142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

302636
ACCION: Against colorectal cancer in our communities

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Navkiran Shokar, MD, MPH , Family MEdicine, Texas Tech Paul L FOster School of Medicine, El Paso, TX
Theresa Byrd, DrPH , Department of Public Health, Texas Tech Health Sciences Center, Lubbock, TX
Rebekah Salaiz, MS , Department of Family Medicine, Texas Tech Health Sciences Center El Paso, El Paso, TX
Jessica Calderon-Mora, MPH , Office of Diversity, Texas Tech Health Sciences Center El Paso, El Paso, TX
Norma Nguyen, MPH , Department of Family Medicine, Texas Tech Health Sciences Center El Paso, El Paso, TX
Melchor Ortiz, PhD , Department of Statistics, Texas Tech Health Sciences Center El Paso, El Paso, TX
Eribeth Penaranda, MD , Department of Family Medicine, Texas Tech Health Sciences Center El Paso, El Paso, TX
Maria Chaparro, MPH , Department of Family Medicine, Texas Tech Health Sciences Center El Paso, El Paso, TX
Background: Colorectal cancer is the second leading cause of cancer death in the USA; screening is widely recommended. CRC screening rates remain suboptimal among Hispanics and low socioeconomic groups on the US-Mexico Border.

Methods: With community partners, we developed an evidence-based CRC prevention/early detection program for uninsured Texas residents aged 50-75, asymptomatic, without health insurance, due for CRC screening. Excluded: past CRC, recent rectal bleeding/blood in stool. Outreach is done by promotoras at community sites together with community partners. Education: bilingual theory-based 15 minute video starring community residents. Average risk individuals qualify for screening with the FIT. Higher risk or a positive FIT qualifies for no-cost colonoscopy. Navigation is offered to all colonoscopy participants, anyone with a positive FIT, and to people with history of CRC or recent rectal bleeding. Everyone is eligible to receive education.

Results: In 22 months we’ve approached 13,383 people and enrolled 6,465.  The test completion rate is 75.6% for FIT.  The FIT positive rate is 5.5% and 73.9% of those (n=340) have had colonoscopy. Colonoscopy findings include pre-cancerous polyps which were removed from 98 participants. Seven were diagnosed with cancer and navigated into treatment.  Preliminary analysis of pre-tests and 6 month post-tests demonstrate a significant increase in knowledge, self-efficacy and perceived benefits in participants compared to the control group (non-educated) in Brownsville, TX. 

Promotoras have recruited from 137 community sites. A community advisory board meets quarterly to review progress.

Conclusion: Networking with community partners has led to a screening rate (75%) higher than anticipated.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Communication and informatics
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Describe the development of community-University partnerships for cancer prevention Discuss the problem of lack of insurance on the US-Mexico border Discuss how the ACCION project is working to decrease rates of colorectal cancer

Keyword(s): Cancer Prevention and Screening, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-project director of ACCION with Dr. Shokar. We wrote the proposal and have been managing the project for the last 3 years.
Any relevant financial relationships? No

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.