Adler David, Bonham Adrienne, Chamberlin Sydney, Fiscella Kevin, Mustian Karen, Park Chanjun Syd, Wood Nancy, Abar Beau
University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
Prev Med Rep. 2023 Apr 25;33:102221. doi: 10.1016/j.pmedr.2023.102221. eCollection 2023 Jun.
The emergency department patient population is disproportionately under-screened for cancer, making it an optimal environment to promote cancer screening among hard-to-reach populations and those without routine access to primary care. The first step in a cancer screening process is identifying screening eligibility (e.g. age, sex) and need (i.e. due or past due). In an effort to support the scalability of an emergency department (ED)-based cervical cancer screening intervention, we examined the performance of a low-resource approach of determining cervical cancer screening needs among ED patients. A convenience sample of ED patients (N = 2807) was randomized to (a) an in-person interview with human subjects research staff or, (b) a self-administered, tablet computer-based survey for determining cervical cancer eligibility and need. Patients were recruited from a high-volume urban ED in Rochester, NY and a low-volume rural ED in Dansville, NY between December 2020 and December 2022. Results of these approaches were compared for equivalence of method for determining adherence status with screening guidelines and under/over-reporting of screening activity. Nearly identical reported rates of non-adherence with screening were identified across conditions (1.7% absolute difference; Χ = 0.96, = 0.33). Our results demonstrate that a low-resource approach of using a tablet-based self-administered survey to determine cervical cancer screening needs is equivalent to a labor intensive in-person interview approach conducted by trained research staff among ED patients.
急诊科患者群体接受癌症筛查的比例严重偏低，这使其成为在难以触及的人群以及无法定期获得初级医疗服务的人群中推广癌症筛查的理想环境。癌症筛查过程的第一步是确定筛查资格（如年龄、性别）和需求（即应筛查或逾期未筛查）。为了支持基于急诊科（ED）的宫颈癌筛查干预措施的可扩展性，我们研究了一种低资源方法在确定急诊科患者宫颈癌筛查需求方面的表现。选取了急诊科患者的便利样本（N = 2807），随机分为两组：（a）由人类受试者研究人员进行面对面访谈，或（b）通过基于平板电脑的自我管理调查问卷来确定宫颈癌筛查资格和需求。2020年12月至2022年12月期间，从纽约州罗切斯特市的一家高流量城市急诊科和纽约州丹斯维尔市的一家低流量农村急诊科招募患者。比较了这些方法在确定筛查指南依从性状态以及筛查活动报告不足/报告过度方面的等效性。在不同条件下，筛查不依从的报告率几乎相同（绝对差异为1.7%；Χ = 0.96，P = 0.33）。我们的结果表明，使用基于平板电脑的自我管理调查问卷来确定宫颈癌筛查需求的低资源方法，与由训练有素的研究人员对急诊科患者进行的劳动密集型面对面访谈方法等效。
