Designing a randomized controlled trial to evaluate a community-based narrative intervention for improving colorectal cancer screening for African Americans

Ellis, Erin M.; Erwin, Deborah O.; Jandorf, Lina; Saad‐Harfouche, Frances G.; Sriphanlop, Pathu; Clark, Nikia; Dauphin, Cassandre; Johnson, Detric; Klasko-Foster, Lynne; Martinez, Clarissa; Sly, Jamilia; White, Drusilla; Winkel, Gary; Kiviniemi, Marc T.

doi:10.1016/j.cct.2017.11.019

Cited by 10 publications

(7 citation statements)

References 47 publications

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“…Despite the inconvenience that the secular trend of increasing prevalence of CRC screenings presented to our study goals for recruitment, this was wonderful news as screening rates were slowly creeping up to the goals set in CDC's Healthy People 2020 agenda (retrieved September 26, 2022, from https:// www.cdc.gov/nchs/healthy_people/hp2020.htm). We have noted that other researchers conducting community-based recruitment for CRC screening studies also appear to be finding a higher-than-expected rate of ineligibility because of higherthan-expected rates of CRC screening adherence-and we take this as a positive sign (Ellis et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Recruitment Challenges of a Colorectal Cancer Screening Dissemination Study

Larkey¹,

Szalacha²,

Bucho-Gonzalez³

et al. 2022

Nursing Research

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Background: Dissemination strategies to reach underserved and minority populations to promote screening for colorectal cancer (CRC) are key to reducing disparities. We conducted a study to examine a tailored messaging approach to navigate individuals from communities (i.e., lower income, less access to care, and underscreened) to clinics to receive CRC screening. We encountered several political, demographic, and secular trend issues that required reconsideration and redesign of implementation strategies.Objectives: Through study implementation from 2012 to 2017, changes in medical reimbursement and immigration policiesat the state level and later at the national level-affected healthcare delivery systems that had initially committed to supporting the study and our recruitment methods. Although our selected zip codes and sites had previously yielded high rates of CRC screening nonadherence, within a few years, these sites showed substantially higher screening adherence rates-yielding limited numbers of eligible participants. In addition, state immigration policy trends created mistrust and fear, leading to lower participation rates than anticipated. This report documents and provides valuable insights on how we and the community network developed creative strategies to overcome these challenges.Methods: New relationships with community partners were extended to tap advisory board input to meet the challenges. Criteria for clinic participation widened from originally selected Federally Qualified Health Centers (FQHCs) to various nonprofit, hybrid, and privately insured reimbursement types. Recruitment site options were creatively redefined to reach community participants where they live, work, and receive services.Results: Strategies that engage community members in identifying alternative healthcare delivery structures and that link recruitment efforts to community-based service organizations were found to be critical to recapturing community trust in the face of unfavorable political environments. Widening the type of clinic partners from FQHCs to stand-alone nonprofits and private clinics and identifying unusual types of recruitment sites provided alternative solutions for successful study implementation.Discussion: In prevention-based studies that face unplanned system and political barriers to recruitment, embedding the study in the community may aid in reestablishing trust levels to improve engagement and recruitment of clinic partners and eligible participants.

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Section: Discussionmentioning

confidence: 99%

Recruitment Challenges of a Colorectal Cancer Screening Dissemination Study

Larkey¹,

Szalacha²,

Bucho-Gonzalez³

et al. 2022

Nursing Research

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“…There is mounting evidence that EE can increase screening or its theoretical determinants for health conditions such as HIV and other sexually transmitted infections (Kennedy, O'Leary, Beck, Pollard, & Simpson, 2004;Whittier, Kennedy, Seeley, St. Lawrence, & Beck, 2005); depression (Hernandez & Organista, 2013); and cancers of the breast (Wilkin et al, 2007), cervix (Moran, Frank, Chatterjee, Murphy, & Baezconde-Garbanati, 2016), and prostate (Volk et al, 2008). However, there is scant evidence that narrative formats such as EE have more influence on topics like CRC screening than a well-constructed didactic stimulus would have (Ellis et al, 2017;Hwang et al, 2013;Jensen et al, 2014;Larkey et al, 2015).…”

Section: The Potential Contribution Of Entertainment Educationmentioning

confidence: 99%

Effects of an entertaining, culturally targeted narrative and an appealing expert interview on the colorectal screening intentions of African American women

