Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
Am J Manag Care. 2013 Apr;19(4):265-71.
Examine association of comprehensiveness of colorectal cancer (CRC) screening discussion by primary care physicians (PCPs) with completion of CRC screening.
Observational study in Kaiser Permanente Northwest, a group-model health maintenance organization.
A total of 883 participants overdue for CRC screening received an automated telephone call (ATC) between April and June 2009 encouraging CRC screening. Between January and March 2010, participants completed a survey on PCPs' discussion of CRC screening and patient beliefs regarding screening.
receipt of CRC screening (assessed by electronic medical record [EMR], 9 months after ATC). Primary independent variable: comprehensiveness of CRC screening discussion by PCPs (7-item scale). Secondary independent variables: perceived benefits of screening (4-item scale assessing respondents' agreement with benefits of timely screening) and primary care utilization (EMR; 9 months after ATC). The independent association of variables with CRC screening was assessed with logistic regression.
Average scores for comprehensiveness of CRC discussion and perceived benefits were 0.4 (range 0-1) and 4.0 (range 1-5), respectively. A total of 28.2% (n = 249) completed screening, 84% of whom had survey assessments after their screening date. Of screeners, 95.2% completed the fecal immunochemical test. More comprehensive discussion of CRC screening was associated with increased screening (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.03-2.21). Higher perceived benefits (OR = 1.46, 95% CI = 1.13-1.90) and 1 or more PCP visits (OR = 5.82, 95% CI = 3.87-8.74) were also associated with increased screening.
More comprehensive discussion of CRC screening was independently associated with increased CRC screening. Primary care utilization was even more strongly associated with CRC screening, irrespective of discussion of CRC screening.
探讨初级保健医生（PCP）对结直肠癌（CRC）筛查全面性的讨论与完成 CRC 筛查之间的关联。
在 Kaiser Permanente Northwest（一个团体模式健康维护组织）进行观察性研究。
2009 年 4 月至 6 月期间，对 883 名逾期接受 CRC 筛查的参与者进行了自动电话呼叫（ATC），以鼓励 CRC 筛查。2010 年 1 月至 3 月期间，参与者完成了一项关于 PCP 讨论 CRC 筛查和患者对筛查的看法的调查。
CRC 筛查的接受情况（通过电子病历 [EMR] 评估，在 ATC 后 9 个月）。主要自变量：PCP 对 CRC 筛查的全面性（7 项量表）。次要自变量：对筛查的感知益处（4 项量表评估受访者对及时筛查益处的认同）和初级保健利用（EMR；在 ATC 后 9 个月）。使用逻辑回归评估变量与 CRC 筛查的独立关联。
CRC 讨论全面性和感知益处的平均得分分别为 0.4（范围 0-1）和 4.0（范围 1-5）。共有 28.2%（n=249）完成了筛查，其中 84%在筛查日期后进行了调查评估。在筛查者中，95.2%完成了粪便免疫化学测试。对 CRC 筛查的更全面讨论与增加筛查有关（优势比[OR] = 1.51，95%置信区间[CI] = 1.03-2.21）。更高的感知益处（OR = 1.46，95%CI = 1.13-1.90）和 1 次或更多次 PCP 就诊（OR = 5.82，95%CI = 3.87-8.74）也与增加的筛查有关。
对 CRC 筛查的更全面讨论与增加的 CRC 筛查独立相关。初级保健的利用与 CRC 筛查的关联更强，无论 CRC 筛查的讨论如何。
