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Kim J, Dai HD, Michaud T, Verma S, King KM, Ewing JW, Mabiala-Maye G, Estabrooks P. Leveraging Multi-Sectoral Partnership for Colorectal Cancer Education and Screening in the African American Community: A Protocol and Preliminary Results. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02506-w. [PMID: 39313626 DOI: 10.1007/s13187-024-02506-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/10/2024] [Indexed: 09/25/2024]
Abstract
Colorectal cancer (CRC) awareness and screening rates are still low in African Americans (AAs), especially for those who do not have regular access to health care. We established a multi-sector community partnership between academia, health system, cancer advocacy, and local county treasurer's office (CTO), to test a pilot CRC screening intervention using a tailored educational brochure and fecal immunochemical test (FIT). Participants were recruited at a local CTO in an urban midwestern region. Once eligible, participants were assigned to 2-by-2 intervention arms by educational strategy (brochure vs. no brochure) and FIT provision strategy (direct provision by onsite staff vs. indirect provision via phone/online request). We compared the effect of different strategies on FIT return rates. Of 1500 individuals approached, 212 were eligible for the study. The final sample consisted of 209 participants who were predominantly men (57%) and AAs (85%). No differences were found in the return rates by educational brochure (24% [brochure] vs. 23% [no brochure]; p = 0.82). In regard to FIT provision strategy, direct FIT provision yielded higher return rates than indirect provision (31% vs. 15%; p = 0.01). When the four groups were compared, direct provision with education brochure yielded the highest return rates (33.9%), followed by direct provision only (27.5%), indirect provision only (18%), and indirect provision with a brochure (12.2%). For community-based CRC screening intervention using stool-based test, the direct provision of FIT kits with educational brochure outperforms the other three strategies.
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Affiliation(s)
- Jungyoon Kim
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Hongying Daisy Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tzeyu Michaud
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sachi Verma
- Nebraska Hospital Association, Lincoln, NE, USA
| | - Keyonna M King
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Grace Mabiala-Maye
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Paul Estabrooks
- Department of Health and Kinesiology, University of Utah College of Health, Salt Lake City, UT, USA
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Anderson JC, Robertson DJ. Fecal Immunochemical Test Screening: Maximizing Success by Minimizing Failure. Cancer Epidemiol Biomarkers Prev 2024; 33:183-185. [PMID: 38317627 DOI: 10.1158/1055-9965.epi-23-1393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 02/07/2024] Open
Abstract
Implementing fecal immunochemical testing (FIT) through clinic based opportunistic screening or programmatic mailing is not as straightforward as it seems. Liu and colleagues present data for 56,980 individuals who submitted a FIT in a safety net hospital system. In 10.2% (N = 5,819), the test was deemed unsatisfactory. These data demonstrate that there is significant room for improvement in clinical practice regarding colorectal cancer screening with FIT. The high rate of 10% for unsatisfactory FIT tests is higher than the 5% benchmark suggested by the U.S. Multi-Society Task Force on colorectal cancer screening. To maximize FIT success, there needs to be a preoccupation with failure at the system level that results in reducing the number of FIT tests that are rejected. Completing a stool test independently at home is not easy. The medical system needs to help and support individuals in completing the test every step of the way. Suggestions include patient related tips such as labelling and mailing the tests. There are also suggestions for the ordering clinician including administrative tracking to notify clinicians when a FIT has not been performed or is rejected. Papers like this get us focused exactly where we need to be to improve FIT-based screening. See related article by Liu et al., p. 215.
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Affiliation(s)
- Joseph C Anderson
- University of Connecticut School of Medicine, Farmington, Connecticut
- Department of Veterans Affairs Medical Center, White River Junction, Vermont
- The Geisel School of Medicine at Dartmouth Medical, Hanover, New Hampshire
| | - Douglas J Robertson
- Department of Veterans Affairs Medical Center, White River Junction, Vermont
- The Geisel School of Medicine at Dartmouth Medical, Hanover, New Hampshire
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