，并生成个性化的提供者警报。我们将在初级保健诊所环境中测试PRE-VIEW，然后制定一项计划，以维护PRE-VIEW并将其传播到其他环境中。最后，在一项RCT中证明PRE-VIEW是成功的，并成功地维护和传播后，为准备一项单独的提案，以扩展在前几个阶段中的工作，我们将开始调整PRE-VIEW，使其适用于西班牙语，并与不同的用户界面（如互联网、手机或平板电脑）一起使用，同时仍然促进患者与医生的讨论。

DESCRIPTION (provided by applicant): With funding from the NCI through the R21 mechanism, we have developed PRE-VIEW (The PREventive VIdeo Education in Waiting Rooms Program). This innovative tool is designed to increase rates of recommended cancer screening and discussions about cancer screening. PRE-VIEW is a multimedia intervention that assesses stage of change for each individual type of cancer screening, uses an interactive Video Doctor who gives feasible, efficient messages targeted to individual stage of change and individual barriers for each cancer, and generates individualized Provider Alerts. PRE- VIEW is novel in that it 1) focuses on all recommended cancer screening for a particular individual 2) is tailored to an individual's stage of change and his/her barriers to screening for each particular cancer and 3) has been pilot tested for feasibility. Our first objective is to determine in a randomized controlled trial (RCT), whether patients who use PRE-VIEW before seeing their physician will be more likely than patients who receive usual care to demonstrate increased rates of screening for breast cancer with mammography; cervical cancer with Pap tests; or colorectal cancer with fecal occult blood tests, fecal immunochemical tests, sigmoidoscopy or colonoscopy when indicated and to engage in shared decision-making with primary care physicians about prostate cancer screening with prostate specific antigen testing (PSA) when indicated. Based on the results of the RCT, our second objective is to tailor and modify PRE-VIEW to facilitate continued adoption, implementation, and maintenance at sites participating in the RCT. Our third objective is to develop a Dissemination and Facilitation Toolkit and a plan for broader dissemination of PRE-VIEW to new primary care clinic sites and to measure the success of dissemination with respect to adoption, uptake and continued use. Our final objective, in preparation for a future proposal, is to begin to adapt PRE-VIEW in two ways: 1) to a new language (Spanish) and 2) for use with different user interfaces, such as the Internet, cell phones or tablets, while still facilitating patient-physician discussion. PUBLIC HEALTH RELEVANCE: Cancer screening decreases mortality and routine screening for several cancers is recommended by multiple organizations for men and women aged 50 to 70. We have developed PRE-VIEW (The PREventive VIdeo Education in Waiting Rooms Program), a multimedia cancer prevention intervention to be use in primary care clinic settings that uses an interactive Video Doctor who focuses on all recommended cancer screening for a particular individual, gives feasible, efficient messages targeted to individual stage of change and individual barriers for each cancer, and generates individualized Provider Alerts. We will test PRE-VIEW in the primary care clinic setting and then develop a plan for maintenance and dissemination of PRE-VIEW to other settings. Finally, after PRE-VIEW is proven successful in an RCT, and successfully maintained and disseminated, in preparation for a separate proposal to expand on what worked in prior phases, we will begin to adapt PRE-VIEW for the Spanish language and for use with different user interfaces, such as the Internet, cell phones or tablets, while still facilitating patient-physician discussion.