Development, implementation, and evaluation of the “Get Behind Your Health!” colorectal cancer screening media campaign

Background: Certain population groups experience higher rates of cancer. Residents of Ohio Appalachia have increased colon cancer incidence and mortality rates.

Purpose: To use a community-based participatory research approach, academic researchers worked with an Ohio Appalachia cancer coalition to develop and evaluate a colorectal cancer (CRC) screening media campaign in Ohio Appalachia.

Methods: A convenience sample of adults (>50 years) completed surveys at two different time points. CRC screening knowledge, behaviors, and barriers were assessed in the first survey prior to the county-wide media campaign. The second survey evaluated the 3 month media campaign that featured a local CRC survivor.

Findings: Among average risk participants (n=170) who completed the first survey, 15% had not completed high school, 56% reported a household income <$0,000, and 12% had no health insurance. CRC knowledge was adequate in 60%, but only 41% had received a doctor recommendation and 29% had completed CRC screening within guidelines. In a multivariate model, CRC screening was higher for participants receiving a doctor's recommendation (OR=6.09), having 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 receiving a doctor's recommendation for screening. The media campaign evaluation (n=97) documented that 64% of the participants remembered the campaign message, with the most frequent source of the message being a billboard.

Conclusions: This study suggests that a community-based participatory approach may be useful in developing cancer prevention strategies in rural Appalachia.