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Carbunaru S, Rich JM, Neshatvar Y, Murray K, Nayan M. Differences in the treatment patterns of small renal masses: A disaggregated analyses by race/ethnicity. Urol Oncol 2024:S1078-1439(24)00638-0. [PMID: 39368941 DOI: 10.1016/j.urolonc.2024.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/27/2024] [Accepted: 08/27/2024] [Indexed: 10/07/2024]
Abstract
OBJECTIVE To characterize differences in the management of small renal masses among disaggregated race/ethnic subgroups. MATERIAL AND METHODS We used the National Cancer Database to identify patients diagnosed with clinically localized kidney cancer and tumor size ≤4cm. We studied 16 predefined racial/ethnic subgroups and compared 1) the use of surveillance for tumors <2cm and 2) the use of radical nephrectomy for tumors ≤4cm. We used multivariable logistic regression to evaluate the independent association of race/ethnicity with management, adjusting for baseline characteristics. We also compared our disaggregated analyses to the 6 National Institute of Health aggregate race categories. RESULTS We identified 286,063 patients that met inclusion criteria. For tumors <2cm, Black Non-Hispanic (aOR 1.43) and Mexican patients (aOR 1.29) were significantly more likely to undergo surveillance compared to White patients. For tumors ≤4cm, Black Non-Hispanic (aOR 1.43), Filipino (aOR 1.28), Japanese (aOR 1.28), Mexican (aOR 1.32), and Native Indian patients (aOR 1.15) were significantly more likely to undergo radical nephrectomy compared to White patients. When comparing our disaggregated analyses to the NIH categories, we found that many disaggregated race/ethnic subgroups had associations with management strategies that were not represented by their aggregated group. CONCLUSIONS In this study, we found that the use of surveillance for tumors <2cm and radical nephrectomy for tumors ≤4cm varied significantly among certain race/ethnic subgroups. Our disaggregated approach provides information on differences in treatment patterns in particular subgroups that warrant further study to optimize kidney cancer care for all patients.
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Affiliation(s)
- Samuel Carbunaru
- Department of Urology, New York University School of Medicine, New York, NY
| | - Jordan M Rich
- Department of Urology, New York University School of Medicine, New York, NY
| | - Yassamin Neshatvar
- Department of Urology, New York University School of Medicine, New York, NY
| | - Katie Murray
- Department of Urology, New York University School of Medicine, New York, NY
| | - Madhur Nayan
- Department of Urology, New York University School of Medicine, New York, NY; Department of Population Health, New York University School of Medicine, New York, NY.
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Sun YX, Tang T, Zou JY, Yue QQ, Hu LF, Peng T, Meng XR, Feng GH, Huang LL, Zeng Y. Interventions to Improve Endoscopic Screening Adherence of Cancer in High-Risk Populations: A Scoping Review. Patient Prefer Adherence 2024; 18:709-720. [PMID: 38524198 PMCID: PMC10961025 DOI: 10.2147/ppa.s443607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Background Colorectal, and gastric cancers have the second, and fourth mortality rates worldwide, respectively. Endoscopic screening is a crucial diagnostic tool for colorectal, and gastric cancers. Effective interventions can improve adherence to endoscopic screening in high-risk populations, which is important for cancer prevention and mortality reduction. This study aimed to identify interventions that could improve adherence to endoscopic screening for cancer in high-risk populations. Methods Combination keywords including colorectal cancer, gastric cancer, screening adherence, and interventions were used to search for articles in PubMed, Web of Science, Cochrane Library, and MEDLINE Complete. The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR). Results A total of 12 articles were included in this review: 9 randomized controlled trials(RCT) and 3 quasi-experimental studies(QEDs). Among the extracted studies, 11 were about colorectal cancer, and 1 was about gastric cancer. Most studies used lecture-based or Information Technology-based health education interventions. Narrative interventions have proven to be novel and effective approaches for promoting adherence to endoscopic screening. Health education interventions included cancer epidemiology, cancer risk factors, warning symptoms, and screening methods. Conclusion All interventions involved were effective in increasing individual knowledge of cancer-related endoscopic screening, willingness to undergo screening, and screening behaviors. These findings provide a reference for designing endoscopy-related cancer screening interventions.
