Lay health educators and print materials for the promotion of colorectal cancer screening among Korean Americans: A randomized comparative effectiveness study

Angela M. Jo, Tung T. Nguyen, Susan L Stewart, Min J. Sung, Ginny Gildengorin, Janice Y. Tsoh, Elisa Tong, Penny Lo, Charlene Cuaresma, Angela Sy, Hy Lam, Ching Wong, Matthew Jeong, Moon S Chen, Marjorie Kagawa-Singer

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND: Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Korean American men and women. Although CRC screening is effective in reducing the burden of this disease, studies have shown that Korean Americans have low screening rates. METHODS: The authors conducted a 2-arm cluster randomized controlled trial comparing a brochure (print) with a brochure and lay health educator (LHE) outreach (print+LHE) in increasing CRC screening rates among Korean American individuals. Self-administered written surveys at baseline and at 6 months assessed knowledge of CRC and its screening, ever screening, and being up to date with screening. RESULTS: A total of 28 LHEs recruited 348 participants aged 50 to 75 years from their social networks. Significant percentages of participants reported not having health insurance (29.3%) or a usual source of care (35.6%). At 6 months postintervention, the print+LHE participants had a greater increase in knowledge compared with those in the print arm (P=.0013). In multivariable analyses, both groups had significant increases in ever screening (print plus LHE: odds ratio [OR], 1.60 [95% confidence interval (95% CI), 1.26-2.03] and print: OR, 1.42 [95% CI, 1.10-1.82]) and being up to date with screening (print plus LHE: OR, 1.63 [95% CI, 1.23-2.16] and print: OR, 1.40 [95% CI, 1.04-1.89]). However, these increases did not differ significantly between the study arms. Having insurance and having seen a provider within the past year were found to be positively associated with screening. CONCLUSIONS: Compared with a brochure, LHE outreach yielded greater increases in knowledge but resulted in similar increases in CRC screening in a Korean American population with barriers to health care access. More work is needed to appropriately address logistical and system barriers in this community.

Original languageEnglish (US)
JournalCancer
DOIs
StateAccepted/In press - 2017

Fingerprint

Health Educators
Asian Americans
Early Detection of Cancer
Colorectal Neoplasms
Pamphlets
Odds Ratio
Confidence Intervals
Health Services Accessibility
Health Insurance
Insurance
Social Support
Randomized Controlled Trials
Population
Neoplasms

Keywords

  • Asian Americans
  • Cancer screening
  • Colorectal cancer
  • Health education
  • Lay health educators

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Lay health educators and print materials for the promotion of colorectal cancer screening among Korean Americans : A randomized comparative effectiveness study. / Jo, Angela M.; Nguyen, Tung T.; Stewart, Susan L; Sung, Min J.; Gildengorin, Ginny; Tsoh, Janice Y.; Tong, Elisa; Lo, Penny; Cuaresma, Charlene; Sy, Angela; Lam, Hy; Wong, Ching; Jeong, Matthew; Chen, Moon S; Kagawa-Singer, Marjorie.

In: Cancer, 2017.

Research output: Contribution to journalArticle

Jo, Angela M. ; Nguyen, Tung T. ; Stewart, Susan L ; Sung, Min J. ; Gildengorin, Ginny ; Tsoh, Janice Y. ; Tong, Elisa ; Lo, Penny ; Cuaresma, Charlene ; Sy, Angela ; Lam, Hy ; Wong, Ching ; Jeong, Matthew ; Chen, Moon S ; Kagawa-Singer, Marjorie. / Lay health educators and print materials for the promotion of colorectal cancer screening among Korean Americans : A randomized comparative effectiveness study. In: Cancer. 2017.
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title = "Lay health educators and print materials for the promotion of colorectal cancer screening among Korean Americans: A randomized comparative effectiveness study",
abstract = "BACKGROUND: Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Korean American men and women. Although CRC screening is effective in reducing the burden of this disease, studies have shown that Korean Americans have low screening rates. METHODS: The authors conducted a 2-arm cluster randomized controlled trial comparing a brochure (print) with a brochure and lay health educator (LHE) outreach (print+LHE) in increasing CRC screening rates among Korean American individuals. Self-administered written surveys at baseline and at 6 months assessed knowledge of CRC and its screening, ever screening, and being up to date with screening. RESULTS: A total of 28 LHEs recruited 348 participants aged 50 to 75 years from their social networks. Significant percentages of participants reported not having health insurance (29.3{\%}) or a usual source of care (35.6{\%}). At 6 months postintervention, the print+LHE participants had a greater increase in knowledge compared with those in the print arm (P=.0013). In multivariable analyses, both groups had significant increases in ever screening (print plus LHE: odds ratio [OR], 1.60 [95{\%} confidence interval (95{\%} CI), 1.26-2.03] and print: OR, 1.42 [95{\%} CI, 1.10-1.82]) and being up to date with screening (print plus LHE: OR, 1.63 [95{\%} CI, 1.23-2.16] and print: OR, 1.40 [95{\%} CI, 1.04-1.89]). However, these increases did not differ significantly between the study arms. Having insurance and having seen a provider within the past year were found to be positively associated with screening. CONCLUSIONS: Compared with a brochure, LHE outreach yielded greater increases in knowledge but resulted in similar increases in CRC screening in a Korean American population with barriers to health care access. More work is needed to appropriately address logistical and system barriers in this community.",
keywords = "Asian Americans, Cancer screening, Colorectal cancer, Health education, Lay health educators",
author = "Jo, {Angela M.} and Nguyen, {Tung T.} and Stewart, {Susan L} and Sung, {Min J.} and Ginny Gildengorin and Tsoh, {Janice Y.} and Elisa Tong and Penny Lo and Charlene Cuaresma and Angela Sy and Hy Lam and Ching Wong and Matthew Jeong and Chen, {Moon S} and Marjorie Kagawa-Singer",
year = "2017",
doi = "10.1002/cncr.30568",
language = "English (US)",
journal = "Cancer",
issn = "0008-543X",
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T1 - Lay health educators and print materials for the promotion of colorectal cancer screening among Korean Americans

