Background Asian Americans have lower colorectal cancer (CRC) screening rates than non-Hispanic Whites. Hmong Americans have limited socioeconomic resources and literacy. This randomized controlled trial (RCT) was conducted to determine if bilingual/bicultural lay health educator (LHE) education can increase CRC screening among Hmong Americans Methods We conducted a cluster RCT among Hmong Americans in Sacramento, California. LHEs and recruited participants were randomized to intervention or control groups. The intervention group received CRC education over 3 months delivered by a LHE. The control group received education about nutrition and physical activity delivered by a health educator. The outcomes were change in self-reported ever and up-to-date CRC screening after 6 months. Results All participants (n=329) were foreign-born with mostly no formal education, limited English proficiency, and no employment. Most were insured and had a regular place for care. The intervention group had greater changes after the intervention than the control group for ever screening (p=0.068) and being up-to-date (p<0.0001). In multivariable regression analyses, the intervention group had a greater increase than the control group in reporting ever screening (AOR = 1.73, 95% CI: 1.07–2.79) and being up-to-date (AOR = 1.71, 95% CI: 1.26–2.32). Having health insurance had > 4 times the odds for receiving screening, both ever and up-to-date. A higher CRC knowledge score mediated the intervention effect for both screening outcomes. Conclusions A culturally and linguistically appropriate educational intervention delivered by trained LHEs increases colorectal cancer screening in an immigrant population with low levels of education, employment, English proficiency, and literacy. Trial Registration Clinicaltrials.gov # NCT01904890

The results have implications for research, school health promotion practice, and the implementation of evidence-based youth tobacco use prevention curricula.

Compared with a brochure, LHE outreach yielded greater increases in knowledge but resulted in similar increases in CRC screening in a Korean American population with barriers to health care access. More work is needed to appropriately address logistical and system barriers in this community. Cancer 2017;123:2705-15. © 2017 American Cancer Society.

The Research Centers in Minority Institu­tions (RCMI) program was established by the US Congress to support the develop­ment of biomedical research infrastructure at minority-serving institutions granting doctoral degrees in the health professions or in a health-related science. RCMI institu­tions also conduct research on diseases that disproportionately affect racial and ethnic minorities (ie, African Americans/Blacks, American Indians and Alaska Natives, His­panics, Native Hawaiians and Other Pacific Islanders), those of low socioeconomic sta­tus, and rural persons. Quantitative metrics, including the numbers of doctoral science degrees granted to underrepresented stu­dents, NIH peer-reviewed research funding, peer-reviewed publications, and numbers of racial and ethnic minorities participat­ing in sponsored research, demonstrate that RCMI grantee institutions have made substantial progress toward the intent of the Congressional legislation, as well as the NIH/NIMHD-linked goals of addressing workforce diversity and health disparities. Despite this progress, nationally, many challenges remain, including persistent disparities in research and career develop­ment awards to minority investigators. The continuing underrepresentation of minority investigators in NIH-sponsored research across multiple disease areas is of concern, in the face of unrelenting national health inequities. With the collaborative network support by the RCMI Translational Research Network (RTRN), the RCMI community is uniquely positioned to address these chal­lenges through its community engagement and strategic partnerships with non-RCMI institutions. Funding agencies can play an important role by incentivizing such col­laborations, and incorporating metrics for research funding that address underrep­resented populations, workforce diversity and health equity.Ethn Dis. 2019;29(Suppl 1):135-144; doi:10.18865/ed.29.S1.135.