Limits...
eCROPS-CA: a systematic approach toward effective and sustainable cancer prevention in rural China.

Chai J, Shen X, Feng R, Cheng J, Chen Y, Zha Z, Jia S, Liang H, Zhao T, Sha R, Shi Y, Li K, Wang D - BMC Cancer (2015)

Bottom Line: Contemporary prevention relies primarily on strategies targeting general population with limited attention being paid to individualized approaches.The study utilizes a quesi-RCT design involving 4320 high risk individuals selected, via rapid and detailed risk assessments, from about 72,000 farmers aged 35+ in 36 administrative villages randomized into equal intervention and delayed intervention arms.The prevention package incorporates key success factors in a synergetic way toward cost-effectiveness and long-term sustainability.

View Article: PubMed Central - PubMed

Affiliation: School of Health Service Management, Anhui Medical University, Hefei, Anhui, China. jingchai82@sina.com.

ABSTRACT

Background: Effective prevention against cancers depends heavily on sustained individual efforts practicing protective behaviors and avoiding risk factors in a complex sociocultural context, which requires continuous and personalized supports. Contemporary prevention relies primarily on strategies targeting general population with limited attention being paid to individualized approaches. This study tests a novel package called, in acronym of core intervention components, eCROPS-CA that leverages protective behaviors against over 80% leading cancers among high risk individuals via continuous and tailored counseling by village doctors.

Methods/design: The study utilizes a quesi-RCT design involving 4320 high risk individuals selected, via rapid and detailed risk assessments, from about 72,000 farmers aged 35+ in 36 administrative villages randomized into equal intervention and delayed intervention arms. The intervention arm receives baseline and semiannual follow up evaluations plus eCROPS-CA for 5 years; while the control arm, only the baseline and follow-up evaluations for the first 5 years and eCROPS-CA starting from the 6(th) year if the intervention is proved effective. eCROPS-CA comprises electronic supports and supervision (e), counseling cancer prevention (C), recipe for objective behaviors (R), operational toolkit (O), performance-based incentives (P), and screening and assessment (S). Evaluation measures include: incidence and stage of the leading cancers, cancer-related knowledge, attitudes and practices; easy biophysical indicators (e.g., body mass index, blood pressure); intervention compliance, acceptance of the package.

Discussion: The prevention package incorporates key success factors in a synergetic way toward cost-effectiveness and long-term sustainability. It targets a set rather than any single cancer; choses village doctors as key solution to the widespread lack of professional manpower in implementing personalized and thus relatively sophisticated prevention; adopts real-time monitoring in reaching continuous improvement; utilizes smart web aids to enable prioritizing complex determinants of objective behaviors, linking counseling sessions happened at different time points and hence delivering highly coordinated prevention; uses 2-stage risk assessment models in identifying high risk individuals so as to focus on the most needed; applies standardized operation procedures in simplifying and smoothing behavior intervention yet ensuring delivery of essential steps and key elements.

Trials registry: ISRCTN33269053.

Show MeSH

Related in: MedlinePlus

Sample applications of project operational toolkit viewed using a smart phone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4416351&req=5

Fig4: Sample applications of project operational toolkit viewed using a smart phone.

Mentions: Operational toolkit (O) gears with a series of operational tools including: “reference table/lists” of cross-links between cancers and risk factors, contacts of related referral services etc.; “worksheets” for planning diet, physical activities, follow up visits etc.; “easy calculators” for estimating body mass index (BMI), diet calorie intake or glycemic index, activity calorie consumption etc.; and “visual-aids” for demonstrating composition of risk factors and trends in estimated cancer risk score, BMI,blood pressure, plasma glucose etc. All these tools are easily accessible by participating doctors and farmers via the project website at any time (Figure 4).Figure 4


eCROPS-CA: a systematic approach toward effective and sustainable cancer prevention in rural China.

Chai J, Shen X, Feng R, Cheng J, Chen Y, Zha Z, Jia S, Liang H, Zhao T, Sha R, Shi Y, Li K, Wang D - BMC Cancer (2015)

Sample applications of project operational toolkit viewed using a smart phone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4416351&req=5

Fig4: Sample applications of project operational toolkit viewed using a smart phone.
Mentions: Operational toolkit (O) gears with a series of operational tools including: “reference table/lists” of cross-links between cancers and risk factors, contacts of related referral services etc.; “worksheets” for planning diet, physical activities, follow up visits etc.; “easy calculators” for estimating body mass index (BMI), diet calorie intake or glycemic index, activity calorie consumption etc.; and “visual-aids” for demonstrating composition of risk factors and trends in estimated cancer risk score, BMI,blood pressure, plasma glucose etc. All these tools are easily accessible by participating doctors and farmers via the project website at any time (Figure 4).Figure 4

Bottom Line: Contemporary prevention relies primarily on strategies targeting general population with limited attention being paid to individualized approaches.The study utilizes a quesi-RCT design involving 4320 high risk individuals selected, via rapid and detailed risk assessments, from about 72,000 farmers aged 35+ in 36 administrative villages randomized into equal intervention and delayed intervention arms.The prevention package incorporates key success factors in a synergetic way toward cost-effectiveness and long-term sustainability.

View Article: PubMed Central - PubMed

Affiliation: School of Health Service Management, Anhui Medical University, Hefei, Anhui, China. jingchai82@sina.com.

ABSTRACT

Background: Effective prevention against cancers depends heavily on sustained individual efforts practicing protective behaviors and avoiding risk factors in a complex sociocultural context, which requires continuous and personalized supports. Contemporary prevention relies primarily on strategies targeting general population with limited attention being paid to individualized approaches. This study tests a novel package called, in acronym of core intervention components, eCROPS-CA that leverages protective behaviors against over 80% leading cancers among high risk individuals via continuous and tailored counseling by village doctors.

Methods/design: The study utilizes a quesi-RCT design involving 4320 high risk individuals selected, via rapid and detailed risk assessments, from about 72,000 farmers aged 35+ in 36 administrative villages randomized into equal intervention and delayed intervention arms. The intervention arm receives baseline and semiannual follow up evaluations plus eCROPS-CA for 5 years; while the control arm, only the baseline and follow-up evaluations for the first 5 years and eCROPS-CA starting from the 6(th) year if the intervention is proved effective. eCROPS-CA comprises electronic supports and supervision (e), counseling cancer prevention (C), recipe for objective behaviors (R), operational toolkit (O), performance-based incentives (P), and screening and assessment (S). Evaluation measures include: incidence and stage of the leading cancers, cancer-related knowledge, attitudes and practices; easy biophysical indicators (e.g., body mass index, blood pressure); intervention compliance, acceptance of the package.

Discussion: The prevention package incorporates key success factors in a synergetic way toward cost-effectiveness and long-term sustainability. It targets a set rather than any single cancer; choses village doctors as key solution to the widespread lack of professional manpower in implementing personalized and thus relatively sophisticated prevention; adopts real-time monitoring in reaching continuous improvement; utilizes smart web aids to enable prioritizing complex determinants of objective behaviors, linking counseling sessions happened at different time points and hence delivering highly coordinated prevention; uses 2-stage risk assessment models in identifying high risk individuals so as to focus on the most needed; applies standardized operation procedures in simplifying and smoothing behavior intervention yet ensuring delivery of essential steps and key elements.

Trials registry: ISRCTN33269053.

Show MeSH
Related in: MedlinePlus