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Am J Prev Med. 2017 Mar;52(3):e67-e76. doi: 10.1016/j.amepre.2016.10.003. Epub 2016 Dec 13.

Colorectal Cancer Screening and Chinese Americans: Efficacy of Lay Health Worker Outreach and Print Materials.

Author information

1
Asian American Research Center on Health, San Francisco, California; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California. Electronic address: tung.nguyen@ucsf.edu.
2
Asian American Research Center on Health, San Francisco, California; Department of Psychiatry, University of California, San Francisco, San Francisco, California.
3
Asian American Research Center on Health, San Francisco, California; NICOS Chinese Health Coalition, San Francisco, California.
4
Department of Public Health Sciences, University of California, Davis, Davis, California.
5
Asian American Research Center on Health, San Francisco, California; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California.
6
Asian American Research Center on Health, San Francisco, California; Department of Health Education, San Francisco State University, San Francisco, California.
7
Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California.
8
Asian American Research Center on Health, San Francisco, California; The American College of Traditional Chinese Medicine, San Francisco, California.
9
Department of Psychiatry, University of California, San Francisco, San Francisco, California; NICOS Chinese Health Coalition, San Francisco, California.
10
Asian American Research Center on Health, San Francisco, California; Chinatown Public Health Center, Department of Public Health, San Francisco, California.

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.

PMID:
27986352
PMCID:
PMC5318244
DOI:
10.1016/j.amepre.2016.10.003
[Indexed for MEDLINE]
Free PMC Article

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