An intervention to improve colorectal screening rates among low-income Latinos

Latinos face a significant gap in meeting the Healthy People 2010 goal for colorectal cancer screening. The national goal for colorectal cancer screening is set at 50% for having had a FOBT within the past two years and for ever having had a sigmoidoscopy. Yet only 24.4% of Latinos over age 50 had received a FOBT within the past two years and 46.6% had ever had a sigmoidoscopy according to 2006 CDC data; the screening rates are even lower for low-income Latinos. This disparity in cancer screening rates places Latinos at high risk for diagnoses at an advanced stage of the disease, with the consequence of diminished chances for survival. The public health challenge is to significantly improve Latino colorectal cancer screening rates. This is the pivotal obstacle to improved Latino survival rates for colorectal cancer. It compels the need for interventions that can improve screening and early detection and can be deployed on a sufficiently large national scale to reverse this trend. However, this requires an intervention that can effectively overcome cultural, linguistic and attitudinal barriers to promote adoption of recommended screening and risk reduction practices by low-income Latinos.

This presentation describes a culturally competent education intervention designed to deliver colorectal cancer information to low-income, low literacy Latinos in both English and Spanish. The design of the intervention was guided by formative research that identified barriers to screening among non-adherent, low-income Latinos as well as pathways to screening among low-income Latinos adherent to the 2005 USPSTF recommendations for colorectal cancer screening. The intervention is delivered as an individual, self-paced experience via interactive, multimedia touchscreen kiosks that overcome attention, literacy and cultural barriers in delivering cancer education messages about risk factors, screening and prevention, and risk reduction behaviors.