Increasing Colorectal and Breast Cancer Screnning in Women

描述（由申请人提供）：50岁及以上女性的适当癌症筛查可降低结直肠癌（CRC）和乳腺癌（BC）的死亡率，但对这两种筛查行为的坚持是不够的。本提案的目的是测试一种定制的互动干预措施，以增加51至75岁未遵守CRC但遵守BC（A组）或不遵守CRC和BC（B组）筛查的妇女的CRC和BC筛查。该干预措施基于理论模型，将同时解决一个以上的健康行为。我们将比较通过邮寄数字视频光盘（TIDVD）、癌症筛查电话（CSC）、TIDVD + CSC的组合以及常规护理提供的定制互动程序，以在单点接触期间增加CRC和BC筛查。将对大约2 616名妇女进行资格评估，她们是家庭护理实践网络的成员，由Wellpoint保险。合格的女性将是仅不依从CRC（A组）或不依从CRC和BC（B组）筛选的女性。在合格性评估和知情同意后，女性将入组研究，并随机分配至TIDVD、CSC、TIDVD + CSC或常规治疗组。TIDVD计划和CSC将根据接受者对与CRC或CRC和BC相关的风险、益处、障碍和自我效能的看法定制信息。干预措施将鼓励在BC筛查成功的基础上进行CRC筛查（A组），或者如果女性不遵守任何一种筛查，则鼓励同时进行两种筛查（B组）。干预组的妇女将能够通过电话安排BC或CRC筛查，而无需诊所访视。所有干预武器都可以直接送到妇女家中。基线电话评估后一周，将提供干预措施。将通过电话访谈以及6个月时的索赔数据和医疗记录审计获得结果。将在干预后4周收集有关干预的过程数据。将计算两种干预措施的成本效益，以加快转化为实践，如果发现其中一种或两种干预措施都有效。 公共卫生相关性：通过常规筛查早期检测乳腺癌和结直肠癌可以显着减少这些癌症的死亡。这项研究将测试一项计划，该计划包括通过直接邮寄到女性家中的DVD提供的乳腺癌和结直肠癌筛查干预措施，癌症筛查电话以及两种策略的组合，以增加乳腺癌和结直肠癌。女性可以在打电话的时候安排筛查。如果发现有效，这些干预措施可以很容易地纳入医疗保健系统。

DESCRIPTION (provided by applicant): Appropriate cancer screening in women 50 and older reduces both colorectal cancer (CRC) and breast cancer (BC) mortality, but adherence to both screening behaviors is inadequate. The purpose of this proposal is to test a tailored and interactive intervention to increase both CRC and BC screening in women 51 to 75 who are non-adherent to CRC but adherent to BC (Group A) or to a group which is non-adherent to both CRC and BC (Group B) screening. The intervention is based on theoretical modeling that will simultaneously address more than one health behavior. We will compare a tailored interactive program delivered via a mailed digital video disc (TIDVD), a cancer screening call (CSC), the combination of a TIDVD + CSC, and usual care to increase CRC and BC screening during a single point of contact. Approximately 2616 women, who are members of a family care practice network and insured by Wellpoint will be assessed for eligibility. Eligible women will be either non-adherent to CRC only (Group A) or non-adherent to both CRC and BC (Group B) screening. After eligibility assessment and consent, women will be enrolled in the study and randomly assigned to the TIDVD, CSC, TIDVD + CSC, or usual care. The TIDVD program and CSC will tailor messages to recipients' perceptions of risk, benefits, barriers, and self-efficacy associated with either CRC or with CRC and BC. Interventions will encourage either CRC screening building on their success with BC screening (Group A) or will encourage both screenings simultaneously (Group B) if the woman is non-adherent to either screening. Women in interventions groups will have the ability to schedule BC or CRC screening via telephone without a clinic visit. All intervention arms can be delivered directly to the women in their homes. One week after baseline telephone assessment, interventions will be delivered. Outcomes will be obtained by telephone interviews as well as through claims data and medical records audit at 6 months. Process data about the intervention will be collected at 4 weeks post intervention. Cost effectiveness will be computed for both interventions to speed translation to practice if either or both are found to be efficacious. PUBLIC HEALTH RELEVANCE: Detecting breast and colorectal cancer early through routine screening could dramatically reduce death from these cancers. This research will test a program that includes both breast and colorectal cancer screening interventions delivered through a DVD that is mailed directly to a woman's home, a cancer screening call, and a combination of the two strategies to increase breast and colorectal cancer. Women can schedule screening while on the phone. If found effective, these interventions could be easily incorporated into the health care system.