The Family Health Promotion Project (FHPP): Design and baseline data from a randomized trial to increase colonoscopy screening in high risk families

Colorectal cancer (CRC) is a significant cause of mortality and morbidity in the United States, much of which could be prevented through adequate screening. Consensus guidelines recommend that high-risk groups initiate screening earlier with colonoscopy and more frequently than average risk persons. However, a large proportion of high risk individuals do not receive regular colonoscopic screening. The Family Health Promotion Project (FHPP) is a randomized-controlled trial to test the effectiveness of a telephone-based counseling intervention to increase adherence to risk-appropriate colonoscopy screening in high risk individuals. Unaffected members of CRC families from two national cancer family registries were enrolled (n=632) and randomized to receive either a single session telephone counseling intervention using Motivational Interviewing techniques or a minimal mail-out intervention. The primary endpoint, rate of colonoscopy screening, was assessed at 6, 12 and 24 months post-enrollment. In this paper, we describe the research design and telephone counseling intervention of the FHPP trial, and report baseline data obtained from the two high risk cohorts recruited into this trial. Results obtained at baseline confirm the need for interventions to promote colonoscopy screening among these high risk individuals, as well as highlighting several key opportunities for intervention, including increasing knowledge about risk-appropriate screening guidelines, and providing both tailored risk information and barriers counseling

A Randomized Trial to Increase Colonoscopy Screening in Members of High-Risk Families in the Colorectal Cancer Family Registry and Cancer Genetics Network

Individuals with a strong family history of colorectal cancer (CRC) have significant risk for CRC, though adherence to colonoscopy screening in these groups remains low. This study assessed whether a tailored, telephone counseling intervention can increase adherence to colonoscopy in members of high risk families in a randomized, controlled trial

Motivate To Communicate 300 Permainan dan Aktivitas untuk Anak Autis

Buku praktis ini berisi beragam ide menarik dan panduan untuk memotivasi anak-anak yang mengalami gangguan spektrum autisme dan masalah-masalah komunikasi lainnya. Formatnya yang praktis memudahkan anda untuk mengakses lebih dari 300 permainan dan aktivitas seru untuk mengembangkan keterampilan komunikasi anak anda. Gagasan-gagasan Innovatif dalam buku ini telah dikembangkan dari pengalaman klinis dan edukatif selama lebih dari 40 tahun dan didesain sedemikian rupa sehingga menyenangkan baik untuk anak-anak maupun orang dewasa.xi+160 hlm; 15x23 c

A Randomized Trial to Increase Colonoscopy Screening in Members of High-Risk Families in the Colorectal Cancer Family Registry and Cancer Genetics Network

BACKGROUND: Individuals with a strong family history of colorectal cancer (CRC) have significant risk for CRC, though adherence to colonoscopy screening in these groups remains low. This study assessed whether a tailored, telephone counseling intervention can increase adherence to colonoscopy in members of high risk families in a randomized, controlled trial. METHODS: Eligible participants were recruited from two national cancer registries if they had a first-degree relative with CRC under age 60 or multiple affected family members, which included families that met Amsterdam criteria for Hereditary Non-Polyposis Colon Cancer, and if they were due for colonoscopy within 24-months. Participants were randomized to receive a tailored, telephone intervention grounded in behavioral theory or a mailed packet with general information about screening. Colonoscopy status was assessed through follow-up surveys and endoscopy reports. Cox-proportional hazards models were used to assess intervention effect. RESULTS: Of the 632 participants (aged 25–80), 60% were female, the majority were White, non-Hispanic, educated and had health insurance. Colonoscopy adherence increased 11 percentage points in the tailored, telephone intervention group, compared to no significant change in the mailed group. The telephone intervention was associated with a 32% increase in screening adherence compared to the mailed intervention (Hazard Ratio=1.32; p=0.01). CONCLUSIONS: A tailored, telephone intervention can effectively increase colonoscopy adherence in high risk persons. This intervention has the potential for broad dissemination to health-care organizations or other high risk populations. IMPACT: Increasing adherence to colonoscopy among persons with increased CRC risk could effectively reduce incidence and mortality from this disease

FHPP Baseline Survey from A Randomized Trial to Increase Colonoscopy Screening in Members of High-Risk Families in the Colorectal Cancer Family Registry and Cancer Genetics Network

PDF - 80K, Family Health Promotion Project: Baseline Questionnaire used in trial.</p

Evaluating explanations about drug prescriptions: effects of varying the nature of information about side effects and its relative position in explanations

This study evaluates computer-generated written explanations about drug prescriptions that are based on an analysis of both patient and doctor informational needs. Three experiments examine the effects of varying the type of information given about the possible side effects of the medication, and the order of information within the explanation. Experiment 1 investigated the effects of these two factors on people's ratings of how good they consider the explanations to be and of their perceived likelihood of taking the medication, as well as on their memory for the information in the explanation. Experiment 2 further examined the effects of varying information about side effects by separating out the contribution of number and severity of side effects. It was found that participants in this study did not “like” explanations that described severe side effects, and also judged that they would be less likely to take the medication if given such explanations. Experiment 3 therefore investigated whether information about severe side effects could be presented in such a way as to increase judgements of how good explanations are thought to be, as well as the perceived likelihood of adherence. The results showed some benefits of providing additional explanatory information