Testing to Prevent Colon Cancer: Results From a Rural Community Intervention

Abstract

PURPOSE Colon cancer is the second leading cause of cancer death in the United States. Despite tests that can detect and enable removal of precancerous polyps, effectively preventing this disease, screening for colon cancer lags behind other cancer screening. The purpose of this study was to develop and test a community-based participatory approach to increase colon cancer screening.METHODS Using a community-based participatory research approach, the High Plains Research Network and their Community Advisory Council developed a multicomponent intervention-Testing to Prevent Colon Cancer-to increase colon cancer screening. A controlled trial compared 9 intervention counties in northeast Colorado with 7 control counties in southeast Colorado. We performed a baseline and postintervention random digit-dial telephone survey and conducted both intent-to-treat and on-treatment analyses. RESULTSIn all, 1,050 community members completed a preintervention questionnaire and 1,048 completed a postintervention questionnaire. During the study period, there was a 5% absolute increase in the proportion of respondents who reported ever having had any test in the intervention region (from 76% to 81%) compared with no increase in the control region (77% at both time points) (P = .22). No significant differences between these groups were found in terms of being up to date generally or on specific tests. The extent of exposure to intervention materials was associated with a significant and cumulative increase in screening.CONCLUSIONS This community-based multicomponent intervention engaged hundreds of community members in wide dissemination aimed at increasing colorectal cancer screening. Although we did not find any statistically significant differences, the findings are consistent with an intervention-related increase in screening and provide preliminary evidence on the effectiveness of such interventions to improve colon cancer screening.

Community-based interventions for health promotion and disease prevention in noncommunicable diseases: A narrative review

“…[ 17 21 22 23 24 25 26 27 ] The reviewed articles reported a number of intervention strategies. Even though many of those interventions are commonly used in community health programs,[ 20 21 22 25 26 28 29 30 31 32 33 34 35 36 37 38 ] few innovative ones were also reported[ 17 19 22 23 33 39 40 41 42 43 ] [ Table 4 ]. The focus of interventions was individual, group, community, and policy levels [ Table 5 ].…”

“…The objectives of these intervention programs were to increase cancer-related knowledge, reduce the time to diagnosis, improve screening rate, decrease risk behaviors, and correct cancer-related myths. [ 19 21 22 24 25 26 28 30 33 34 ] CBPR model was used in five articles. Peer leaders, general practitioners, patient navigators, community health workers (CHWs), kin keepers, and lay health workers led interventions were the persons delivering the intervention in five articles.…”

“…Community-based programs reviewed in this paper described experimental and quasi-experimental study designs. The quasi-experimental designs include non-RCTs,[ 25 29 30 34 43 45 50 ] interventions without control[ 37 40 41 44 47 48 ] and longitudinal crossover design. [ 36 ] The quasi-experimental study design was used in half of the articles reviewed.…”

Engaging practices and communities in the development of interventions to promote HPV vaccine uptake: a protocol for implementing Boot Camp Translation in the private practice setting

“…The same approach has been replicated in another region of Colorado with an estimated 5% increase in testing. 17 Since inception, BCT has been used numerous times to address a wide variety of health topics, including hypertension, diabetes, chronic pain, mental health, asthma and cardiovascular disease prevention. 15 18 19 The BCT focused on asthma resulted in (1) A set of messages to increase awareness of asthma and its symptoms, and 2A provider toolkit for use in primary care practices.…”

In This Issue: Working in Community and Improving Health Care Quality

“…1 An essay by the same Community Advisory Council 2 reveals the CBPR process through the voices of participants. A compelling accompanying video (www.annfammed.…”