Colorectal Cancer Screening Preferences in Primary Care

描述(由申请人提供) 该项目将使用联合分析(CA)评估不同种族的初级保健患者对结直肠癌筛查(CRC)选项的偏好。筛查率低和改善筛查率的干预措施的有效性有限，最近的注意力集中在更多地了解一种CRCS检测相对于另一种检测的偏好差异上。几乎没有关于不同种族/民族的患者如何看待CRC的信息，或者某些测试对不同少数群体的个人是更有吸引力还是更不受欢迎。这项由三部分组成的研究的具体目的是：1)开发一个教育模块和附带的评估工具，以引起使用CA的不同患者群体对CRCS的偏好；2)使用CA并以大型的城市实践研究网络为实验室，评估对CRCS方案的偏好的差异；以及3)确定种族/民族(性别和年龄)对CRCS测试属性的偏好，可用于未来干预措施的开发。联合分析是一种偏好评估技术，其起源于市场研究和最近在确定卫生服务偏好方面的应用。联合分析在评估不同人群中对结直肠癌筛查的偏好方面有3个优势：1)当必须相互权衡某些产品属性时，它是最好的方法，例如用测试的准确性来换取侵袭性；2)潜在的“如果”情况，例如更准确的粪便潜血测试或虚拟结肠镜检查，可以很容易地使用CA进行评估；3)该方法确定了人群的特征，如种族/民族、性别和/或年龄，这些特征或多或少地倾向于某种特定的服务或测试。拟议研究的第一部分将开发使用CA评估CRC偏好所需的教育模块，而实施阶段将使用这些材料评估225名白人、非裔美国人和西班牙裔初级保健患者(每组75人)的偏好。对结果的评估将揭示最喜欢的CRCS测试属性(例如，准确性、侵入性)，无论这些偏好是否随着患者特征的不同而变化。拟议的研究将为一项更大规模的研究奠定基础，该研究将在更大的人口中复制CA方法，并利用结果开发和测试基于偏好的干预或决策援助，以改善少数群体对CRCs的遵从性。

DESCRIPTION (provided by applicant) This project will assess preferences for colorectal cancer screening (CRCS) options among ethnically-diverse primary care patients using conjoint analysis (CA). Low screening rates and limited effectiveness of interventions to improve them has focused recent attention on understanding more about variation in preferences for one CRCS test over another. Little information exists about how racial/ethnically diverse patients regard CRCS, or whether certain tests are more appealing or less desirable to individuals of different minority groups. The specific aims of this 3-part study are to: 1) develop an educational module and accompanying assessment instrument to elicit preferences for CRCS among diverse patient populations using CA; 2) assess differences in preferences for CRCS options using CA with a large, urban practice-based research network serving as the laboratory; and 3) determine racial/ethnic (gender and age) differences in preferences for CRCS test attributes that can be used in development of future interventions. Conjoint analysis is a preference assessment technique with its roots in marketing research and more recent applications in determination of preferences for health services. Conjoint analysis has 3 strengths for assessment of preferences for colorectal cancer screening in a diverse population: 1) it is the best method when certain product attributes have to be traded off against one another, such as trading test accuracy for invasiveness; 2) potential "what if' situations, such as a more accurate fecal occult blood test or virtual colonoscopy, can be easily evaluated using CA; and 3) the approach identifies characteristics of populations, such as race/ethnicity, gender and/or age, that are more or less likely to prefer a particular service, or test. The first part of the proposed study will develop the educational modules needed to assess CRCS preferences using CA, while the implementation phase will use these materials to assess preferences among 225 white, African American and Hispanic primary care patients (75 per group). The evaluation of the results will reveal the most preferred CRCS test attributes (e.g., accuracy, invasiveness) whether these preferences vary according to patient characteristics. The proposed study will provide the groundwork for a larger study that will replicate the CA methods in a larger population, and use the results to develop and test a preference-based intervention, or decision aid, to improve compliance with CRCS among minority populations.