153460 Healthy Colon, Healthy Life: A Model for Increasing Rates of Colorectal Cancer Screening in Latinos and Vietnamese

Tuesday, November 6, 2007: 3:20 PM

Judith Walsh, MD, MPH , Division of General Internal Medicine and Women's Health Clinical Research Center, University of California, San Francisco, San Francisco, CA
Rene Salazar, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Tung Nguyen, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Celia Kaplan, DrPH , Medical Effectiveness Research Center, University of California, San Francisco, San Francisco, CA
Jimmy Hwang, PhD , Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
Rena Pasick, DrPH , Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
Steve McPhee, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
     
PROBLEM: Although rates of colorectal cancer (CRC) screening are increasing, they are still low, particularly in ethnic minority groups.

METHODS: We developed in Spanish and Vietnamese brochures and telephone counseling (TC) tailored both to cultural and individual barriers. In partnership with a community-based organization, we trained 8 lay health workers to perform TC and then randomized 1793 participants to 1) brochure plus fecal occult blood test (FOBT) kit (n=765), 2) brochure, FOBT plus tailored TC (n=768), and 3) usual care (n=256). Participants completed baseline surveys about CRC screening, then received intervention, then completed follow-up surveys. FOBT receipt was the main outcome. Individuals with FOBT within 1 y, sigmoidoscopy within 5 y, or colonoscopy within 10 y were defined as up-to-date with screening.

RESULTS: At baseline, among 1013 Latinos, 38% had FOBT within 1 y; 51% were up-to-date with screening. Among 808 Vietnamese, 53% had FOBT within 1 year; 74% were up-to-date with screening. To date, 804 participants (45%) have completed the follow-up survey, to be done by 4/07. Preliminary analyses show a significant impact of the intervention: FOBT screening rates increased by 4.3% in the control group, 17.7% in the brochure group and 26.6% in the brochure/TC group (p<0.01). Additional analyses will analyze the impact of the intervention in Latinos and Vietnamese separately and multiple regression models will help define additional sociodemographic, health and attitudinal predictors of CRC screening.

CONCLUSION: Spanish and Vietnamese brochuresand telephone counseling by lay health workers may produce a significant impact on rates of CRC screening.

Learning Objectives:
1.Learn about rates of CRC screening and predictors among Latinos and Vietnamese Americans in California 2.Learn about the effect of an intervention that includes culturally tailored brochures and lay health workers doing tailored telephone counseling on rates of CRC screening in this community.

Keywords: Cancer Screening, Epidemiology

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Cancer Screening
See more of: Epidemiology