A trial of 3 interventions to promote colorectal cancer screening in African Americans

Abstract

BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. CRC incidence and mortality rates are higher among blacks than among whites, and screening rates are lower in blacks than in whites. For the current study, the authors tested 3 interventions that were intended to increase the rate of CRC screening among African Americans. METHODS: The following interventions were chosen to address evidence gaps in the Centers for Disease Control and Prevention's Guide to Community Preventive Services: one-on-one education, group education, and reducing out-of-pocket costs. Three hundred sixty-nine African-American men and women aged 50 years were enrolled in this randomized, controlled community intervention trial. The main outcome measures were postintervention increase in CRC knowledge and obtaining a screening test within 6 months. RESULTS: There was substantial attrition: Two hundred fifty-seven participants completed the intervention and were available for follow-up 3 months to 6 months later. Among completers, there were significant increases in knowledge in both educational cohorts but in neither of the other 2 cohorts. By the 6-month follow-up, 17.7% (11 of 62 participants) of the Control cohort reported having undergone screening compared with 33.9% (22 of 65 participants) of the Group Education cohort (P ¼ .039). Screening rate increases in the other 2 cohorts were not statistically significant. CON-CLUSIONS: The current results indicated that group education could increase CRC cancer screening rates among African Americans. The screening rate of <35% in a group of individuals who participated in an educational program through multiple sessions over a period of several weeks indicated that there still are barriers to overcome. Cancer 2010;116:922-9.

Implementation of an evidence-based intervention to promote colorectal cancer screening in community organizations: a cluster randomized trial

“…Compared to other studies [20,22], our study assisted a relatively large number of participants in obtaining CRC screening, and given their low income and low level of health insurance, many of our participants would probably have remained unscreened if they had not participated in our study. Our multi-component intervention was quite intensive and achieved a relatively high screening rate (around 50 %), similar to high rates achieved in two other CRC screening promotion programs among Korean and Vietnamese Americans in non-clinical settings [18,20].…”

“…Many prior trials to promote CRC screening have been conducted in clinical settings [10][11][12][13][14][15][16][17]. While a few pilot studies have demonstrated the feasibility of promoting CRC screening in community settings such as churches [18][19][20], few large trials have been conducted in these venues [21,22]. This study reports on a large CRC screening controlled trial conducted in partnership with a variety of community organizations.…”

What is the Most Effective Strategy for Improving the Cancer Screening Rate in Japan?

“…The U.S. Center for Disease Control and Prevention (CDC) conducted systematic reviews on the effectiveness of various interventions in increasing the screening rates for breast, cervical, and colorectal cancers, and published guidelines based on their findings, which recommend certain interventions for improving the screening rates for these cancers (Baron et al, 2008a;Sabatino et al, 2012; Community Preventive Services Task Force (CPSTF), 2013). The guidelines also aid decision makers in choosing an appropriate intervention (Townsend et al, 2009;Blumenthal et al, 2010;Lobb et al, 2011;Hannon et al, 2012).…”

“…Some studies have previously evaluated the effectiveness of various strategies (Hisamichi et al, 1991;Watanabe, 2003;Shimada et al, 2010a;Shimada et al, 2010b;Matsuda et al, 2011;Takaku, 2011;Kuroki, 2012;Yoshida et al, 2012), but it was difficult to compare the effectiveness of these strategies, as each study focused on the effectiveness of an individual strategy using different subjects and methodologies. As the most effective strategy in improving cancer screening rates differs depending on the country and region (McAvoy and Raza, 1991;King et al, 1994;Saywell et al, 1999;Champion et al, 2003;Saywell et al, 2003;Saywell et al, 2004;Blumenthal at al., 2010;Lee et al, 2012;Frie et al, 2013), it remains unclear which strategy would be the most effective in Japan. Therefore, a study comparing the effectiveness of different strategies used to improve cancer screening rates in Japan is warranted and poised to be very useful for decision makers.…”

Community-Partnered Evaluation of Depression Services for Clients of Community-Based Agencies in Under-Resourced Communities in Los Angeles

“…Our response rates for clients and programs were acceptable (78 to over 90 %), but low to moderate (50 %) for agencies relative to the field. Many studies of quality improvement in specific sites or applying CBPR to health rely on convenience samples, 7,38,[55][56][57][58][59][60][61] and use integrated systems or households or settings in government districts. 39,49,[62][63][64][65][66] The study findings are based on client self-report and may not accurately reflect actual service use due to problems such as client recall.…”