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Affiliation(s)
- Ying-Xue Sun
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Tian Tang
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Jin-Yu Zou
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Qian-Qian Yue
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Li-Feng Hu
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Tong Peng
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Xin-Ru Meng
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Ge-Hui Feng
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Li-Li Huang
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
| | - Ying Zeng
- Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
- Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China
- Hunan Engineering Research Center for Early Diagnosis and Treatment of Liver Cancer, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, People's Republic of China
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3
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Gray C, Porter G, Lobo R, Crawford G. Development and evaluation of health education resources for culturally and linguistically diverse populations: a systematic review. HEALTH EDUCATION RESEARCH 2024; 39:102-118. [PMID: 36994771 DOI: 10.1093/her/cyad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/13/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
People from culturally and linguistically diverse (CaLD) backgrounds in Australia generally experience poorer health outcomes, explained in part by low levels of health literacy. We conducted a systematic review to examine the development and evaluation of health education resources designed for CaLD populations. Five electronic databases were searched for English language, peer-reviewed studies published between 1980 and 2020. Thirty-four studies met the inclusion criteria. Twenty-four different health education resources were described and broadly categorized into four types: media campaigns (n = 10), text-based materials (n = 5), films (n = 8) and radio (n = 1). Studies were assessed against domains adapted from a health literacy guideline incorporating: need, collaboration, audience, health literacy, theory, test and process and impact evaluation. All but one study met the majority of the domains. All studies reported positive evaluation outcomes; this may be due to studies involving community early in resource design and including health literacy considerations in their design. Reporting resource design and evaluation against standard practice controls is recommended to build a more robust evidence base for developing effective health education resources for use by audiences from CaLD backgrounds.
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Affiliation(s)
- Corie Gray
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Georgia Porter
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Gemma Crawford
- Curtin School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
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Ma GX, Zhu L, Tan Y, Do P, Guerrier G, Wang MQ, Nguyen M, Tran T, Pham P. Multilevel and multicomponent intervention to promote colorectal cancer screening among underserved Vietnamese Americans: A cluster randomized trial. RESEARCH SQUARE 2024:rs.3.rs-3934937. [PMID: 38405822 PMCID: PMC10889079 DOI: 10.21203/rs.3.rs-3934937/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Purpose The fecal immunochemical test (FIT) is a non-invasive method for colorectal cancer (CRC) screening, particularly effective in underserved Vietnamese American communities with low screening rates. This study reports on a culturally tailored multilevel intervention, incorporating FIT, aimed at increasing CRC screening among these populations aged 50 or above in the Greater Philadelphia metropolitan area. Methods From 2017 to 2020, we conducted a two-arm cluster randomized controlled trial to test the efficacy of a culturally tailored, multicomponent multilevel intervention aimed at increasing CRC screening uptake via enhanced self-awareness and self-efficacy, improved access to care, and changes in social norms and removal of stigma. The intervention group received multicomponent, multilevel CRC intervention including provision of a FIT self-sampling kit, with intervention approaches informed by the Centers for Disease Control's Clinical Preventive Services (CPS) Guidelines for adults 50+. The control group received only the CPS education. Results The study sample consisted of 746 eligible Vietnamese American participants recruited from 20 community-based organizations, with 95% having limited English proficiency. At 12-month follow-up, the intervention group showed substantially higher rates of FIT completion (89.56% vs. 7.59%, p < .001) and any CRC testing (91.48% vs. 42.41%, p < .001) compared to the control group. Conclusion The results suggest that the community-based, culturally-tailored multilevel intervention, which incorporates with FIT self-testing, effectively enhances CRC screening among low-income Vietnamese Americans. Additionally, these results underscore the significance of community-oriented strategies, like collaborating with relevant community-based organizations, in achieving CRC screening targets.
