Prompting and Reminding at Encounters for Prevention

描述(由申请人提供) 预防接触提醒(PREP)项目旨在评估结直肠癌筛查提供提醒的具体方法的实施情况。它将研究在属于密歇根五大湖研究实践网络(GRIN)的12个社区实践中实施计算机提醒系统ClinfoTracker的情况。到目前为止，该系统已经在密歇根大学附属社区的一组实践中开发和使用。我们建议在12个全州范围的社区实践中评估其实施情况，并使用不同的基础设施集。 在一系列评估中，我们将评估49个已经确定的、有兴趣的网络实践，评估它们实施结直肠癌筛查提醒系统的能力，选择12个实践进行实际实施。实施后，这些做法将随机分为3种提醒模式之一，即临床医生目标提醒、患者目标提醒以及临床医生和患者目标提醒。实践将在指定模式下使用提醒系统9个月，之后我们将对结直肠癌筛查率以及临床医生、办公室工作人员和患者对提醒系统的态度和看法进行深入评估。在这一评估后阶段，我们将对提示的患者进行基线和干预期图表审查，对临床医生、办公室工作人员和患者进行调查，并详细观察该系统如何融入常规实践。 在准备完成后，我们将了解如何最好地将提醒系统实施到各种实践中，我们将获得三种提醒模式(临床医生提醒、患者提醒以及临床医生和患者提醒)每种模式的效果大小估计。这些信息将被用来为计算机化提醒的整群随机有效性试验提供方法和实践样本量计算，该试验具有足够的能力来确定为结直肠癌筛查提供提醒的最佳模式。

DESCRIPTION (provided by applicant) The Prompting & Reminding at Encounters for Prevention (PREP) project is designed to evaluate the implementation of a specific method of delivering reminders for colorectal cancer screening. It will study the implementation of a computerized reminder system, ClinfoTracker, in 12 community practices belonging to the Michigan Great Lakes Research Into Practice Network (GRIN). This system has been developed and used to date in a group of University of Michigan affiliated community practices. We propose to evaluate its implementation in 12 statewide community practices with a varied set of infrastructures. In a series of assessments, we will evaluate 49 already identified, interested network practices on their ability to implement the colorectal cancer screening reminder system, selecting 12 practices for actual implementation. Following implementation, these practices will he randomized to one of 3 modes of reminding, clinician targeted reminders, patient targeted reminders, and both clinician and patient targeted reminders. The practices will use the reminder system in the assigned mode for 9 months, following which we will perform an in depth assessment of colorectal cancer screening rates and clinician, office staff and patient attitudes and perceptions regarding the reminder system. During this post-assessment phase we will perform baseline and intervention period chart reviews of prompted patients, conduct surveys of clinicians, office staff and patients, as well as detailed observations of how the system integrates into routine practice. At the completion of PREP we will understand how to best implement the reminder system into a variety of practices, we will have effect size estimates of each of the three reminding modes (clinician reminders, patient reminders and clinician and patient reminders). This information will be used to inform the methods and practice sample size calculations for a cluster-randomized effectiveness trial of computerized reminders with adequate power to determine the best mode of delivering reminders for colorectal cancer screening.