Kennedy

McClish

Jones

et al. 2018

Journal Community Psychology

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Universal screening for colorectal cancer (CRC) is recommended for individuals 50–75 years of age, but screening uptake is suboptimal and African Americans have suffered persistent racial disparities in CRC incidence and deaths. We compared a culturally tailored fictional narrative and an engaging expert interview on the ability to increase intentions to be screened for CRC among African American women. In a post-only experiment, women (N = 442) in face-to-face listening groups in African American churches heard audio recordings of either a narrative or an expert interview. Questionnaires were completed immediately afterward and 30 days later. Women who heard narratives reported stronger intentions to be screened with a home stool blood test than women who heard the interview; the effect lasted at least 30 days. Culturally tailored, fictional narratives appear to be an effective persuasive strategy for reducing racial disparities in CRC outcomes.

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“…For example, for all sexes combined, non-Hispanic-African-American/Black (Black) and American Indian/Alaska Native (AIAN) adults experience higher CRC incidence (45.7 and 43.3 per 100,000, respectively) and mortality (19.0 and 15.8 per 100,000, respectively) than Non-Hispanic Whites (Whites) ( 2 , 3 , 7 , 11 ). CRC incidence has been found to be 24–27% higher ( 11 ) and mortality 36–52% higher among Black men compared with White men ( 8 , 11 , 12 ). Black adults have the lowest rate of 5-year CRC survival across all racial, ethnic, and sex subgroups ( 11 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

The Black Panther, Masculinity Barriers to Medical Care, and Colorectal Cancer Screening Intention Among Unscreened American Indian/Alaska Native, Black, and White Men

Brooks

Islam

Perdue

et al. 2022

Front. Public Health

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ObjectiveTo determine if masculinity barriers to medical care and the death from colorectal cancer (CRC) of actor Chadwick Boseman (The Black Panther) influenced CRC early-detection screening intent among unscreened American Indian/Alaska Native (AIAN) and Non-Hispanic-Black (Black) men compared with Non-Hispanic-White (White) men.MethodsUsing a consumer-panel, we surveyed U.S. men aged 18–75 years (N = 895) using the 24-item Masculinity Barriers to Medical Care (MBMC) scale. We calculated the median score to create binary exposures to evaluate associations with CRC screening intent and conducted multivariable logistic regression to evaluate independent associations stratified by race/ethnicity.ResultsOverall, Black respondents were most likely to have a high MBMC score (55%) compared to White (44%) and AIAN (51%) men (p = 0.043). AIAN men were least likely to report CRC screening intent (51.1%) compared with Black (68%) and White men (64%) (p < 0.001). Black men who reported the recent death of Chadwick Boseman increased their awareness of CRC were more likely (78%) to report intention to screen for CRC compared to those who did not (56%) (p < 0.001). Black men who exhibited more masculinity-related barriers to care were more likely to intend to screen for CRC (OR: 1.76, 95% CI: 0.98–3.16) than their counterparts, as were Black men who reported no impact of Boseman's death on their CRC awareness (aOR: 2.96, 95% CI: 1.13–7.67). Conversely, among AIAN men, those who exhibited more masculinity-related barriers to care were less likely to have CRC screening intent (aOR: 0.47, 95% CI: 0.27–0.82) compared with their counterparts.ConclusionsMasculinity barriers to medical care play a significant role in intention to screen for CRC. While Black men were most likely to state that The Black Panther's death increased their awareness of CRC, it did not appear to modify the role of masculine barriers in CRC screening intention as expected. Further research is warranted to better understand how masculine barriers combined with celebrity-driven health-promotion interventions influence the uptake of early-detection screening for CRC.ImpactOur study provides formative data to develop behavioral interventions focused on improving CRC screening completion among diverse men.

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Designing a randomized controlled trial to evaluate a community-based narrative intervention for improving colorectal cancer screening for African Americans

Cited by 10 publications

References 47 publications

Recruitment Challenges of a Colorectal Cancer Screening Dissemination Study

Recruitment Challenges of a Colorectal Cancer Screening Dissemination Study

Effects of an entertaining, culturally targeted narrative and an appealing expert interview on the colorectal screening intentions of African American women

The Black Panther, Masculinity Barriers to Medical Care, and Colorectal Cancer Screening Intention Among Unscreened American Indian/Alaska Native, Black, and White Men

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