Barrier-focused intervention to increase colonoscopy attendance among nonadherent high-risk populations  

作　　者：Wen Meng Xi-Wen Bi Xiao-Yin Bai Hua-Feng Pan Shan-Rong Cai Qi Zhao Su-Zhan Zhang 

机构地区：[1]Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China [2]Department of Cardiothoracic Surgery, Hangzhou No. 1 People Hospital, Hangzhou 310006, Zhejiang Province, China [3]Xiacheng District Center for Disease Control and Prevention, Hangzhou 310003, Zhejiang Province, China

出　　处：《World Journal of Gastroenterology》2009年第31期3920-3925,共6页世界胃肠病学杂志（英文版）

基　　金：Supported by 11th 5-year Key Program for Science and Technology Development of China,No.2006BAI02A08

摘　　要：AIM： To increase attendance tor colonoscopy among nonadherent high-risk individuals for colorectal cancer （CRC） screening in China. METHODS： During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression. RESULTS： 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% （428/1858） during the first 12 mo without intervention, and 37.69% （539/1430） during the second 12 mo with intervention （P 〈 0.001）. Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers （OR： 34.590, 95% CI： 23.204-51.563） or subjects with some specific highrisk characteristics： first-degree relatives diagnosed with CRC （OR： 1.778, 95% CI： 1.010-3.131）, personal history of intestinal polyps （OR： 3.815, 95% CI： 1.994-7.300） and positive result for immunochemical fecal occult blood testing （OR： 2.718, 95% CI： 1.479-4.996）. CONCLUSION： The barrier-focused telephone or on- site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.AIM:To increase attendance for colonoscopy among nonadherent high-risk individuals for colorectal cancer (CRC) screening in China.METHODS:During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression.RESULTS: 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% (428/1858) during the first 12 mo without intervention, and 37.69% (539/1430) during the second 12 mo with intervention (P< 0.001). Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers (OR:34.590, 95% CI:23.204-51.563) or subjects with some specific high-risk characteristics: first-degree relatives diagnosed with CRC (OR:1.778, 95% CI:1.010-3.131), personal history of intestinal polyps (OR:3.815, 95% CI:1.994-7.300) and positive result for immunochemical fecal occult blood testing (OR: 2.718, 95% CI:1.479-4.996).CONCLUSION: The barrier-focused telephone or on-site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.

关 键 词：Colorectal cancer Screening INTERVENTION COLONOSCOPY ATTENDANCE 

分 类 号：TH776.1[机械工程—仪器科学与技术] B846[机械工程—精密仪器及机械]