academic detailing to increase colorectal cancer screening by primary care practices in appalachian pennsylvania学术详细增加结直肠癌筛查初级护理实践在宾夕法尼亚州的阿巴拉契亚山脉.pdfVIP

Curry et al. BMC Health Services Research 2011, 11:112 /1472-6963/11/112 RESEARCH ARTICLE Open Access Academic detailing to increase colorectal cancer screening by primary care practices in Appalachian Pennsylvania William J Curry1,2,3*, Eugene J Lengerich3,4, Brenda C Kluhsman3,4, Marie A Graybill1,2, Jason Z Liao3,4, Eric W Schaefer3, Angela M Spleen3 and Mark B Dignan5 Abstract Background: In the United States, colorectal cancer (CRC) is the third most frequently diagnosed cancer and second leading cause of cancer death. Screening is a primary method to prevent CRC, yet screening remains low in the U.S. and particularly in Appalachian Pennsylvania, a largely rural area with high rates of poverty, limited health care access, and increased CRC incidence and mortality rates. Receiving a physician recommendation for CRC screening is a primary predictor for patient adherence with screening guidelines. One strategy to disseminate practice-oriented interventions is academic detailing (AD), a method that transfers knowledge or methods to physicians, nurses or office staff through the visit(s) of a trained educator. The objective of this study was to determine acceptability and feasibility of AD among primary care practices in rural Appalachian Pennsylvania to increase CRC screening. Methods: A multi-site, practice-based, intervention study with pre- and 6-month post-intervention review of randomly selected medical records, pre- and post-intervention surveys, as well as a post-intervention key informant interview was conducted. The primary outcome was the proportion of patients current with CRC screening recommendations and having received a CRC screening within the past year. Four practices received three separate AD visits to review four different learning modules. Results: We reviewed 323 records pre-intervention an