Department of Pediatrics, The University of Chicago, Chicago, IL, USA.
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
BMC Health Serv Res. 2022 May 23;22(1):691. doi: 10.1186/s12913-022-08082-3.
Cancer survivors treated with any dose of radiation to the abdomen, pelvis, spine, or total body irradiation (TBI) are at increased risk for developing colorectal cancer (CRC) compared to the general population. Since earlier detection of CRC is strongly associated with improved survival, the Children's Oncology Group (COG) Long-Term Follow-Up Guidelines recommend that these high-risk cancer survivors begin CRC screening via a colonoscopy or a multitarget stool DNA test at the age of 30 years or 5 years following the radiation treatment (whichever occurs last). However, only 37% (95% CI 34.1-39.9%) of high-risk survivors adhere to CRC surveillance. The Activating cancer Survivors and their Primary care providers (PCP) to Increase colorectal cancer Screening (ASPIRES) study is designed to assess the efficacy of an intervention to increase the rate of CRC screening among high-risk cancer survivors through interactive, educational text-messages and resources provided to participants, and CRC screening resources provided to their PCPs.
ASPIRES is a three-arm, hybrid type II effectiveness and implementation study designed to simultaneously evaluate the efficacy of an intervention and assess the implementation process among participants in the Childhood Cancer Survivor Study (CCSS), a North American longitudinal cohort of childhood cancer survivors. The Control (C) arm participants receive electronic resources, participants in Treatment arm 1 receive electronic resources as well as interactive text messages, and participants in Treatment arm 2 receive electronic educational resources, interactive text messages, and their PCP's receive faxed materials. We describe our plan to collect quantitative (questionnaires, medical records, study logs, CCSS data) and qualitative (semi-structured interviews) intervention outcome data as well as quantitative (questionnaires) and qualitative (interviews) data on the implementation process.
There is a critical need to increase the rate of CRC screening among high-risk cancer survivors. This hybrid effectiveness-implementation study will evaluate the effectiveness and implementation of an mHealth intervention consisting of interactive text-messages, electronic tools, and primary care provider resources. Findings from this research will advance CRC prevention efforts by enhancing understanding of the effectiveness of an mHealth intervention and highlighting factors that determine the successful implementation of this intervention within the high-risk cancer survivor population.
This protocol was registered at clinicaltrials.gov (identifier NCT05084833 ) on October 20, 2021.
与一般人群相比，接受过腹部、骨盆、脊柱或全身照射（TBI）任何剂量放射治疗的癌症幸存者患结直肠癌（CRC）的风险增加。由于早期发现 CRC 与生存率的提高密切相关，儿童肿瘤学组（COG）长期随访指南建议这些高危癌症幸存者在 30 岁或放射治疗后 5 年（以较晚者为准）开始通过结肠镜检查或多靶点粪便 DNA 检测进行 CRC 筛查。然而，只有 37%（95%CI 34.1-39.9%）的高危幸存者遵循 CRC 监测。旨在评估通过互动式、教育性短信和资源为参与者提供，以及为他们的初级保健提供者（PCP）提供 CRC 筛查资源的干预措施，以提高高危癌症幸存者 CRC 筛查率的激活癌症幸存者及其初级保健提供者以增加结直肠癌筛查（ASPIRES）研究。
ASPIRES 是一项三臂、混合 II 型有效性和实施研究，旨在同时评估对童年癌症幸存者研究（CCSS）中参与者的干预措施的疗效，CCSS 是北美儿童癌症幸存者的纵向队列。对照组（C）参与者接收电子资源，治疗组 1 参与者接收电子资源和互动短信，治疗组 2 参与者接收电子教育资源、互动短信和他们的 PCP 接收传真材料。我们描述了我们收集定量（问卷、病历、研究日志、CCSS 数据）和定性（半结构化访谈）干预结果数据以及关于实施过程的定量（问卷）和定性（访谈）数据的计划。
迫切需要提高高危癌症幸存者的 CRC 筛查率。这项混合有效性-实施研究将评估由互动短信、电子工具和初级保健提供者资源组成的移动健康干预措施的有效性和实施情况。这项研究的结果将通过增强对移动健康干预措施有效性的理解，并突出确定该干预措施在高危癌症幸存者人群中成功实施的因素，来推进 CRC 预防工作。
该方案于 2021 年 10 月 20 日在 clinicaltrials.gov（标识符 NCT05084833）注册。
