Promoting culturally appropriate colorectal cancer screening through a health educator

Abstract

BACKGROUND.Colorectal cancer (CRC) is a leading cause of cancer mortality in the US. Surveys reveal low CRC screening levels among Asians in the US, including Chinese Americans.METHODS.A randomized controlled trial was conducted with Chinese patients to evaluate a clinic‐based, culturally and linguistically appropriate intervention promoting fecal occult blood test (FOBT) screening. The multifaceted intervention included a trilingual and bicultural health educator, bilingual materials (a video, a motivational pamphlet, an informational pamphlet, and FOBT instructions), and three FOBT cards. Patients in the control arm received usual care. Our primary outcome measure was FOBT screening within 6 months after randomization. The proportion of FOBT completion in the intervention and control arms was compared by using a chi‐square test, and logistic regression analysis was performed to adjust for the effects of sociodemographic variables and prior screening history. Potential effect modifications were also tested by using logistic regression models.RESULTS.Our intervention had a strong effect on FOBT completion (intervention group, 69.5%; control group, 27.6%), and the adjusted odds of FOBT slightly increased to over 6‐fold greater in the intervention arm compared with the control arm. No effect modification by age, gender, language, insurance, or prior FOBT was found.CONCLUSIONS.The authors' multifaceted, culturally appropriate intervention significantly increased FOBT screening in a group of low‐income and less‐acculturated minority patients. Given the large effect size, future research should determine the effective core component(s) that can increase CRC screening in both the general and minority populations. Cancer 2006. © 2006 American Cancer Society.

The effects of teamwork and system support on colorectal cancer screening in primary care practices

“…Most studies that examine preventive CRC screening do so aiming to find the problem -e.g., patient barriers, [25][26][27][28][29][30] physician barriers, [5][6][7]31,32] system barriers [14,23,24,33,34] -and implement targeted interventions that solely impact CRC screening. These approaches, while successful to varying degrees, may be limited in their usefulness in applied practice settings for a number of reasons.…”

Navigating Language Barriers: A Systematic Review of Patient Navigators’ Impact on Cancer Screening for Limited English Proficient Patients

“…25,26 RESULTS Figure 1 presents a PRISMA flow diagram demonstrating the systematic review process and the final 15 articles that were included in the narrative review. The 15 studies were subdivided according to type of cancer screening that was evaluated, including breast (combined with other cancers), [27][28][29][30][31] colorectal cancer, [32][33][34][35][36][37][38][39][40][41][42][43][44] and cervical cancer, [45][46][47] represented in Table 1. Fifteen non-English languages were evaluated in these studies.…”

A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

“…40 Two randomized trials have evaluated navigator programs designed specifically for CRC screening: one focused primarily on increasing fecal occult blood testing among ethnic Chinese patients, 41 while a second study involved small numbers of patients receiving navigation services in an urban neighborhood health clinic. 35 To our knowledge, there have been no large-scale trials designed to increase overall rates of colonoscopy screening in low-income communities using a multilingual navigator program.…”