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参与式研究推进结肠癌预防(PROMPT):一项实用试验的研究方案。

Participatory Research to Advance Colon Cancer Prevention (PROMPT): Study protocol for a pragmatic trial.

机构信息

The Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, Oregon 97227, USA.

Oregon Rural Practice-based Research Network (ORPRN), Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon 97239, USA.

出版信息

Contemp Clin Trials. 2018 Apr;67:11-15. doi: 10.1016/j.cct.2018.02.001. Epub 2018 Feb 9.

Abstract

BACKGROUND

Colon cancer is the second leading cause of cancer deaths in the United States. The Participatory Research to Advance Colon Cancer Prevention (PROMPT) study is a collaboration between two research institutions and a federally qualified health center (FQHC). The study seeks to raise colon cancer screening rates using a direct-mail fecal immunochemical testing (FIT) and reminder program in an FQHC serving a predominantly Latino population in California.

METHODS

PROMPT is a pragmatic trial enrolling 16 clinics. The study will test automated and live prompts (i.e., alerts, reminders) to a direct-mail FIT program in two phases. In Phase I, we tailored and defined intervention components for the pilot using a community-based participatory research approach called boot camp translation. We then plan to conduct a three-arm patient-randomized comparative effectiveness trial in two pilot clinics to compare 1) automated prompts, 2) live prompts, and 3) a combination of automated plus live prompts to alert and remind patients to complete screening. In Phase II, the adapted best practice intervention will be spread to additional clinics within the FQHC (estimated population 27,000) and assessed for effectiveness. Patient and staff interviews will be conducted to explore receptivity to the program and identify barriers to implementation.

DISCUSSION

This pragmatic trial applies innovative approaches to engage diverse stakeholders and will test the effectiveness and spread of a direct-mail plus reminder program. If successful, the program will provide a model for a cost-effective method to raise colon cancer screening rates among Latino patients receiving care in FQHCs.

TRIAL REGISTRATION

National Clinical Trial (NCT) Identifier NCT03167125.

摘要

背景

结肠癌是美国癌症死亡的第二大主要原因。参与推进结肠癌预防研究(PROMPT)是两个研究机构和一个合格的联邦健康中心(FQHC)之间的合作。该研究旨在通过在加利福尼亚州为主要拉丁裔人群服务的 FQHC 中使用直接邮寄粪便免疫化学检测(FIT)和提醒计划来提高结肠癌筛查率。

方法

PROMPT 是一项实用试验,共招募了 16 家诊所。该研究将在两个阶段测试直接邮寄 FIT 计划的自动化和实时提示(即警报、提醒)。在第一阶段,我们使用一种称为“训练营翻译”的基于社区的参与式研究方法来定制和定义试点的干预组件。然后,我们计划在两个试点诊所中进行一项三臂患者随机对照有效性试验,以比较 1)自动化提示、2)实时提示和 3)自动加实时提示组合,以提醒和提醒患者完成筛查。在第二阶段,适应性最佳实践干预措施将推广到 FQHC 内的其他诊所(估计人口 27000 人),并评估其有效性。将进行患者和工作人员访谈,以探讨对该计划的接受程度,并确定实施障碍。

讨论

这项实用试验采用了创新方法来吸引不同的利益相关者,并将测试直接邮寄加提醒计划的有效性和推广。如果成功,该计划将为 FQHC 中接受护理的拉丁裔患者提高结肠癌筛查率提供一种具有成本效益的方法模型。

试验注册

国家临床试验(NCT)标识符 NCT03167125。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9c8/5903679/3c5e72245047/nihms956478f1.jpg

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