定制的交互式多媒体计算机程序对结直肠癌筛查决定因素的影响:在医生办公室进行的一项随机对照试验研究
Effects of a tailored interactive multimedia computer program on determinants of colorectal cancer screening: a randomized controlled pilot study in physician offices.
作者信息
Jerant Anthony, Kravitz Richard L, Rooney Mairin, Amerson Scott, Kreuter Matthew, Franks Peter
机构信息
Department of Family and Community Medicine (DF&CM), University of California Davis (UCD) School of Medicine (SOM), 4860 Y Street, Suite 2300, Sacramento, CA 95817, United States.
出版信息
Patient Educ Couns. 2007 Apr;66(1):67-74. doi: 10.1016/j.pec.2006.10.009. Epub 2006 Dec 6.
OBJECTIVE
Screening reduces colorectal cancer (CRC) mortality and is cost-effective, yet uptake is suboptimal. We developed and evaluated a personally tailored interactive multimedia computer program (IMCP) to encourage CRC screening.
METHODS
Randomized controlled pilot trial evaluating the effects of the personally tailored CRC screening IMCP as compared with a non-tailored IMCP ("electronic leaflet") control. The IMCP was tailored to patient preference, self-efficacy, barriers, and readiness and deployed in busy primary care offices before scheduled doctor visits. Main outcomes were: CRC screening knowledge, self-efficacy, benefits and barriers, and stage of readiness.
RESULTS
We enrolled 54 subjects; software glitches occurred in 5, leaving 49 subjects for analysis. In adjusted analyses, compared with control, the experimental group had a significant increase in CRC screening self-efficacy (p=0.049), a significantly greater likelihood of moving to a more advanced stage of readiness for screening (p=0.034), a trend toward fewer perceived barriers to screening (p=0.149), and no difference in perceived benefits or knowledge of screening.
CONCLUSION
Our personally tailored IMCP was significantly more effective than control in bolstering CRC screening readiness and self-efficacy.
PRACTICE IMPLICATIONS
If further streamlined, personally tailored IMCPs might be usefully deployed in busy primary care offices to improve uptake of CRC screening.
目的
筛查可降低结直肠癌(CRC)死亡率且具有成本效益,但接受度并不理想。我们开发并评估了一个个性化的交互式多媒体计算机程序(IMCP),以鼓励进行CRC筛查。
方法
进行随机对照试验,评估个性化的CRC筛查IMCP与非个性化IMCP(“电子传单”)对照相比的效果。IMCP根据患者偏好、自我效能、障碍和准备程度进行定制,并在繁忙的初级保健办公室中,于预定的医生就诊前部署。主要结果包括:CRC筛查知识、自我效能、益处和障碍以及准备阶段。
结果
我们招募了54名受试者;5人出现软件故障,剩余49名受试者进行分析。在调整分析中,与对照组相比,实验组的CRC筛查自我效能显著提高(p=0.049),进入更高级筛查准备阶段的可能性显著增加(p=0.034),筛查感知障碍有减少趋势(p=0.149),在筛查感知益处或知识方面无差异。
结论
我们的个性化IMCP在增强CRC筛查准备度和自我效能方面比对照组显著更有效。
实践意义
如果进一步简化,个性化IMCP可能会有效地部署在繁忙的初级保健办公室,以提高CRC筛查的接受度。