PRE-VIEW An Interactive Video Doctor to Encourage Cancer Screening

描述(由申请人提供)：在NCI通过R21机制提供资金的情况下，我们开发了预览版(候诊室预防视频教育计划)。这一创新工具旨在提高推荐的癌症筛查和关于癌症筛查的讨论的比率。预览是一种多媒体干预，它评估每一种癌症筛查的变化阶段，使用交互式视频医生，该医生针对每种癌症的个别变化阶段和个人障碍提供可行、有效的信息，并生成个性化的提供者警报。预览是新颖的，因为它1)集中于为特定个人推荐的所有癌症筛查；2)根据个人的变化阶段和他/她对每一种特定癌症的筛查障碍而量身定做；3)已经进行了可行性的试点测试。我们的第一个目标是在一项随机对照试验(RCT)中确定，与接受常规护理的患者相比，在就诊前使用预览的患者是否更有可能通过乳房X光检查证明乳腺癌、子宫颈癌通过巴氏试验进行筛查，或结直肠癌通过粪便潜血测试、粪便免疫化学测试、乙状结肠镜检查或结肠镜检查(如果有指征)，并与初级保健医生共同制定前列腺癌筛查的决策(如果有指征)。根据随机对照试验的结果，我们的第二个目标是调整和修改预览版，以促进参与随机对照试验的地点继续采用、实施和维护。我们的第三个目标是开发一个传播和促进工具包和一项计划，以便向新的初级保健诊所地点更广泛地传播预览，并衡量传播在采用、吸收和继续使用方面的成功程度。在为未来的提案做准备时，我们的最终目标是开始以两种方式调整预览：1)适应一种新的语言(西班牙语)；2)用于不同的用户界面，如互联网、手机或平板电脑，同时仍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.