Department of Family and Community Medicine, University of California San Francisco School of Medicine, 94143-0900, USA.
Am J Prev Med. 2011 Jul;41(1):9-16. doi: 10.1016/j.amepre.2011.03.011.
The FLU-FOBT Program is an intervention in which nurses provide home fecal occult blood tests (FOBTs) to eligible patients during annual influenza vaccination (FLU) campaigns. The effectiveness of the FLU-FOBT Program when implemented during primary care visits has not been extensively studied.
The effectiveness of the FLU-FOBT Program was tested as adapted for use during primary care visits in community clinics serving multiethnic patients with low baseline colorectal cancer (CRC) screening rates.
Randomized clinical trial. During intervention weeks, nurses routinely initiated the offering of FOBT to eligible patients who were given FLU (FLU-FOBT group). During control weeks, nurses provided FOBT with FLU only when ordered by the primary care clinician during usual care (FLU-only group).
SETTING/PARTICIPANTS: The study was conducted in six community clinics in San Francisco. Participants were patients aged 50-75 years who received FLU during primary care visits during an 18-week intervention beginning on September 28, 2009.
The primary outcome was the change in CRC screening rates in the FLU-FOBT group compared to the FLU-only group at the end of the study period, on March 30, 2010. Multivariate logistic regression analysis was used to determine predictors of becoming up-to-date with CRC screening.
Data were analyzed in 2010. A total of 695 participants received FLU on FLU-FOBT dates, and 677 received FLU on FLU-only dates. The CRC screening rate increased from 32.5% to 45.5% (+13.0 percentage points) in the FLU-FOBT group, and from 31.3% to 35.6% (+4.3 percentage points) in the FLU-only group (p=0.018 for change difference). For those due for CRC screening, the OR for completing CRC screening by the end of the measurement period was 2.22 (95% CI=1.24, 3.95) for the FLU-FOBT group compared to the FLU-only group.
FLU-FOBT Program participants were twice as likely to complete CRC screening as those receiving usual care. The FLU-FOBT Program is a practical strategy to increase CRC screening in community clinics. TRIAL REGISTRATION #: NCT01211379.
FLU-FOBT 项目是一项干预措施，其中护士在年度流感疫苗接种（FLU）活动期间为符合条件的患者提供家庭粪便潜血检测（FOBT）。当在初级保健就诊时实施 FLU-FOBT 项目的效果尚未得到广泛研究。
本研究旨在测试 FLU-FOBT 项目在为服务于具有低基线结直肠癌（CRC）筛查率的多种族患者的社区诊所进行初级保健就诊时的适应性。
随机临床试验。在干预周期间，护士通常会向符合条件的接受流感疫苗（FLU-FOBT 组）的患者提供 FOBT。在对照周期间，护士仅在初级保健临床医生根据常规护理开出处方时才会在接受 FLU 的同时提供 FOBT（仅 FLU 组）。
地点/参与者：研究在旧金山的六家社区诊所进行。参与者为年龄在 50-75 岁之间的患者，他们在 2009 年 9 月 28 日开始的为期 18 周的干预期间在初级保健就诊时接受了 FLU。
主要结局是在研究结束时（2010 年 3 月 30 日），FLU-FOBT 组与仅 FLU 组相比 CRC 筛查率的变化。使用多变量逻辑回归分析确定与 CRC 筛查相关的预测因素。
2010 年进行了数据分析。共有 695 名参与者在 FLU-FOBT 日期接受了 FLU，677 名参与者在仅 FLU 日期接受了 FLU。FLU-FOBT 组 CRC 筛查率从 32.5%上升至 45.5%（+13.0 个百分点），仅 FLU 组从 31.3%上升至 35.6%（+4.3 个百分点）（FLU-FOBT 组变化差异有统计学意义 p=0.018）。对于需要进行 CRC 筛查的患者，FLU-FOBT 组完成 CRC 筛查的比值比（OR）为 2.22（95%CI=1.24，3.95），而仅接受 FLU 组为 1.00。
FLU-FOBT 项目的参与者完成 CRC 筛查的可能性是仅接受常规护理的参与者的两倍。FLU-FOBT 项目是提高社区诊所 CRC 筛查率的实用策略。试验注册号：NCT01211379。
