American Journal of Preventive Medicine
Volume 52, Issue 3, 2017, Pages e67-e76

Colorectal Cancer Screening and Chinese Americans: Efficacy of Lay Health Worker Outreach and Print Materials (Article)

Nguyen T.T.* , Tsoh J.Y. , Woo K. , Stewart S.L. , Le G.M. , Burke A. , Gildengorin G. , Pasick R.J. , Wang J. , Chan E. , Fung L.-C. , Jih J. , McPhee S.J.
  • a Asian American Research Center on Health, San Francisco, California, United States, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, United States
  • b Asian American Research Center on Health, San Francisco, California, United States, Department of Psychiatry, University of California, San Francisco, San Francisco, California, United States
  • c Asian American Research Center on Health, San Francisco, California, United States, NICOS Chinese Health Coalition, San Francisco, California, United States
  • d Department of Public Health Sciences, University of California, Davis, Davis, California, United States
  • e Asian American Research Center on Health, San Francisco, California, United States, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, United States
  • f Asian American Research Center on Health, San Francisco, California, United States, Department of Health Education, San Francisco State University, San Francisco, California, United States
  • g Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, United States
  • h Asian American Research Center on Health, San Francisco, California, United States, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, United States
  • i Asian American Research Center on Health, San Francisco, California, United States, The American College of Traditional Chinese Medicine, San Francisco, California, United States
  • j Department of Psychiatry, University of California, San Francisco, San Francisco, California, United States, NICOS Chinese Health Coalition, San Francisco, California, United States
  • k Asian American Research Center on Health, San Francisco, California, United States, Chinatown Public Health Center, Department of Public Health, San Francisco, California, United States
  • l Asian American Research Center on Health, San Francisco, California, United States, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, United States
  • m Asian American Research Center on Health, San Francisco, California, United States, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, United States

Abstract

Introduction Chinese Americans have low colorectal cancer (CRC) screening rates. Evidence-based interventions to increase CRC screening in this population are lacking. This study aims to compare the efficacy of two interventions in increasing CRC screening among Chinese Americans. Design Cluster randomized comparative trial. Setting/participants From 2010 to 2014, a community–academic team conducted this study in San Francisco, CA with Chinese Americans aged 50–75 years who spoke English, Cantonese, or Mandarin. Intervention Lay health worker (LHW) intervention plus in-language brochure (LHW+Print) versus brochure (Print). LHWs in the LHW+Print arm were trained to teach participants about CRC in two small group sessions and two telephone calls. Main outcome measures Change in self-reports of ever having had CRC screening and being up to date for CRC screening from baseline to 6 months post-intervention. Statistical analysis was performed from 2014 to 2015. Results This study recruited 58 LHWs, who in turn recruited 725 participants. The average age of the participants was 62.2 years, with 81.1% women and 99.4% foreign born. Knowledge increase was significant (p<0.002) for nine measures in the LHW+Print group and six in the Print group. Both groups had increases in having ever been screened for CRC (LHW+Print, 73.9%–88.3%, p<0.0001; Print, 72.3%–79.5%, p=0.0003) and being up to date for CRC screening (LHW+Print, 60.0%–78.1%, p<0.0001; Print, 58.1%–64.1%, p=0.0003). In multivariable analyses, the intervention OR for LHW+Print versus Print was 1.94 (95% CI=1.34, 2.79) for ever screening and 2.02 (95% CI=1.40, 2.90) for being up to date. Conclusions Both in-language print materials and LHW outreach plus print materials increased CRC screening among Chinese Americans. The combination of LHW+Print was more effective than Print alone. These findings can guide clinicians and policymakers in choosing appropriate interventions to increase CRC screening among Chinese American immigrants. Trial registration This study is registered at www.clinicaltrials.gov NCT00947206. © 2016 American Journal of Preventive Medicine

Author Keywords

[No Keywords available]

Index Keywords

statistical analysis publication Pamphlets health promotion comparative effectiveness mass screening English (language) health care personnel human Self Report middle aged colorectal cancer colorectal tumor controlled study comparative study early cancer diagnosis randomized controlled trial Colorectal Neoplasms cancer screening Aged Mandarin (language) Cantonese (language) Early Detection of Cancer San Francisco procedures knowledge cluster analysis Humans California Asian Americans male Asian American female Multivariate Analysis telephone interview medical information Health Knowledge, Attitudes, Practice Article lay health worker adult health education attitude to health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85008213273&doi=10.1016%2fj.amepre.2016.10.003&partnerID=40&md5=599f959e81cbdb5f17b129a2bd61fe2d
DOI: 10.1016/j.amepre.2016.10.003
ISSN: 07493797
Cited by: 13
Original Language: English