T2 - A randomized comparative effectiveness study

AU - Jo, Angela M.

AU - Nguyen, Tung T.

AU - Stewart, Susan L

AU - Sung, Min J.

AU - Gildengorin, Ginny

AU - Tsoh, Janice Y.

AU - Tong, Elisa

AU - Lo, Penny

AU - Cuaresma, Charlene

AU - Sy, Angela

AU - Lam, Hy

AU - Wong, Ching

AU - Jeong, Matthew

AU - Chen, Moon S

AU - Kagawa-Singer, Marjorie

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Korean American men and women. Although CRC screening is effective in reducing the burden of this disease, studies have shown that Korean Americans have low screening rates. METHODS: The authors conducted a 2-arm cluster randomized controlled trial comparing a brochure (print) with a brochure and lay health educator (LHE) outreach (print+LHE) in increasing CRC screening rates among Korean American individuals. Self-administered written surveys at baseline and at 6 months assessed knowledge of CRC and its screening, ever screening, and being up to date with screening. RESULTS: A total of 28 LHEs recruited 348 participants aged 50 to 75 years from their social networks. Significant percentages of participants reported not having health insurance (29.3%) or a usual source of care (35.6%). At 6 months postintervention, the print+LHE participants had a greater increase in knowledge compared with those in the print arm (P=.0013). In multivariable analyses, both groups had significant increases in ever screening (print plus LHE: odds ratio [OR], 1.60 [95% confidence interval (95% CI), 1.26-2.03] and print: OR, 1.42 [95% CI, 1.10-1.82]) and being up to date with screening (print plus LHE: OR, 1.63 [95% CI, 1.23-2.16] and print: OR, 1.40 [95% CI, 1.04-1.89]). However, these increases did not differ significantly between the study arms. Having insurance and having seen a provider within the past year were found to be positively associated with screening. CONCLUSIONS: Compared with a brochure, LHE outreach yielded greater increases in knowledge but resulted in similar increases in CRC screening in a Korean American population with barriers to health care access. More work is needed to appropriately address logistical and system barriers in this community.

AB - BACKGROUND: Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Korean American men and women. Although CRC screening is effective in reducing the burden of this disease, studies have shown that Korean Americans have low screening rates. METHODS: The authors conducted a 2-arm cluster randomized controlled trial comparing a brochure (print) with a brochure and lay health educator (LHE) outreach (print+LHE) in increasing CRC screening rates among Korean American individuals. Self-administered written surveys at baseline and at 6 months assessed knowledge of CRC and its screening, ever screening, and being up to date with screening. RESULTS: A total of 28 LHEs recruited 348 participants aged 50 to 75 years from their social networks. Significant percentages of participants reported not having health insurance (29.3%) or a usual source of care (35.6%). At 6 months postintervention, the print+LHE participants had a greater increase in knowledge compared with those in the print arm (P=.0013). In multivariable analyses, both groups had significant increases in ever screening (print plus LHE: odds ratio [OR], 1.60 [95% confidence interval (95% CI), 1.26-2.03] and print: OR, 1.42 [95% CI, 1.10-1.82]) and being up to date with screening (print plus LHE: OR, 1.63 [95% CI, 1.23-2.16] and print: OR, 1.40 [95% CI, 1.04-1.89]). However, these increases did not differ significantly between the study arms. Having insurance and having seen a provider within the past year were found to be positively associated with screening. CONCLUSIONS: Compared with a brochure, LHE outreach yielded greater increases in knowledge but resulted in similar increases in CRC screening in a Korean American population with barriers to health care access. More work is needed to appropriately address logistical and system barriers in this community.

KW - Asian Americans

KW - Cancer screening

KW - Colorectal cancer

KW - Health education

KW - Lay health educators

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DO - 10.1002/cncr.30568

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