Marcus A C, Bastani R, Reardon K, Karlins S, Das I P, Van Herle M P, McClatchey M W, Crane L A
AMC Cancer Research Center, Denver, CO 80214.
J Natl Cancer Inst Monogr. 1993(14):119-29.
In 1987, the Division of Cancer Prevention and Control, National Cancer Institute (NCI), funded a randomized trial of a proactive counseling protocol to promote screening mammography among age-eligible female callers to the Cancer Information Service (CIS). This protocol included interactive counseling by CIS counselors to help callers overcome barriers to screening mammography; this counseling was an extension of usual service and was combined with a 2-week follow-up mailout to reinforce the brief (6-minute) proactive telephone-counseling protocol. The screening-mammography counseling intervention was tested in two regional CIS offices using a randomized two-group design. Callers were randomly assigned to the intervention or control group based on the week of their call to the CIS (n = 1831 eligible female callers). Self-reported adherence to NCI screening-mammography guidelines was assessed from telephone interviews conducted at 12 months' follow-up (87% response rate). Among all CIS callers enrolled in this study, self-reported adherence to screening-mammography guidelines at 12 months' follow-up was 63.5%. The most frequently cited barriers to screening mammography reported by CIS callers were inconvenience/being too busy (52%), cost (36%), lack of physician referral (34%), no symptoms (34%), and fear of radiation (29%). A significant intervention effect on adherence behavior was found but only in one of the two test sites and only among CIS callers reporting total family income of $30,000 or more (odds ratio = 1.38, P = .04). The vast majority (90%) of CIS callers (both intervention and control subjects) endorsed the concept of proactive counseling by the CIS. The implications of these findings for the CIS and future research are discussed.
1987年，美国国立癌症研究所（NCI）癌症预防与控制司资助了一项随机试验，该试验采用一种积极主动的咨询方案，以促进符合年龄条件的女性拨打癌症信息服务（CIS）热线时进行乳腺钼靶筛查。该方案包括CIS咨询员进行的互动咨询，以帮助来电者克服乳腺钼靶筛查的障碍；这种咨询是常规服务的延伸，并与为期两周的后续邮寄相结合，以强化简短（6分钟）的积极主动电话咨询方案。采用随机两组设计在两个地区性CIS办公室对乳腺钼靶筛查咨询干预措施进行了测试。根据来电者拨打CIS热线的周次，将其随机分配到干预组或对照组（n = 1831名符合条件的女性来电者）。在12个月随访时通过电话访谈评估自我报告的对NCI乳腺钼靶筛查指南的依从性（应答率87%）。在参与本研究的所有CIS来电者中，12个月随访时自我报告的对乳腺钼靶筛查指南的依从性为63.5%。CIS来电者报告的乳腺钼靶筛查最常见障碍是不便/太忙（52%）、费用（36%）、缺乏医生转诊（34%）、无症状（34%）以及担心辐射（29%）。发现对依从行为有显著干预效果，但仅在两个测试地点之一，且仅在报告家庭总收入为30,000美元或以上的CIS来电者中（优势比 = 1.38，P = 0.04）。绝大多数（90%）的CIS来电者（干预组和对照组受试者）都认可CIS积极主动咨询的理念。讨论了这些发现对CIS及未来研究的意义。
