A culturally and linguistically salient pilot intervention to promote colorectal cancer screening among Latinos receiving care in a Federally Qualified Health Center

Abstract

Despite established benefits, colorectal cancer (CRC) screening is underutilized among Latinos/Hispanics. We conducted a pilot 2-arm randomized controlled trial evaluating efficacy of two intervention conditions on CRC screening uptake among Latinos receiving care in community clinics. Participants (N = 76) were aged 50–75, most were foreign-born, preferred to receive their health information in Spanish, and not up-to-date with CRC screening. Participants were randomized to either a culturally linguistically targeted Spanish-language fotonovela booklet and DVD intervention plus fecal immunochemical test [FIT] (the LCARES, Latinos Colorectal Cancer Awareness, Research, Education and Screening intervention group); or a non-targeted intervention that included a standard Spanish-language booklet plus FIT (comparison group). Measures assessed socio-demographic variables, health literacy, CRC screening behavior, awareness and beliefs. Overall, FIT uptake was 87%, exceeding the National Colorectal Cancer Roundtable’s goal of 80% by 2018. The LCARES intervention group had higher FIT uptake than did the comparison group (90% versus 83%), albeit not statistically significant (P = 0.379). The LCARES intervention group was associated with greater increases in CRC awareness (P = 0.046) and susceptibility (P = 0.013). In contrast, cancer worry increased more in the comparison group (P = 0.045). Providing educational materials and a FIT kit to Spanish-language preferring Latinos receiving care in community clinics is a promising strategy to bolster CRC screening uptake to meet national targets.

Effectiveness of Colorectal Cancer Screening Promotion Using E-Media Decision Aids: A Systematic Review and Meta-Analysis

“…A total of 10 studies were included in this review. Eight studies were conducted in the United States [31][32][33][34][35][36][37][38], while the remaining two took place in New Zealand [39] and Iran [40]. Eight studies were randomized controlled trials [31][32][33]35,[37][38][39][40]; another two had quasi-experimental designs [34,36].…”

“…Four studies followed their patients for a minimum of 3 months [32,35,38,39]; one for 4 months [40]; two for 6 months [33,37]; and one each for 12 months [36], 14 months [31], and the maximum duration of 24 months [34]. The majority of studies reported interventions targeting eligible patients [31][32][33][34][35][36][37][38]40]; one study targeted non-adherence patients [39].…”

“…Four studies followed their patients for a minimum of 3 months [32,35,38,39]; one for 4 months [40]; two for 6 months [33,37]; and one each for 12 months [36], 14 months [31], and the maximum duration of 24 months [34]. The majority of studies reported interventions targeting eligible patients [31][32][33][34][35][36][37][38]40]; one study targeted non-adherence patients [39]. More than half of the included studies focused on improving the screening participation of specific vulnerable populations that tend to be under-screened or never screened [32][33][34][35][36]38,39].…”

“…The majority of studies reported interventions targeting eligible patients [31][32][33][34][35][36][37][38]40]; one study targeted non-adherence patients [39]. More than half of the included studies focused on improving the screening participation of specific vulnerable populations that tend to be under-screened or never screened [32][33][34][35][36]38,39].…”

“…In total, 9393 patients were had follow-ups. The sample sizes ranged from 65 [38] to 5271 [39], with most studies taking place in a multi-clinic setting [31][32][33][34][35][36]40]. Table 2 provides an overview of the characteristics of the included studies.…”