High Colorectal Cancer Screening Adherence Rates when Pairing CHWs with FIT among Racial/Ethnic Minorities

To address colorectal cancer (CRC) incidence and mortality disparities in South Florida, we tested the feasibility of pairing community health workers (CHWs) with culturally and linguistically-appropriate CRC education and fecal immunology test (FIT) kits in medically-underserved Hispanic and Haitian neighborhoods in Miami-Dade County. Our previous research demonstrated the effectiveness of using CHWs in improving cervical cancer screening rates. For this study, CHWs recruited and educated Hispanic and Haitian males and females age 50-75 at average risk for CRC and who are not up-to-date with recommended screenings. Participants were recruited from neighborhood locations, word-of-mouth, churches, and clinics. CHWs provided either group or individual education about CRC and instructions on using FIT in the participant's language of preference, and a pre-paid mailer for returning the sample. Follow-up telephone interviews were conducted to assess acceptability of the intervention. Participants with positive FIT results were navigated to appropriate care. To date, of the 885 people screened for inclusion, 568 were eligible, 381 received the intervention, and 336 samples have been analyzed (2% positive rate; 1 person identified with CRC). Of the 381 participants, 90% of Haitians and 83% of Hispanics returned their FIT test. Recruitment ends June 2014. The majority of participants (95%) reported they would use FIT again and would recommend it to others. Differences between groups and possibly reasons for the low positivity rate will be discussed. This study demonstrates that using CHWs and culturally-tailored education is an effective and acceptable strategy for increasing cancer screening in communities with limited access to services.