Colorectal cancer screening in rural and poor-resourced communities

Abstract

To test the efficacy of a community-based intervention, Empowering Communities for Life (EC4L), designed to increase colorectal cancer (CRC) screening through fecal occult blood test (FOBT) in rural underserved communities in a randomized controlled trial. Participants were randomized into 3 groups (2 interventions and 1 control). Interventions were delivered by community lay health workers or by academic health professionals. The main outcome of interest was return rate of FOBT screening kit within 60 days. Participants included 330 screening-eligible adults. The overall return rate of FOBT kits within 60 days was 32%. The professional group (Arm 2) had the highest proportion of returned FOBTs within 60 days at 42% (n = 46/110), a significantly higher return rate than the lay group (Arm 1) [28%(n = 29/103);P = 0.0422] or control group (Arm 3) [25%(n = 29/117);P = 0.0099]. Thus, one arm (Arm 2) of our intervention produced significantly higher CRC screening through FOBT. Community-based participation partnered with academic health professionals enhanced CRC screening among rural and poor-resourced communities.

Barriers to and solutions for representative inclusion across the lifespan and in life course research: The need for structural competency highlighted by the COVID-19 pandemic

“…Although precision-targeted online advertising, including Facebook ads, may be effective for recruiting this population [67], strategies to build trust and communicate shared values among clinic administrators, providers, staff, stakeholders in the community, and patients are well-established methods for improving recruitment efforts [23,57,61,62,65,68]. Allocation of resources towards the needs of patients (e.g., reducing participant burden by offering telehealth and flexible hours, flexibility in screening tool used or in time and location of study visits, transportation reimbursement) may improve recruitment and retention [44,57,61,65].…”

“…Engaging in community-based participatory research and in community partnerships in general has been shown to improve recruitment and retention in ethnic and minority groups [23,31,51,54,68,76,77]. Community partnerships help establish trust and credibility [44,52,57,62,71,[77][78][79].…”

“…Community partnerships help establish trust and credibility [44,52,57,62,71,[77][78][79]. Further, by collaborating with community organizations and leaders, researchers can develop culturally relevant studies, including culturally tailored recruitment methods and materials that enhance participants' understanding of potential benefits from participation [44,52,54,57,68,71,76,77,79]. Hiring study staff that reflects the community of potential participants (e.g., share a common language, culture, and values), maintaining continuity of research personnel throughout the study period, and engaging staff in regular cultural competency training may also engender trust between participants and researchers [23,31,38,44,52,57,71,72,76,77,[79][80][81].…”

Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review

“…Similar to cervical cancer, colorectal cancer screenings can be effectively conducted using noninvasive stool-based test kits at home [44,45]. Studies have shown that stool-based test kits can help reach underresourced communities and increase colorectal cancer screening uptake [46]. Although the stool-based tests have a high false-positive rate [47], patients testing negative can be assured that they do not have colorectal cancers [26].…”

Saúde digital e telemedicina aplicados ao câncer colorretal: uma revisão

“…Através do rastreio e acompanhamento clínico, pode-se detectar e remover lesões pré-cancerosas precocemente, impedindo o desenvolvimento do CCR, sendo, portanto, uma doença evitável. Mesmo que a doença já esteja instalada, os pacientes ainda podem se beneficiar do tratamento precoce, que é mais efetivo (PRESTON et al, 2018).…”