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基于诊所的针对服务不足的西班牙裔人群的结直肠癌筛查推广计划的效果。

Effectiveness of a clinic-based colorectal cancer screening promotion program for underserved Hispanics.

机构信息

Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.

出版信息

Cancer. 2011 Apr 15;117(8):1745-54. doi: 10.1002/cncr.25730. Epub 2010 Nov 8.

Abstract

BACKGROUND

Hispanics in the United States are less likely than other groups to receive screening services for colorectal cancer.

METHODS

The authors conducted a clinic-based individual randomized trial that enrolled Hispanic patients ages 50 to 79 years who had been seen in the Seattle-based community clinic in the past 5 years. A total of 501 patients met the eligibility criteria and were randomized to 1 of 3 conditions: 1) usual care; 2) mailed fecal occult blood test (FOBT) card and instructions on how to complete the test (mailed FOBT only); and 3) mailed FOBT card and instructions on how to complete the test, telephone reminders, and home visits (mailed FOBT and outreach). The authors assessed postintervention differences in rates of FOBT screening in intervention and usual care groups using computerized medical records reviewed from June 2007 to March 2008.

RESULTS

Data analysis occurred between November 2008 and September 2009. Nine-month postintervention screening rates were 26% among patients who received the mailed packet only intervention (P < .001 compared with usual care) and 31% in the group that received the mailed packet and outreach intervention (P < .001 compared with usual care). This compared with 2% in the group that received usual care. Screening rates in the mailed FOBT only group and in the mailed FOBT and outreach group were not significantly different (P = .28).

CONCLUSIONS

Culturally appropriate clinic-based interventions may increase colorectal cancer screening among underserved Hispanics.

摘要

背景

与其他群体相比,美国的西班牙裔接受结直肠癌筛查服务的可能性较低。

方法

作者进行了一项基于诊所的个体随机试验,该试验招募了过去 5 年内曾在西雅图社区诊所就诊的年龄在 50 至 79 岁的西班牙裔患者。共有 501 名患者符合入选标准,并随机分为 3 组:1)常规护理;2)邮寄粪便潜血检测(FOBT)卡和完成检测的说明(仅邮寄 FOBT);3)邮寄 FOBT 卡和完成检测的说明、电话提醒和家访(邮寄 FOBT 和外展)。作者使用从 2007 年 6 月至 2008 年 3 月期间审查的计算机医疗记录评估干预组和常规护理组在干预后的 FOBT 筛查率差异。

结果

数据分析于 2008 年 11 月至 2009 年 9 月之间进行。在仅接受邮寄包干预的患者中,9 个月后的筛查率为 26%(P <.001 与常规护理相比),在接受邮寄包和外展干预的患者中为 31%(P <.001 与常规护理相比)。而接受常规护理的患者的筛查率为 2%。仅接受邮寄 FOBT 组和接受邮寄 FOBT 和外展组的筛查率无显著差异(P =.28)。

结论

基于诊所的文化上适当的干预措施可能会增加服务不足的西班牙裔人群的结直肠癌筛查率。

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