PRE-VIEW An Interactive Video Doctor to Encourage Cancer Screening

描述（由申请人提供）：在NCI通过R21机制的资助下，我们开发了PRE-VIEW（候诊室预防性视频教育项目）。这个创新的工具旨在提高推荐的癌症筛查率和关于癌症筛查的讨论。PRE-VIEW是一种多媒体干预，用于评估每种癌症筛查类型的变化阶段，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的新颖之处在于：1)专注于针对特定个体的所有推荐的癌症筛查；2)根据个体的变化阶段和他/她针对每种特定癌症进行筛查的障碍量身定制；3)已经进行了可行性试点测试。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显示出乳房x光检查增加的乳腺癌筛查率；宫颈癌和巴氏涂片检查；或结肠直肠癌，在有指征时进行粪便隐血检查、粪便免疫化学检查、乙状结肠镜检查或结肠镜检查，并在有指征时与初级保健医生共同决定是否进行前列腺特异性抗原检测（PSA）的前列腺癌筛查。基于RCT的结果，我们的第二个目标是裁剪和修改PRE-VIEW，以促进参与RCT的站点的持续采用、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和一个计划，以便在新的初级保健诊所更广泛地传播PRE-VIEW，并从采用、吸收和继续使用方面衡量传播的成功。为了准备未来的提案，我们的最终目标是开始以两种方式调整PRE-VIEW: 1)适应一种新的语言（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，同时仍然促进医患讨论。

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.