Department of Public Health Sciences and Penn State Hershey Cancer Institute, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
J Stroke Cerebrovasc Dis. 2011 Jul-Aug;20(4):330-5. doi: 10.1016/j.jstrokecerebrovasdis.2010.02.002. Epub 2010 Aug 7.
Stroke risk factors are routinely assessed in community screening programs; however, the rate of patient follow-up for health care once risk factors are identified is known to be low. This study was conducted to test the effectiveness of a brief behavioral telephonic intervention in an ongoing community stroke prevention screening program on health care seeking for stroke risk. A total of 227 participants with 2 or more stroke risk factors were randomly allocated to either an attention control arm or a behavioral intervention arm. The control group received standard information on risk and advice, whereas the intervention group received a brief Health Belief Model telephonic intervention designed to motivate care-seeking. The effect of treatment on the participants who completed a health care visit for stroke risk concerns was assessed using logistic regression. Cox survival analysis was used to compare time to physician visit between the 2 groups. Participants in the intervention arm were 1.85 times more likely to visit a primary care physician than controls. At 3 months, 69.2% of subjects in the intervention arm and 52.9% of those in the controls arm reported a new primary care visit after screening (P = .02), with 56.0% in the intervention arm and 38.4% in the control arm reporting a primary care visit specifically to discuss the stroke screening results (P < .01). Our data indicate that the brief, low-cost, motivational intervention effectively promoted adherence to screening advice and merits further testing.
中风危险因素通常在社区筛查项目中进行评估；然而，一旦确定了危险因素，患者为了获得医疗保健而进行后续治疗的比率是已知较低的。本研究旨在测试在正在进行的社区中风预防筛查计划中，简短的行为电话干预对寻求中风风险的医疗保健的有效性。共有 227 名患有 2 个或更多中风危险因素的参与者被随机分配到对照组或行为干预组。对照组接受了有关风险和建议的标准信息，而干预组则接受了旨在激励寻求护理的简短健康信念模型电话干预。使用逻辑回归评估了治疗对完成中风风险相关医疗保健就诊的参与者的效果。使用 Cox 生存分析比较了两组之间的就诊时间。与对照组相比，干预组的参与者更有可能看初级保健医生，其可能性是对照组的 1.85 倍。在 3 个月时，干预组的 69.2%和对照组的 52.9%的受试者在筛查后报告了新的初级保健就诊（P =.02），干预组的 56.0%和对照组的 38.4%报告了专门讨论中风筛查结果的初级保健就诊（P <.01）。我们的数据表明，这种简短、低成本、激励性的干预措施有效地促进了对筛查建议的依从性，值得进一步测试。
