Tailored Navigation in CRC Screening

描述（由申请人提供）：拟议的项目代表了一个令人兴奋的机会，让城市中的老年非洲裔美国人参与到增加CRC筛查方法的比较有效性研究中。非裔美国人只占父母研究参与者的25%。因此，我们将无法确定不同的干预方法对这一高危人群的影响。确定如何增加非裔美国人的结直肠癌筛查将有助于减少疾病发病率和死亡率的差异。在这一竞争性修订中，该研究的患者群体将来自费城爱因斯坦卫生系统的初级保健实践，主要服务于非洲裔美国患者群体。采用两组随机设计，我们将完成基线电话调查的同意参与者（N=472）随机分配到标准干预组（N=236）或增强定制导航干预组（N=236）。圣莱科特的参与者将收到一份鼓励CRC筛查的通用邮件干预。E-TNI小组的参与者将收到针对非裔美国人的邮件干预、电话联系和旨在鼓励CRC筛查的电子通信。本研究的具体目的，按照优先顺序，是确定(1)E-TNI对结直肠癌筛查利用的影响，(2)E-TNI对结直肠癌筛查偏好的影响，(3)E-TNI对结直肠癌筛查认知的影响。我们假设E-TNI组将比SI组有更高的CRC筛查使用率，对CRC筛查的偏好增加，对CRC筛查的看法更有利。从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。公共卫生相关性：拟议的竞争性修订代表了一个令人兴奋的机会，使城市中老年非洲裔美国人参与到增加CRC筛查方法的比较有效性研究中。确定如何增加非裔美国人的结直肠癌筛查将有助于减少疾病发病率和死亡率的差异。

DESCRIPTION (provided by applicant): The proposed project represents an exciting opportunity to engage older urban African Americans in a comparative effectiveness study of methods to increase CRC screening. African American participants represent only about 25% of study participants in the parent study. As a result, we will not be able to determine the impact of different intervention methods in this high-risk group. Determining how to increase CRC screening among African Americans will help to reduce disparities in disease incidence and mortality. In this competitive revision, the patient population for the study will be drawn from Einstein Health System primary care practices in Philadelphia that serve a predominantly African American patient population. Using a two-group randomized design, we will randomly assign consenting participants who complete a baseline telephone survey (N=472) to either a Standard Intervention (SI) Group (N=236) or an Enhanced Tailored Navigation Intervention (E-TNI) Group (N=236). SI Group participants will receive a generic mailed intervention that encourages CRC screening. E-TNI Group participants will receive a mailed intervention that is culturally-targeted to African Americans, telephone contacts, and electronic communications intended to encourage CRC screening. Specific aims of the study, in order of priority, are to determine (1) E-TNI impact on CRC screening utilization, (2) E-TNI impact on CRC screening preference, and (3) E-TNI impact on perceptions about CRC screening. We hypothesize that the E-TNI Group will have significantly higher CRC screening use, increased preference for CRC screening, and more favorable perceptions about CRC screening than the SI Group. Data obtained from an endpoint survey and an endpoint chart audit will be used to assess study group differences. PUBLIC HEALTH RELEVANCE: The proposed competitive revision represents an exciting opportunity to engage older urban African Americans in a comparative effectiveness study of methods to increase CRC screening. Determining how to increase CRC screening among African Americans will help to reduce disparities in disease incidence and mortality.