社区健康诊所的第三届年度粪便潜血检测
Third Annual Fecal Occult Blood Testing in Community Health Clinics.
作者信息
Arnold Connie L, Rademaker Alfred, Wolf Michael S, Liu Dachao, Hancock Jill, Davis Terry C
机构信息
Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.
出版信息
Am J Health Behav. 2016 May;40(3):302-9. doi: 10.5993/AJHB.40.3.2.
OBJECTIVES
Our objective was to determine the effectiveness of 3 approaches to encourage completion of fecal occult blood testing (FOBT) in the third year of the intervention.
METHODS
Between 2008 and 2011, a quasi-experimental intervention was conducted in 8 predominantly rural Federally Qualified Health Centers. Clinics were randomly assigned to enhanced care (screening recommendation and FOBT kit mailed annually), education (patients additionally received a health literacy appropriate pamphlet and simplified FOBT instructions), or nurse support (same as education but with nurse follow-up). Participants included 206 patients with negative FOBTs in years 1 and 2; ages 50-85, 80% female, 70% African American, and 52% had limited health literacy. The main outcome measure was completion of a third annual FOBT.
RESULTS
Third-year FOBT rates were 48% overall, 34.2% enhanced care, 59.6% education, and 47.4% nurse support (p = .21), even after adjustment for sex, marital status, and health literacy.
CONCLUSION
All mailed interventions were similarly effective in sustaining rates of FOBT screening. Post hoc analyses of the results analyzed by health literacy skills found that patients with both limited and adequate health literacy skills were more likely to complete FOBTs when mailed simplified instructions.
目的
我们的目标是确定在干预的第三年，三种促进粪便潜血试验（FOBT）完成的方法的有效性。
方法
2008年至2011年期间，在8家主要位于农村的联邦合格健康中心进行了一项准实验性干预。诊所被随机分配到强化护理组（每年邮寄筛查建议和FOBT试剂盒）、教育组（患者额外收到一份适合健康素养的宣传册和简化的FOBT说明）或护士支持组（与教育组相同，但有护士随访）。参与者包括在第1年和第2年FOBT结果为阴性的206名患者；年龄在50 - 85岁之间，80%为女性，70%为非裔美国人，52%的健康素养有限。主要结局指标是完成第三次年度FOBT。
结果
即使在对性别、婚姻状况和健康素养进行调整后，第三年的总体FOBT率为48%，强化护理组为34.2%，教育组为59.6%，护士支持组为47.4%（p = 0.21）。
结论
所有邮寄干预措施在维持FOBT筛查率方面同样有效。根据健康素养技能对结果进行的事后分析发现，当邮寄简化说明时，健康素养有限和足够的患者完成FOBT的可能性更大。
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