Developing Culturally Relevant Colorectal Cancer Education Materials: The Case for Integrating Traditional Chinese Medicine and Biomedical Approaches

Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although CRC screening is effective, screening rates in this population are low. Given the high use of Traditional Chinese Medicine (TCM) among Chinese Americans, a study was conducted to explore the involvement of TCM providers in CRC prevention. Methods: Phase I was the creation of educational materials acceptable to TCM providers. A graphically rich 32-page Chinese language TCM-provider CRC prevention flipchart was developed, based on a previously tested biomedical-oriented lay health worker outreach CRC flipchart. The TCM provider version included traditional theories on disease causation and prevention, health proverbs, and culturally appropriate images. Design of the TCM provider flipchart was an iterative process involving the research team and community members, including input from four TCM providers, cognitive testing with 2 additional providers, and final evaluation by 2 focus groups comprised of 12 users and non-users of TCM.

Results: Qualitative findings revealed that TCM providers found the integrated CRC prevention messages more acceptable than an exclusively biomedical CRC approach. TCM providers and community members noted areas of compatibility between TCM and biomedicine regarding cancer prevention. They also agreed that biomedical testing was more precise and reliable for detecting abnormalities, and that the combination of the traditional and biomedical approaches was best for the prevention of colon cancer.

Conclusions: It is feasible to design CRC education materials that integrate TCM and biomedical approaches. In Phase II we will test the efficacy of this approach in encouraging actual CRC screening.