Promoting culturally appropriate colorectal cancer screening through a health educator

A randomized controlled trial

Shin-Ping Tu, Vicky Taylor, Yutaka Yasui, Alan Chun, Mei Po Yip, Elizabeth Acorda, Lin Li, Roshan Bastani

Research output: Contribution to journalReview article

99 Citations (Scopus)

Abstract

BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer mortality in the US. Surveys reveal low CRC screening levels among Asians in the US, including Chinese Americans. METHODS. A randomized controlled trial was conducted with Chinese patients to evaluate a clinic-based, culturally and linguistically appropriate intervention promoting fecal occult blood test (FOBT) screening. The multifaceted intervention included a trilingual and bicultural health educator, bilingual materials (a video, a motivational pamphlet, an informational pamphlet, and FOBT instructions), and three FOBT cards. Patients in the control arm received usual care. Our primary outcome measure was FOBT screening within 6 months after randomization. The proportion of FOBT completion in the intervention and control arms was compared by using a chi-square test, and logistic regression analysis was performed to adjust for the effects of sociodemographic variables and prior screening history. Potential effect modifications were also tested by using logistic regression models. RESULTS. Our intervention had a strong effect on FOBT completion (intervention group, 69.5%; control group, 27.6%), and the adjusted odds of FOBT slightly increased to over 6-fold greater in the intervention arm compared with the control arm. No effect modification by age, gender, language, insurance, or prior FOBT was found. CONCLUSIONS. The authors' multifaceted, culturally appropriate intervention signifi-cantly increased FOBT screening in a group of low-income and less-acculturated minority patients. Given the large effect size, future research should determine the effective core component(s) that can increase CRC screening in both the general and minority populations.

Original languageEnglish (US)
Pages (from-to)959-966
Number of pages8
JournalCancer
Volume107
Issue number5
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

Fingerprint

Health Educators
Occult Blood
Hematologic Tests
Early Detection of Cancer
Colorectal Neoplasms
Randomized Controlled Trials
Pamphlets
Logistic Models
Asian Americans
Chi-Square Distribution
Random Allocation
Insurance
Language
History
Regression Analysis
Outcome Assessment (Health Care)
Control Groups

Keywords

  • Asian American
  • Chinese American
  • Colorectal cancer screening
  • Fecal occult blood test
  • Health educator
  • Intervention

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Promoting culturally appropriate colorectal cancer screening through a health educator : A randomized controlled trial. / Tu, Shin-Ping; Taylor, Vicky; Yasui, Yutaka; Chun, Alan; Yip, Mei Po; Acorda, Elizabeth; Li, Lin; Bastani, Roshan.

In: Cancer, Vol. 107, No. 5, 01.09.2006, p. 959-966.

Research output: Contribution to journalReview article

Tu, S-P, Taylor, V, Yasui, Y, Chun, A, Yip, MP, Acorda, E, Li, L & Bastani, R 2006, 'Promoting culturally appropriate colorectal cancer screening through a health educator: A randomized controlled trial', Cancer, vol. 107, no. 5, pp. 959-966. https://doi.org/10.1002/cncr.22091
Tu, Shin-Ping ; Taylor, Vicky ; Yasui, Yutaka ; Chun, Alan ; Yip, Mei Po ; Acorda, Elizabeth ; Li, Lin ; Bastani, Roshan. / Promoting culturally appropriate colorectal cancer screening through a health educator : A randomized controlled trial. In: Cancer. 2006 ; Vol. 107, No. 5. pp. 959-966.
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abstract = "BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer mortality in the US. Surveys reveal low CRC screening levels among Asians in the US, including Chinese Americans. METHODS. A randomized controlled trial was conducted with Chinese patients to evaluate a clinic-based, culturally and linguistically appropriate intervention promoting fecal occult blood test (FOBT) screening. The multifaceted intervention included a trilingual and bicultural health educator, bilingual materials (a video, a motivational pamphlet, an informational pamphlet, and FOBT instructions), and three FOBT cards. Patients in the control arm received usual care. Our primary outcome measure was FOBT screening within 6 months after randomization. The proportion of FOBT completion in the intervention and control arms was compared by using a chi-square test, and logistic regression analysis was performed to adjust for the effects of sociodemographic variables and prior screening history. Potential effect modifications were also tested by using logistic regression models. RESULTS. Our intervention had a strong effect on FOBT completion (intervention group, 69.5{\%}; control group, 27.6{\%}), and the adjusted odds of FOBT slightly increased to over 6-fold greater in the intervention arm compared with the control arm. No effect modification by age, gender, language, insurance, or prior FOBT was found. CONCLUSIONS. The authors' multifaceted, culturally appropriate intervention signifi-cantly increased FOBT screening in a group of low-income and less-acculturated minority patients. Given the large effect size, future research should determine the effective core component(s) that can increase CRC screening in both the general and minority populations.",
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T1 - Promoting culturally appropriate colorectal cancer screening through a health educator

