Community Involvement in the Development and Feedback About a Colorectal Cancer Screening Media Campaign in Ohio Appalachia

Abstract

A community needs assessment focused on colorectal cancer (CRC) screening knowledge, behaviors, and barriers was completed in one Ohio Appalachia county. A CRC screening media campaign was developed based on the findings from the needs assessment and feedback was obtained about the media campaign. The survey was completed by 170 self-reported average-risk adults. In a multivariate model, the CRC screening rate was higher for participants who had received a doctor’s recommendation (OR=6.09), had adequate CRC knowledge (OR=2.88), and was lower among participants employed full-time (OR=0.23). Having health insurance (OR=4.20) and being married (OR=2.58) was associated with having received a doctor’s recommendation for screening. Campaign feedback using a second survey completed by self-reported average-risk adults (n=61) revealed that 69% recognized the campaign image and message, with a billboard being the most cited source. This study highlights the importance of involving community members in the development of CRC screening programs to reduce cancer disparities in Appalachia.

Process Evaluation of Cancer Prevention Media Campaigns in Appalachian Ohio

“…In these few cases, we used the closest billboard location available and hung posters at other recommended county locations. In addition, based on several factors (i.e., community preference, pilot study, cost, and lack of high-speed Internet access), the campaigns did not include radio, television, or Internet components (Katz, Reiter, et al, 2011). …”

“…The F&V campaign in each comparison county featured county-specific farmers, grocery store owners, and community members selected by local community cancer coalitions (Katz et al, 2015). The campaigns were guided by social cognitive theory (Bandura, 1986) and were based on a pilot study (Katz, Reiter, et al, 2011). Social cognitive theory constructs addressed by the campaigns included reciprocal determinism (behavior promotion by campaign materials), observational learning (having community members featured with the campaign message), self-efficacy (changing belief about ability to discuss CRC screening), collective efficacy (community members advocating for improved health of the community), self-regulation (enlisting social support), and facilitation (connecting community members with local screening resources).…”

Cancer Incidence in Appalachia, 2004–2011

“…Colon and rectum cancers are higher in Appalachia for both men and women, regardless of region, except for women in the Southern region where rates are consistent with non-Appalachia. Various studies have found lower colorectal cancer screening rates in Appalachia areas, or among persons residing in rural areas (12,30,31). Cervical cancers are also higher in Appalachia overall and appear to be driven by increased rates primarily in Central Appalachia.…”

“…One study evaluated the relationship of screening and deprivation on latestage breast cancer in three states, another focused on cancer survivors in a single university hospital, and others evaluated cancer risk perceptions, specific screening programs, or mortality (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). All generally found higher cancer incidence and death rates, later-stage disease, and higher risk perception and worry about cancer recurrence.…”

Community Members’ Input into Cancer Prevention Campaign Development and Experience Being Featured in the Campaign

“…25 Based on the positive experience and findings, we designed a county-level, randomized trial to evaluate a campaign to increase CRC screening rates. The pilot study's results suggested that a campaign in Appalachia should include billboards, posters, and local newspaper articles featuring community residents.…”