Background Intervention studies among individuals in diverse community settings are needed to reduce health disparities in colorectal cancer (CRC) screening and mortality rates. The current study compared the efficacy of two intervention conditions promoting CRC screening among Black individuals. Methods Black individuals (aged 50-75, N=330) were recruited in community settings in four Tampa Bay counties. Following consent and a baseline interview which assessed sociodemographic and health-related variables, participants received a culturally-targeted CRC photonovella booklet plus fecal immunochemical test (FIT) kit or a standard CRC screening brochure plus FIT kit. The primary outcome was FIT kit screening uptake. Results FIT screening uptake at 6 months was 86.7% overall (90.3% in the brochure group and 81.9% in the photonovella group). Controlling for baseline between group differences, there was no influence of intervention on FIT kit uptake (p=.756). Significant predictors of not returning a FIT kit included being unable to work (p=.010), having higher religious belief scores (p=.015), and living further from the cancer center (p=.015). Conclusions Providing FIT kits and educational print materials to Black individuals in community settings resulted in high rates of CRC screening. The study also identified subgroups of participants who were less likely to return a FIT kit and provides insight for future interventions.

Stout had a role in data collection, analysis and interpretation of data, and drafting the article. Dr. Christy had a role in the conception and design of the study, interpretation of data, and drafting the article. Dr. Winger had a role in the conception and design of the study, acquisition of data, analysis and interpretation of data, and revising the article. Dr. Vadaparampil had a role in the interpretation of data and revising the article. Dr. Mosher had a role in the conception and design of the study, acquisition of data, interpretation of data, and revising the article. All authors approved the final version of the manuscript. Compliance with Ethical StandardsAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Hispanic women suffer disproportionately from cervical cancer incidence and mortality compared with non-Hispanic Whites in the United States. Peer-led health education and coaching via charlas (talking circles) may improve cervical cancer screening and early detection rates among specific sub-groups such as farmworker communities. This pilot study sought to collect preliminary evaluation data about the feasibility of implementing a promotora-led cervical cancer education intervention among women from a farmworker community. The study took place between April 2014 and November 2014. Created based on an established network (Tampa Bay Community Cancer Network, TBCCN), in partnership with a local farmworker organization (Farmworkers Self-Help, Inc.), the project entailed refinement of a curriculum guide including Spanish-language educational resources (teaching cards). Social Cognitive Theory and the Health Belief Model provided the conceptual framework for the study. Six women from the farmworker community helped to refine the intervention and were trained as promotoras. They successfully delivered the program via charlas to a total of 60 participants who completed baseline and post-intervention measures on knowledge (cervical cancer/HPV), beliefs, self-efficacy, and intentions. Findings demonstrated gains in knowledge and self-efficacy among charla participants (P<.0001), and support the promise of a community-driven intervention that is delivered by promotoras who use their cultural knowledge and trustworthiness to educate women about cancer screening practices. Results also add to the literature on the use of a charla approach for cancer prevention education within a farmworker community to prompt discussions about health. Future research should evaluate peer-led programs on a larger scale and among other at-risk groups in other community settings.