T2 - A randomized controlled trial

AU - Tu, Shin-Ping

AU - Taylor, Vicky

AU - Yasui, Yutaka

AU - Chun, Alan

AU - Yip, Mei Po

AU - Acorda, Elizabeth

AU - Li, Lin

AU - Bastani, Roshan

PY - 2006/9/1

Y1 - 2006/9/1

N2 - BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer mortality in the US. Surveys reveal low CRC screening levels among Asians in the US, including Chinese Americans. METHODS. A randomized controlled trial was conducted with Chinese patients to evaluate a clinic-based, culturally and linguistically appropriate intervention promoting fecal occult blood test (FOBT) screening. The multifaceted intervention included a trilingual and bicultural health educator, bilingual materials (a video, a motivational pamphlet, an informational pamphlet, and FOBT instructions), and three FOBT cards. Patients in the control arm received usual care. Our primary outcome measure was FOBT screening within 6 months after randomization. The proportion of FOBT completion in the intervention and control arms was compared by using a chi-square test, and logistic regression analysis was performed to adjust for the effects of sociodemographic variables and prior screening history. Potential effect modifications were also tested by using logistic regression models. RESULTS. Our intervention had a strong effect on FOBT completion (intervention group, 69.5%; control group, 27.6%), and the adjusted odds of FOBT slightly increased to over 6-fold greater in the intervention arm compared with the control arm. No effect modification by age, gender, language, insurance, or prior FOBT was found. CONCLUSIONS. The authors' multifaceted, culturally appropriate intervention signifi-cantly increased FOBT screening in a group of low-income and less-acculturated minority patients. Given the large effect size, future research should determine the effective core component(s) that can increase CRC screening in both the general and minority populations.

AB - BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer mortality in the US. Surveys reveal low CRC screening levels among Asians in the US, including Chinese Americans. METHODS. A randomized controlled trial was conducted with Chinese patients to evaluate a clinic-based, culturally and linguistically appropriate intervention promoting fecal occult blood test (FOBT) screening. The multifaceted intervention included a trilingual and bicultural health educator, bilingual materials (a video, a motivational pamphlet, an informational pamphlet, and FOBT instructions), and three FOBT cards. Patients in the control arm received usual care. Our primary outcome measure was FOBT screening within 6 months after randomization. The proportion of FOBT completion in the intervention and control arms was compared by using a chi-square test, and logistic regression analysis was performed to adjust for the effects of sociodemographic variables and prior screening history. Potential effect modifications were also tested by using logistic regression models. RESULTS. Our intervention had a strong effect on FOBT completion (intervention group, 69.5%; control group, 27.6%), and the adjusted odds of FOBT slightly increased to over 6-fold greater in the intervention arm compared with the control arm. No effect modification by age, gender, language, insurance, or prior FOBT was found. CONCLUSIONS. The authors' multifaceted, culturally appropriate intervention signifi-cantly increased FOBT screening in a group of low-income and less-acculturated minority patients. Given the large effect size, future research should determine the effective core component(s) that can increase CRC screening in both the general and minority populations.

KW - Asian American

KW - Chinese American

KW - Colorectal cancer screening

KW - Fecal occult blood test

KW - Health educator

KW - Intervention

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U2 - 10.1002/cncr.22091

DO - 10.1002/cncr.22091

M3 - Review article

VL - 107

SP - 959

EP - 966

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 5

ER -