Medgar Evers College, City University of New York, Department of Psychology, Brooklyn, New York (Dr Jones)
The Diabetes Research Center, Albert Einstein College of Medicine, Bronx, New York (Dr Walker, Dr Schechter, Ms Blanco)
Diabetes Educ. 2010 Jan-Feb;36(1):118-26. doi: 10.1177/0145721709356116. Epub 2009 Dec 31.
This purpose of this report is to describe a successful telephone intervention to increase the rate of diabetic retinopathy screening, its implementation with English and Spanish speakers, and the characteristics of those who benefited most from the intervention.
Participants in the telephone group (N = 305) received a tailored intervention from trained health educators who were ethnically diverse and representative of the community. The main outcome for the randomized controlled study was documented receipt of a dilated fundus examination (DFE) within the 6-month study window. Exploratory analyses focused on examining the factors that contribute to receiving a DFE within 6 months for participants in the tailored telephone intervention using Pearson chi(2) and logistic regression analysis.
Participants in the telephone intervention who did not receive a DFE had significantly more documented steps in the behavioral process than those who did receive a DFE, and ethnic concordance of the health educator was not significantly associated with a positive outcome in the DFE group. There was a negative association between the time spent building rapport and receipt of DFE. As time spent engaging in educational activities by telephone increased, the likelihood of receiving a DFE increased.
Although the telephone intervention was highly successful compared with the print intervention, these process results demonstrate the difficulties and challenges of conducting a tailored telephone intervention to improve rates of screening in an underserved, diverse urban community.
本报告旨在描述一项成功的电话干预措施，以提高糖尿病视网膜病变筛查率，介绍该措施在英语和西班牙语使用者中的实施情况，以及从干预中受益最多的人群的特征。
电话组（n = 305）的参与者接受了经过培训的健康教育者的个性化干预，这些健康教育者具有种族多样性且能代表社区。这项随机对照研究的主要结果是在 6 个月的研究窗口内记录到接受散瞳眼底检查（DFE）。使用 Pearson chi(2)和逻辑回归分析，对探索性分析侧重于检查个性化电话干预措施中参与者在 6 个月内接受 DFE 的因素。
未接受 DFE 的电话干预组参与者在行为过程中记录的步骤明显多于接受 DFE 的参与者，且健康教育者的种族一致性与 DFE 组的阳性结果并无显著相关性。建立融洽关系所花费的时间与接受 DFE 的时间呈负相关。随着通过电话进行教育活动的时间增加，接受 DFE 的可能性也随之增加。
尽管与印刷干预相比，电话干预措施非常成功，但这些过程结果表明，在服务不足且多样化的城市社区中，开展个性化电话干预以提高筛查率具有困难和挑战。
