Mi-CARE:比较三个基于证据的干预措施,在三个不同的临床背景下,在少数民族中促进结肠直肠癌查
Karriem S Watson1, Katherine Y Tossas2, Yazmin San Miguel3
1National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
International journal of environmental research and public health
|November 24, 2023
概括
选择正确的结肠直肠癌查干预措施很重要. 在服务于边缘化社区的不同诊所中,邮寄提醒,非专业人士导航和提供者教育显示出不同的有效性.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 预防癌症 预防癌症
背景情况:
- 结肠直肠癌 (CRC) 查完成率在联邦合格卫生中心 (FQHC) 服务的边缘化社区仍然很低.
- 基于证据的干预措施 (EBI) 存在,但它们在不同临床环境和人群中的比较有效性未得到充分研究.
- 针对特定患者的人口统计和临床背景的干预措施对于提高CRC查率至关重要.
研究的目的:
- 为了比较三个EBI (邮寄生日卡片,平时导航,提供者提供的教育) 提高CRC查完成率的相对有效性.
- 在FQHC中评估50-75岁的非裔美国 (AA) 和拉丁美洲 (LA) 患者中EBI的有效性.
- 为了确定EBI的有效性是否根据诊所的人口统计和患者种族而有所不同.
主要方法:
- 在美国的三个FQHC诊所招募了1252名符合CRC查条件的患者的便利样本.
- 被认定为非洲裔美国人或拉丁裔美国人的患者.
- 使用后勤回归分析,在三个EBI中比较CRC查完成率,考虑临床特定因素.
主要成果:
- 在研究人群中,CRC查总体完成率从基线13%增加到20%.
- 邮寄的生日提醒在多民族诊所最有效 (p = 0.03).
- 提供者提供的教育在以LA为主的诊所最有效 (p = 0.02),而在以AA为主的诊所 (p = 0.03).
结论:
- 对于CRC查的EBI的有效性因临床背景和患者群体而异.
- 根据特定的诊所特征 (例如,少数民族) 和患者人口统计数据量身定制干预措施可以优化CRC查完成率.
- 了解上下文因素对于在安全网设置中选择和实施最具影响力的EBI至关重要.
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