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参与健康研究的有限英语水平和种族多样化的低收入妇女:患者导航员干预的随机试验。

Engaging limited English proficient and ethnically diverse low-income women in health research: A randomized trial of a patient navigator intervention.

机构信息

Shanti Project, San Francisco, USA.

Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, USA.

出版信息

Patient Educ Couns. 2019 Jul;102(7):1313-1323. doi: 10.1016/j.pec.2019.02.013. Epub 2019 Feb 11.

Abstract

OBJECTIVE

Evaluate a community-based navigator intervention to increase breast cancer patients' and survivors' access to information about health research participation opportunities.

METHODS

In the context of a Community Based Participatory Research collaboration, we conducted a prospective randomized controlled trial of the Health Research Engagement Intervention with pre- and post-intervention surveys (n = 133). The primary outcome was health research information-seeking behavior. Secondary outcomes were health research knowledge, willingness to participate in health research, and health empowerment. Qualitative interviews (n = 11) elucidated participant perspectives on the intervention.

RESULTS

There was no statistically significant difference between intervention and control groups' information-seeking behavior. Knowledge that not all health research studies are about drugs or treatments increased significantly from pre- to post-test among intervention group participants (32% to 48%, p = 0.012), but not in the control group (43% to 30%, p = 0.059); the difference between arms was statistically significant (p = 0.0012). Although survey responses indicated willingness to participate, qualitative interviews identified competing priorities that limited participants' motivation to seek enrollment information.

CONCLUSIONS AND PRACTICE IMPLICATIONS

Community-based navigators are a trusted, and therefore promising link between health research and low-income underserved communities. However, systemic barriers in health research infrastructures need to be addressed to include low income, LEP and immigrant populations.

摘要

目的

评估基于社区的导航员干预措施,以增加乳腺癌患者和幸存者获取有关健康研究参与机会的信息。

方法

在社区参与式研究合作的背景下,我们对健康研究参与干预措施进行了前瞻性随机对照试验,在干预前后进行了调查(n=133)。主要结果是健康研究信息寻求行为。次要结果是健康研究知识、参与健康研究的意愿和健康赋权。定性访谈(n=11)阐明了参与者对干预措施的看法。

结果

干预组和对照组在信息寻求行为方面没有统计学上的显著差异。干预组参与者的知识水平从预测试到后测试显著增加,即并非所有健康研究都是关于药物或治疗的(32%到 48%,p=0.012),而对照组则没有(43%到 30%,p=0.059);两组之间的差异具有统计学意义(p=0.0012)。尽管调查回复表明愿意参与,但定性访谈发现,竞争优先事项限制了参与者寻求注册信息的动机。

结论和实践意义

基于社区的导航员是健康研究与低收入服务不足社区之间值得信赖的纽带。然而,健康研究基础设施中的系统障碍需要得到解决,以包括低收入、语言能力有限和移民群体。

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