Department of Family & Community Medicine, University of California, San Francisco, USA.
Patient Educ Couns. 2012 Mar;86(3):372-7. doi: 10.1016/j.pec.2011.07.002. Epub 2011 Aug 9.
To evaluate a theory based, subject-centered, staff/subject communication program, AASAP (anticipate, acknowledge, standardize, accept, plan), to increase recruitment and retention in RCTs.
AASAP was evaluated with logistical regression by comparing rates of recruitment (at telephone screening, baseline assessment, initial intervention) and intervention retention (over 16 weeks) before (-AASAP) and after (+AASAP) it was introduced to a 3-arm RCT to reduce disease distress among highly distressed subjects with type 2 diabetes.
Included were 250 subjects in -AASAP and 338 in +AASAP. Significant improvement in recruitment occurred at each of the 3 recruitment stages: agreed at screening (OR=2.52; p<0.001), attended baseline assessment (OR=1.91; p<0.001), attended initial intervention (OR=1.46; p<0.03). Higher education and shorter diabetes duration predicted better recruitment in -AASAP (OR=2.23; p<0.001), but not in +AASAP. AASAP also improved intervention retention over 16 weeks (OR=3.46; p<0.05).
AASAP is a structured program of subject/staff communication that helps improve external validity by enhancing both subject recruitment and retention.
AASAP can be taught to non-professional staff and can be adapted to a variety of health settings. It can also be used by clinicians to engage patients in programs of ongoing care.
评估一种基于理论、以受试者为中心、强调医患沟通的方案 AASAP（预期、确认、标准化、接受、计划），以提高随机对照试验的招募和保留率。
通过逻辑回归比较 AASAP 引入减少 2 型糖尿病高度困扰患者疾病困扰的 3 臂 RCT 前后（-AASAP 和 +AASAP）的招募率（电话筛查、基线评估、初始干预时）和干预保留率（16 周以上），评估 AASAP 的效果。
共纳入 250 名 -AASAP 受试者和 338 名 +AASAP 受试者。在 3 个招募阶段均显著提高了招募率：筛选时同意（OR=2.52；p<0.001）、参加基线评估（OR=1.91；p<0.001）、参加初始干预（OR=1.46；p<0.03）。在 -AASAP 中，较高的教育程度和较短的糖尿病病程预测了更好的招募效果（OR=2.23；p<0.001），但在 +AASAP 中则不然。AASAP 还提高了 16 周的干预保留率（OR=3.46；p<0.05）。
AASAP 是一种结构化的医患沟通方案，通过提高受试者的招募和保留率，有助于提高外部有效性。
AASAP 可以教授给非专业人员，并适用于各种医疗环境。它也可以被临床医生用来让患者参与持续护理计划。
