Nursing and Healthcare Leadership Programs, University of Washington Tacoma, and Health Promotion Research Center, University of Washington, Seattle (Dr Laing); and Group Health Research Institute, Seattle (Dr Jones), Washington.
Cancer Epidemiol Biomarkers Prev 2014 Jan 12;23(1):154-9. Epub 2013 Nov 12.
Authors' Affiliations: Health Promotion Research Center, University of Washington; Department of Epidemiology, University of Washington; Group Health Research Institute, Seattle; and Department of Psychology, Eastern Washington University, Bellevue, Washington.
ABSTRACT Screening decreases colorectal cancer (CRC) morbidity and mortality, yet remains underutilized. Screening breakdowns arise from lack of uptake and failure to follow-up after a positive screening test.
Systems of support to increase colorectal cancer screening and follow-up (SOS) is a randomized trial designed to increase: (1) CRC screening and (2) follow-up of positive screening tests. The Chronic Care Model and the Preventive Health Model inform study design.
The setting is a large nonprofit healthcare organization. In part-1 study, patients age 50-75 due for CRC screening are randomized to one of 4 study conditions. Arm 1 receives usual care. Arm 2 receives automated support (mailed information about screening choices and fecal occult blood tests (FOBT)). Arm 3 receives automated and assisted support (a medical assistant telephone call). Arm 4 receives automated, assisted, and care management support (a registered nurse provides behavioral activation and coordination of care). In part-2, study patients with a positive FOBT or adenomas on flexible sigmoidoscopy are randomized to receive either usual care or nurse care management. Primary outcomes are: 1) the proportion with CRC screening, 2) the proportion with a complete diagnostic evaluation after a positive screening test.
We sent recruitment letters to 15,414 patients and 4675 were randomized. Randomly assigned treatment groups were similar in age, sex, race, education, self-reported health, and CRC screening history.
We will determine the effectiveness and cost effectiveness of stepped increases in systems of support to increase CRC screening and follow-up after a positive screening test over 2years.
Int J Psychophys, April 2003, vol 8, issue 1, pages 43-53
International Journal of Psychophysiology
Startle eyeblink modification was examined as a measure of allocation of attentional resources during active attention tasks in the early stage of information processing. Fifty-five participants were presented with a series of 250- and 40-ms tones of either high or low pitch which were followed by startle-eliciting stimuli at a lead interval of 120 ms. Attentional allocation was manipulated by instructing one group (Passive) to simply listen to the tones; the second group (Active 1) to count the number of low tones and the third group (Active 2) to count the long high-pitched tones and the short low-pitched tones. Startle eyeblink was significantly more inhibited for the Active 1 group than the Passive group (control) with no significant difference between the two directed attentional conditions (Active 1 and Active 2 groups). However, across the three attentional groups, the degree of startle eyeblink modulation appeared to reflect the degree of attention allocated to the task. The results support the utility of the startle probe in evaluating controlled attentional allocation during the early stages of information processing.