The pilot study reported in this article culturally and linguistically adapted an educational intervention to promote cancer clinical trials (CCTs) participation among Latinas/os and African Americans. The single-session slide presentation with embedded videos, originally developed through a campus–community partnership in Southern California, was chosen for adaptation because it was perceived to fit the CORRECT model of innovation (credible, observable, relevant, relatively advantageous, easy to understand, compatible, and testable) and because of the potential to customize any components not identified as core, allowing them to be revised for cultural and linguistic alignment in New York City. Most of the 143 community participants (76.2%) were female; most (54.6%) were older than 59 years. More than half (78.3%) preferred to speak English or were bilingual in English and Spanish. A large proportion (41.3%) had not completed high school. Knowledge and perceived benefits and barriers regarding CCT showed small, though statistically significant, increases. There were no statistically significant group differences for changes in mean knowledge, perceived benefits, or perceived barriers when examined by ethnicity, education level, language, or other included sociodemographic variables. However, a small, but statistically significant difference in perceived barriers was observed when examined by country of origin, with the foreign born score worsening 0.08 points (SD = 0.47, p = .007) on the 5-point Likert-type scale administered posteducation compared to preeducation. Participants’ open-ended comments demonstrated the acceptability of the topic and intervention. This adaptation resulted in an intervention with the potential to educate African American and Latina/o general community members in a new geographic region about the purpose, methods, and benefits of CCTs.
Patient Navigation (PN) effectively increases screening colonoscopy (SC)
rates, a key to reducing deaths from colorectal cancer (CRC). Ethnic minority
populations have disproportionately low SC rates and high CRC mortality rates
and, therefore, especially stand to benefit from PN. Adapting the Health Belief
Model as an explanatory model, the current analysis examined predictors of SC
rates in two randomized studies that used PN to increase SC among 411 African
American and 461 Latino/a patients at a large urban medical center. Speaking
Spanish but not English (OR 2.192; p<0.005), having a higher income (OR
1.218; p<0.005), and scoring higher on the Pros of Colonoscopy scale (OR
1.535; p=0.023) independently predicted colonoscopy completion. Health education
and PN programs that increase awareness of the benefits of getting a colonoscopy
may encourage colonoscopy completion. In the context of language-appropriate PN
programs for African American and Latino/a individuals, those with lower incomes
and English speakers may require additional education and counseling to support
their decision-making around colonoscopy.
Possible targets for interventions include using EMRs to improve physician communication and encouraging patients to have timely PCP visits and follow-through after colonoscopy referral. Clinical studies in this area have the potential to improve outcomes for patients by reducing CRC mortality through early detection.
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