Internet-based Motivational Interviewing for Colonoscopy in African Americans

 描述(申请人提供)：与其他种族群体相比，非裔美国人的结直肠癌(CRC)发病率和死亡率最高。虽然结肠镜检查可以预防CRC，但近一半的非裔美国人(40.2%)在推荐的时间范围内(每十年一次结肠镜检查)没有接受过筛查结肠镜检查。提高非裔美国人的结肠镜检查比率，以减少在结直肠癌发病率和死亡率方面的种族不平等，这是至关重要的。米勒博士的试点工作以及目前的文献表明，基于互联网的结肠镜检查动机访谈干预(I-MIIC)可能有助于改善非裔美国人对结肠镜检查的筛查。拟议的项目将首先使用迭代方法对干预措施进行现场测试，转介非裔美国人进行结肠镜检查(N=40)。实地测试结果将指导I-MIIC的开发、修订和定稿。然后，一项随机临床试验将检验-MIIC在改善非裔美国人筛查结肠镜检查方面的有效性。参与者(N=200)将被随机分配到干预组(N=100)，在干预组中，他们进行20分钟的I-MIIC干预，或者对照组(N=100)，在干预组中，他们复习关于结直肠癌筛查的印刷小册子。这一结果将有助于不断增长的关于儿童权利差距的文献。考虑到莎拉·米勒博士在CRC差异和激励性访谈方面的学术和临床背景，她是带头开展这一研究的理想人选。米勒博士的长期目标是成为一名独立研究人员，在早期发现和预防少数族裔癌症方面拥有专业知识。为了实现她的目标，作为K07的一部分，米勒博士将接受四个领域的强化培训：1)定性研究；2)电子健康；3)纵向数据分析；4)专业发展。K07将为米勒博士提供多种途径来实现她的培训目标，并增强她的专业知识。特别是，米勒博士将与经验丰富的导师进行持续的会议，并参加正式的课程作业、研讨会、会议和互动培训。拟议的K07将为一项研究计划奠定基础，该计划的重点是改善种族/少数民族对癌症筛查的接受程度，目标是减少差异。在K07资助期结束时，米勒博士将根据本研究的结果提交一份R01申请。西奈山伊坎医学院(ISMMS)是米勒博士完成她提议的研究项目和培训的理想环境。特别是，ISMMS可以为米勒博士提供：1)完成她的研究所需的资源；2)获得多种培训活动；以及3)接触到不同的患者群体。最重要的是，米勒博士将接受一组优秀导师的指导，这些导师具有以下方面的专业知识：CRC差异、定性研究、生物统计学、电子健康和初级保健。指导团队将与米勒博士密切合作，确保她实现研究和培训目标。总体而言，K07将为米勒博士提供成为一名成功的独立研究人员所需的研究经验、强化培训和指导。

 DESCRIPTION (provided by applicant): Compared to other racial groups, African Americans have the highest colorectal cancer (CRC) morbidity and mortality rates. Although colonoscopies can prevent CRC, nearly half of African Americans (40.2%) have not received a screening colonoscopy within the recommended time frame (one colonoscopy per ten years). It is critical to increase African Americans' screening colonoscopy rates in order to reduce racial inequities in CRC morbidity and mortality. Dr. Miller's pilot work, as well as the current literature, suggest that an Internet-based Motivational Interviewing Intervention for Colonoscopy (I-MIIC) may help improve African Americans' screening colonoscopy uptake. The proposed project will first field-test the intervention, using an iterative approach, with African Americans referred for a screening colonoscopy (N=40). The field-testing results will guide the development, revisions, and finalization of the I-MIIC. Then, a randomized clinical trial will examine the efficacy of the -MIIC for improving African Americans' screening colonoscopy uptake. Participants (N=200) will be randomly assigned to an intervention group (N=100) in which they engage in a 20-minute I-MIIC intervention or a control group (N=100) in which they review a print brochure on CRC screening. The results will contribute to the growing literature on CRC disparities. Dr. Sarah Miller is the ideal candidate to spearhead this line of research given her academic and clinical background in CRC disparities and motivational interviewing. Dr. Miller's long-term goal is to become an independent researcher with expertise in the early detection and prevention of cancer in racial/ethnic minorities. To achieve her goals, as part of the K07, Dr. Miller will receie intensive training in four areas: 1) qualitative research; 2) e-Health; 3) longitudinal data analyss, and 4) professional development. The K07 will provide Dr. Miller with a variety of avenues to achieve her training goals and enhance her expertise. In particular, Dr. Miller will have ongoing meetings with seasoned mentors as well as participate in formal coursework, workshops, conferences, and interactive trainings. The proposed K07 will form the foundation for a program of research that focuses on improving cancer screening uptake in racial/ethnic minorities with the goal of reducing disparities. At the end of the K07 funding period, Dr. Miller will submit an R01 application, based on the results of the present study. The Icahn School of Medicine at Mount Sinai (ISMMS) is the ideal environment for Dr. Miller to complete her proposed research project and training. In particular, the ISMMS can offer Dr. Miller: 1) the resources necessary to complete her research; 2) access to multiple training activities; and 3) access to a diverse patient population. Most importantly, Dr. Miller will receive guidance from a team of superior mentors with expertise in: CRC disparities, qualitative research, biostatistics, e-Health, and primary care. The mentoring team will work closely with Dr. Miller to ensure that she achieves her research and training objectives. Overall, the K07 will provide Dr. Miller with the research experience, intensive training, and mentorship needed to become a successful independent researcher.