Tailored Navigation in CRC Screening

描述（由申请人提供）：我们建议对特拉华州克里斯蒂安娜护理卫生系统（CCHS）的6个社区初级保健实践进行为期4年的研究。结直肠癌筛查在实践中的应用是有限的，就像在美国其他地方一样。研究小组将在实践中确定有资格进行CRC筛查的个体，并将完成基线调查的同意参与者随机分配到3个研究组中的一个：常规护理（对照组）组，标准干预（SI）组或定制导航干预（TNI）组。对照组的参与者将接受常规护理。圣莱科特的参与者将收到标准的干预措施（一个通用的邮寄CRC筛查工具包）和邮寄的提醒。TNI组的参与者将收到量身定制的导航干预（基于偏好的邮寄结直肠癌筛查工具包和患者电话导航）和邮寄提醒。提供给TNI集团的CRC筛查工具包将反映参与者首选的CRC筛查策略。“导航”是指指导TNI集团参与者实现测试绩效的过程。该研究的具体目的是：确定干预措施对患者CRC筛查利用的影响。确定干预措施对CRC筛查偏好的影响。确定干预措施对患者CRC筛查知识和认知的影响。我们假设，与SI组和对照组相比，TNI组将显著增加CRC筛查的使用，增加对CRC筛查的偏好，以及对CRC筛查的更有利的看法。我们也期望这些结果在SI组比对照组明显更明显。从基线调查、终点调查和终点图审计中获得的数据将用于评估研究组差异。最后，将进行分析，以确定与CRC筛查利用相关的干预成本效益。

DESCRIPTION (provided by applicant): We propose to conduct a 4-year study with 6 community-based primary care practices that are part of the Christiana Care Health System (CCHS) in Delaware. CRC screening use in the practices is limited, as it is elsewhere in the United States. The research team will identify individuals in the practices who are eligible for CRC screening and will randomly assign consenting participants who complete a baseline survey to 1 of 3 study groups: a Usual Care (Control) Group, Standard Intervention (SI) Group, or Tailored Navigation Intervention (TNI) Group. Control Group participants will receive usual care. SI Group participants will receive a standard intervention (a generic mailed CRC screening kit) and a mailed reminder. TNI Group participants will receive a tailored navigation intervention (a preference-based mailed CRC screening kit and patient navigation by telephone) and a mailed reminder. The CRC screening kit provided to the TNI Group will reflect the participant's preferred CRC screening strategy. "Navigation" refers to the process of guiding the TNI Group participant towards test performance. Specific aims of the study are to: Determine intervention impact on patient CRC screening utilization. Determine intervention impact on CRC screening preference. Determine intervention impact on patient knowledge and perceptions about CRC screening. We hypothesize that the TNI Group will have significantly higher CRC screening use, increased preference for CRC screening, and more favorable perceptions about CRC screening than the SI and Control Groups. We also expect these outcomes to be significantly more pronounced in the SI Group than the Control Group. Data obtained from baseline survey, endpoint survey, and an endpoint chart audit will be used to assess study group differences. Finally, analyses will be performed to determine intervention cost-effectiveness related to CRC screening utilization.