Objectives: Colorectal cancer (CRC) is the 2nd most diagnosed cancer and leading cause of cancer death in Puerto Rico. However, CRC screening rates remain low. The aim of this study was to test the effectiveness of a Train-the-Trainers’ (TTT) program to develop trainers capable of educating others within their communities about CRC prevention. Methods: The TTT program consisted of didactics and seminars to capacitate participants to become trainers in CRC prevention. This project was evaluated using three components: (1) training workshops; (2) community educational sessions; and (3) the participant’s experience as a trainer. Pre - and post-tests on CRC screening knowledge were given to TTT participants. Program effectiveness was determined by the pre- and post-tests, number of workshop participants completing a community educational session within three months of training and the number of community members reached. Results: Among the 115 total participants, 97 participants took the pre- and post-test. There was a significant difference in the scores for the pre-test (M = 10.56, SD = 2.57) and the post-test (M = 11.43, SD = 1.83) given; t (96) = −4.68, p < 0.001. A total of 955 community members were reached. Participants from the community educational sessions (n = 680) evaluated the program. 77.7% of those participants expressed intent to undergo colonoscopy screening in the future. Conclusions: TTT was effective in preparing trainers in CRC prevention. Participants increased their knowledge about CRC prevention and successfully reached members of their community. Utilization of community trainers is an effective alternative to increase CRC education and awareness in Hispanic communities, which may positively impact CRC screening rates in this population.

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Background: Cancer is the second most common cause of death in Puerto Rico (PR) after heart disease. Colorectal cancer (CRC) is the second most commonly diagnosed cancer among both men and women. The cancer screening guidelines given by the American Cancer Society indicate that adults should begin CRC screening at the age of 50. Although self-reported CRC screening from 1997 to 2006 have showed an increase in PR, CRC screening trends are lower than in the United States. With low screening rates and high CRC mortality in PR, health promotion programs aimed at education and prevention are needed. Methods: The purpose of this study was to evaluate a community-based educational program (Train-the-Trainer – TTTP) to increase knowledge and awareness of prevention about CRC in PR. The TTTP consisted of a formal didactic and hands-on seminar where participants were given didactic information and were trained to become trainers in CRC prevention. The TTTP was open to any adult, who was willing to become a trainer and committed to present the information in another forum using the materials provided at the TTTP. For the evaluation of this project, three main components were measured: (1) the Train the Trainers’ sessions; (2) the Participants’ Community Educational Sessions; and (3) the participant's experience delivering the training intervention. A total of five different questionnaires were design for the evaluation process of each component. Both qualitative and quantitative methods were used to collect data. Evaluations of outcomes were measured within 60-days of the TTT session. Results: Pre- and post-tests were given to the participants of the Train-the-Trainer session (N=115). There was a significant difference in the scores for the pre-test (mean=10.56, SD=2.57) and the post-test (mean=11.43, SD=1.83); t(96)=−4.68, p&lt; 0.001); suggesting an augmentation in knowledge. Overall the participants from the community educational sessions (N=680) evaluated the program to be a success indicating that it provided them with knowledge, resources, and motivation to be screened for colorectal cancer, with 69.9% indicating their willingness to obtain a colonoscopy in the future. The trainer-to-trainee ratio was 1:6, with each participant of the TTTP training an average of 6 individuals from their own community within a 60-day period. Conclusion: The Puerto Rico CRC TTTP was effective in capacitating individuals to become trainers in their respective communities. The TTTP was effective in increasing knowledge of CRC prevention strategies and successfully reached members of the community. Implementation of a community-based program designed to develop trainers in CRC prevention demonstrated to be feasible and effective. Community based training programs are an alternative to promote CRC education and awareness in PR and may impact CRC screening rates, with subsequent decreases in mortality. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1813. doi:10.1158/1538-7445.AM2011-1813

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