Couple-Based Intervention for Colorectal Cancer Screening

描述(由研究人员提供)：虽然结直肠癌筛查(CRC)的摄取率一直在增加，但筛查的参与率仍然相对较低。需要开发新的方法来改进控制资源中心。已经为不遵守CRCs的个人制定了一些以个人为重点的干预措施。虽然其中一些干预措施已经报告了对癌细胞的显著影响，但其他研究尚未报告显著影响。个人层面干预的一个可能的局限性是，它们没有利用大多数健康行为发生的社会背景。婚姻关系是社会背景因素的一个例子，这种因素没有被纳入社区康复中心的干预努力。在这项拟议的研究中，我们试图开发一种创新的、基于夫妇的干预(CBI)，其目标是增加双方都没有按计划进行CRC的夫妇对CRCs的接受。发展CBI，开展试点和可行性研究。我们的干预主要基于相互依赖模型，这是一个二元水平的社会心理学理论，提出伴侣既影响他们自己的行为，也影响他们伴侣的行为，并且将健康行为变化的动机转化为对关系的意义的干预应该比只将改变的意义归因于自己的干预更成功。CBI的目标是增加夫妇建设性地讨论CRC的程度，以及夫妇认为CRC对他们的关系重要的程度。最终目标是提高参与者对CRCs的接受程度。我们会进行两项研究，以达致这个目标。研究1的目的是通过对筛查和未筛查的夫妇进行访谈，收集关于婚姻关系在结肠癌筛查中的作用的信息，并通过让未筛查的夫妇样本评估我们开发的临时CBI材料，来完善CBI。研究2的目标是进行一项小规模的初步研究，通过将其与广泛可获得的关于社区合作的小册子进行比较，提供关于“社区倡议”影响的初步信息。本研究的主要目的是开发CBI并评估其可行性和可接受性。次要目标是收集关于CBI与最低限度护理(MC)对CRC和CRCS意向的影响的初步信息，并收集关于CBI与MC对可能的变化机制的影响的初步信息。公共卫生相关性：虽然结直肠癌筛查的接受率一直在上升，但筛查的参与率仍然相对较低，特别是与其他癌症相比，以及在考虑2010年《健康人》中提出的预防目标时。需要开发新的方法来改进控制资源中心。在拟议的研究中，我们试图开发和试点一种创新的、理论指导的、以夫妇为基础的干预措施，其目标是鼓励夫妇建设性地讨论拥有CRC，最终目标是增加双方都没有按时进行CRC的夫妇对CRC的接受。

DESCRIPTION (provided by investigator): While uptake rates for colorectal cancer screening (CRCS) have been increasing, participation in screening remains relatively low. Novel approaches for improving CRCS need to be developed. A number of individually-focused interventions have been developed for individuals who are not compliant with CRCS. Although some of these interventions have reported significant effects upon CRCS, other studies have not reported significant effects. One possible limitation of individual-level interventions is that they do not take advantage of the social context in which most health behavior occurs. The marital relationship is an example of a social context factor that has not been incorporated into CRCS intervention efforts. In the proposed study, we seek to develop an innovative, couple-based intervention (CBI) whose goal is to increase uptake of CRCS among couples in which neither partner is on-schedule with regard to CRCS. We will develop CBI and conduct a pilot and feasibility study. Our intervention is based primarily on the Interdependence Model, which is a dyad-level social psychological theory proposes that partners influence both their own as well as their partner's behavior and that interventions which transform the motivation for health behavior change to ascribe meaning for the relationship should be more successful than interventions that ascribe meaning for the change only for oneself. The goal of CBI is to increase the degree to which couples constructively discuss CRCS and the degree to which couples think about CRCS as important to their relationship. The ultimate goal is to increase participants' uptake of CRCS. We will achieve this goal by conducting two studies. The goal of Study 1 is to refine CBI by conducting interviews with screened and unscreened couples to gather information regarding the role of the marital relationship in colon cancer screening and by having a sample of unscreened couples evaluate the provisional CBI materials we have developed. The goal of Study 2 is to conduct a small-scale pilot study to provide preliminary information regarding the impact of CBI by comparing it with a widely-available pamphlet about CRCS. The primary aim of this study is to develop CBI and evaluate its feasibility and acceptability. The secondary aims are to gather preliminary information regarding the impact of CBI versus Minimal Care (MC) on CRCS and CRCS intentions and to gather preliminary information regarding the impact of CBI versus MC on possible mechanisms of change. PUBLIC HEALTH RELEVANCE: While uptake rates for colorectal cancer screening have been increasing, participation in screening remains relatively low, particularly in comparison with other cancers and when considering prevention objectives set forth in Healthy People 2010. Novel approaches for improving CRCS need to be developed. In the proposed study, we seek to develop and pilot test an innovative, theoretically-guided, couple-based intervention whose goal is to encourage couples to constructively discuss having CRCS, with the ultimate goal of increasing the uptake of CRCS among couples in which neither partner is on-schedule with regard to CRCS.