Pasick Rena J, Hiatt Robert A, Paskett Electra D
Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California 94143-0981, USA.
Cancer. 2004 Sep 1;101(5 Suppl):1146-64. doi: 10.1002/cncr.20508.
Behaviors associated with cancer screening have been the focus of intensive research over the past 2 decades, primarily in the form of intervention trials to improve screening based in both clinical and community settings. Meta-analyses and literature reviews have synthesized and organized the resulting literature. From the accumulated work, this review distilled lessons learned from cancer screening intervention research in community settings. The authors posed the question, "What do we know about the development of effective community-based interventions (the level of good over harm achieved in real-world conditions)?" Framed around the concept of focal points (the simultaneous combination of target population, behavioral objective, and setting for an intervention), 13 lessons were derived. One lesson was cross-cutting, and the other lessons addressed the three focal-point components and the major intervention categories (access-enhancing strategies, mass media, small media, one-on-one and small-group education, and combinations of these categories). To build more systematically on existing research, recommendations are made for new directions in basic behavioral and intervention research.
在过去20年里,与癌症筛查相关的行为一直是深入研究的重点,主要形式是在临床和社区环境中开展旨在改善筛查的干预试验。荟萃分析和文献综述对所得文献进行了综合整理。通过这些积累的工作,本综述提炼了从社区环境中癌症筛查干预研究中吸取的经验教训。作者提出了这样一个问题:“我们对有效的社区干预措施的发展(在现实世界条件下实现的利大于弊的程度)了解多少?”围绕焦点概念(干预措施的目标人群、行为目标和环境的同时结合)得出了13条经验教训。其中一条经验教训具有贯穿性,其他经验教训则涉及三个焦点组成部分和主要干预类别(增强可及性策略、大众媒体、小众媒体、一对一和小组教育以及这些类别的组合)。为了在现有研究基础上更系统地推进,针对基础行为研究和干预研究的新方向提出了建议。