农村结直肠癌筛查组织动员模式探讨

发布时间：2019-03-28 16:37

【摘要】：目的探索与农村人群特点相适应的结直肠癌筛查组织动员模式,以提高村民结直肠癌筛查参与率。方法采用社区参与式研究方法 (CBPR),以知信行理论(KAP理论)和社区参与理论为指导设计出基于CBPR的农村结直肠癌筛查组织动员模式,主要包括组建社区筛查小组、基线调查了解需求、社区领袖树立筛查模范、社区领袖协助宣传教育、社区领袖带领社区医务人员入户进行个性化劝导等干预措施。采用社区干预试验来评价基于CBPR的农村结直肠癌筛查组织动员模式效果。2014年3—8月,采用目的抽样法从北京市房山区韩村河镇的27个行政村中选取五侯村、孤山口村作为社区干预试验现场,分为干预组(五侯村)和对照组(孤山口村)。干预组采用基于CBPR的农村结直肠癌筛查组织动员模式,对照组采用一般性组织动员模式。从社区干预试验现场选取有当地户籍的符合纳入标准的村民为筛查对象,对其进行免费结直肠癌筛查。记录两组初筛参与率、便隐血试验(FOBT)第1次完成率、FOBT第2次完成率、初筛完成率。结果干预组911例,对照组936例。干预组和对照组初筛参与率分别为35.6%(324/911)、11.6%(109/936),其中FOBT第1次完成率分别为85.5%(277/324)、87.2%(95/109),FOBT第2次完成率分别为71.3%(231/324)、55.0%(60/109),初筛完成率分别为71.3%(231/324)、55.0%(60/109)。多因素Logistic回归分析结果显示,控制性别、年龄因素后,干预组初筛参与率、FOBT第2次完成率、初筛完成率高于对照组(P0.05),干预组与对照组FOBT第1次完成率间差异无统计学意义(P0.05)。结论本研究组设计的基于CBPR的农村结直肠癌筛查组织动员模式有效提高了农村居民结直肠癌筛查的参与率,而且简单方便,适宜于农村结直肠癌筛查的组织动员工作。
[Abstract]:Objective to explore the organization mobilization model of colorectal cancer screening adapted to the characteristics of rural population in order to improve the participation rate of colorectal cancer screening in villagers. Methods with the guidance of knowledge, faith and action theory (KAP theory) and community participation theory, the community participatory research method (CBPR),) was used to design the organization mobilization model of rural colorectal cancer screening based on CBPR, which mainly included the formation of community screening teams. Baseline survey to understand needs, community leaders to set up screening model, community leaders to help promote education, community leaders led community medical staff to carry out personalized counselling and other interventions. Community intervention test was used to evaluate the effectiveness of CBPR-based rural colorectal cancer screening and organization mobilization model. From March to August 2014, Wuhou Village was selected from 27 administrative villages in Hancun he Town, Fangshan District, Beijing, using objective sampling method. Gushankou village was divided into intervention group (Wuhou village) and control group (Gushankou village) as community intervention test site. CBPR-based rural colorectal cancer screening tissue mobilization model was used in the intervention group and general tissue mobilization mode was used in the control group. The villagers who met the inclusion criteria were selected from the site of the community intervention test to screen for colorectal cancer free of charge. The first completion rate of (FOBT), the second completion rate of FOBT and the completion rate of primary screening were recorded. Results there were 911 cases in intervention group and 936 cases in control group. The primary screening participation rates in the intervention group and the control group were 35.6% (324 / 911) and 11.6% (109 / 936), respectively. The first completion rate of FOBT was 85.5% (277 / 324) and 87.2% (95 / 109), respectively. The second completion rate of FOBT was 71.3% (231 / 324) and 55.0% (60 / 109) respectively. The primary screening completion rate was 71.3% (231 / 324) and 55.0% (60 / 109) respectively. Multi-factor Logistic regression analysis showed that after controlling sex and age, the participation rate of primary screening, the second completion rate of FOBT and the completion rate of primary screening in intervention group were higher than those in control group (P0.05). There was no significant difference in the first completion rate of FOBT between the intervention group and the control group (P0.05). Conclusion the CBPR-based rural colorectal cancer screening organization mobilization model designed by the study group can effectively improve the participation rate of rural colorectal cancer screening, and is simple and convenient. It is suitable for rural colorectal cancer screening tissue mobilization.
【作者单位】：首都医科大学卫生管理与教育学院;中国医学科学院肿瘤医院内镜科;韩村河镇社区卫生服务中心;
【基金】：基金项目:北京市科学技术委员会(D121100004712001)——结肠癌早期预警及筛查规范研究
【分类号】：R735.34

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