Tailored Messaging in Colorectal Cancer Screening

筛查可以减轻结直肠癌（CRC）的负担，但在初级保健中仍未得到充分利用。在拟议的研究中，量身定制的信息将用于鼓励FOBT和内窥镜筛查，这是特拉华州Christiana保健卫生系统的14个初级保健实践的一部分。采用准实验前测后测设计，我们将为完成基线调查的患者提供量身定制的筛查干预或TSI（量身定制的筛查工具包，量身定制的电话和量身定制的提醒信）。参与者将收到一个工具包，其中包含一份定制的CRC筛查邀请函和两个定制的信息页面，这些页面反映了他们对FOBT筛查、灵活的鼻窦炎检查和筛查决策阶段的看法。还将包括一份关于CRC筛查和FOBT卡的信息小册子，并附有说明。一名训练有素的护士教育工作者将在包寄出10天后给患者量身定制电话。在电话中，护士教育者将确认收到邮寄的材料，验证当前的决策阶段，审查提供量身定制的信息，确定当前的决策阶段，鼓励决策阶段的积极行动，提供与决策阶段相关的量身定制的信息，解释FOBT和内窥镜检查所涉及的步骤，并提供内窥镜检查的时间表。对于没有报告他们决定进行筛查的患者，护士教育者会建议他们与他们的初级保健医生讨论筛查。在30天内，一封量身定制的提醒信将发送给未进行筛查或未安排筛查的患者及其主治医生。这封信将提供当前量身定制的信息，鼓励在决策阶段采取积极行动，并建议医患讨论筛查。将进行端点调查，并进行端点图审计。研究的主要目的是：1。确定干预措施对CRC筛查利用的影响；2 .确定干预措施对筛查决策阶段的影响；确定干预措施对患者筛查认知的影响。

DESCRIPTION (provided by applicant) Screening can reduce the colorectal cancer (CRC) burden but remains underutilized in primary care. In the proposed study, tailored messaging will be used to encourage FOBT and endoscopic screening in 14 primary care practices that are part of the Christiana Care Health System in Delaware. Using a quasi-experimental pretest-posttest design, we will deliver a Tailored Screening Intervention or TSI (a tailored screening kit, a tailored telephone call, and a tailored reminder letter) to patients who complete a Baseline Survey. Participants will be sent a kit containing a tailored CRC screening invitation letter and two tailored message pages that reflect their perceptions about screening FOBT and flexible sigrnoidoscopy and screening decision stage. An informational booklet on CRC screening and FOBT cards with instructions will also be included. A trained nurse educator will deliver a tailored telephone call to patients 10 days after the kit is mailed. During the call, the nurse educator will confirm receipt of mailed materials, verify current decision stage, review deliver tailored messages, determine current decision stage, encourage positive movement in decision stage, provide tailored messages keyed to decision stage, explain steps involved in FOBT and endoscopy screening, and offer to schedule endoscopy screening. For patients who do not report that they have decided to screen, the nurse educator will recommend that they discuss screening with their primary care physician. At 30 days, a tailored reminder letter will be sent to patients who have not screened or who have not scheduled screening and to their primary physician. The letter will provide current tailored messages, encourage positive movement in decision stage, and suggest physician-patient discussion of screening. An Endpoint Survey will be administered and an Endpoint Chart Audit will be conducted. Primary study aims are to: 1. Determine intervention impact on CRC screening utilization, 2. Determine intervention impact on screening decision stage, and 3. Determine intervention impact on patient perceptions about screening.