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Affiliation(s)
- Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Yin Tan
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Phuong Do
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Guercie Guerrier
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Min Qi Wang
- University of Maryland School of Public Health, College Park, MD
| | - Minhhuyen Nguyen
- Department of Medicine, Section of Gastroenterology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Tam Tran
- Asian American Buddhist Association, Philadelphia, PA
| | - Philip Pham
- Vietnamese International Baptist Church of Philadelphia, Philadelphia, PA
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5
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Jain B, Bajaj SS, Patel TA, Vapiwala N, Lam MB, Mahal BA, Muralidhar V, Amen TB, Nguyen PL, Sanford NN, Dee EC. Colon Cancer Disparities in Stage at Presentation and Time to Surgery for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study with Disaggregated Ethnic Groups. Ann Surg Oncol 2023; 30:5495-5505. [PMID: 37017832 PMCID: PMC10075171 DOI: 10.1245/s10434-023-13339-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/19/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Vast differences in barriers to care exist among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) groups and may manifest as disparities in stage at presentation and access to treatment. Thus, we characterized AANHPI patients with stage 0-IV colon cancer and examined differences in (1) stage at presentation and (2) time to surgery relative to white patients. PATIENTS AND METHODS We assessed all patients in the National Cancer Database (NCDB) with stage 0-IV colon cancer from 2004 to 2016 who identified as white, Chinese, Japanese, Filipino, Native Hawaiian, Korean, Vietnamese, Laotian, Hmong, Kampuchean, Thai, Asian Indian or Pakistani, and Pacific Islander. Multivariable ordinal logistic regression defined adjusted odds ratios (AORs), with 95% confidence intervals (CI), of (1) patients presenting with advanced stage colon cancer and (2) patients with stage 0-III colon cancer receiving surgery at ≥ 60 days versus 30-59 days versus < 30 days postdiagnosis, adjusting for sociodemographic/clinical factors. RESULTS Among 694,876 patients, Japanese [AOR 1.08 (95% CI 1.01-1.15), p < 0.05], Filipino [AOR 1.17 (95% CI 1.09-1.25), p < 0.001], Korean [AOR 1.09 (95% CI 1.01-1.18), p < 0.05], Laotian [AOR 1.51 (95% CI 1.17-1.95), p < 0.01], Kampuchean [AOR 1.33 (95% CI 1.04-1.70), p < 0.01], Thai [AOR 1.60 (95% CI 1.22-2.10), p = 0.001], and Pacific Islander [AOR 1.41 (95% CI 1.20-1.67), p < 0.001] patients were more likely to present with more advanced colon cancer compared with white patients. Chinese [AOR 1.27 (95% CI 1.17-1.38), p < 0.001], Japanese [AOR 1.23 (95% CI 1.10-1.37], p < 0.001], Filipino [AOR 1.36 (95% CI 1.22-1.52), p < 0.001], Korean [AOR 1.16 (95% CI 1.02-1.32), p < 0.05], and Vietnamese [AOR 1.55 (95% CI 1.36-1.77), p < 0.001] patients were more likely to experience greater time to surgery than white patients. Disparities persisted when comparing among AANHPI subgroups. CONCLUSIONS Our findings reveal key disparities in stage at presentation and time to surgery by race/ethnicity among AANHPI subgroups. Heterogeneity upon disaggregation underscores the importance of examining and addressing access barriers and clinical disparities.
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Affiliation(s)
- Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Tej A Patel
- University of Pennsylvania, Philadelphia, PA, USA
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Miranda B Lam
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Brandon A Mahal
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Vinayak Muralidhar
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Kaiser Permanente Northwest, Portland, OR, USA
| | - Troy B Amen
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Paul L Nguyen
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Nina N Sanford
- Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX, USA.
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Korn AR, Walsh-Bailey C, Correa-Mendez M, DelNero P, Pilar M, Sandler B, Brownson RC, Emmons KM, Oh AY. Social determinants of health and US cancer screening interventions: A systematic review. CA Cancer J Clin 2023; 73:461-479. [PMID: 37329257 PMCID: PMC10529377 DOI: 10.3322/caac.21801] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 06/19/2023] Open
Abstract
There remains a need to synthesize linkages between social determinants of health (SDOH) and cancer screening to reduce persistent inequities contributing to the US cancer burden. The authors conducted a systematic review of US-based breast, cervical, colorectal, and lung cancer screening intervention studies to summarize how SDOH have been considered in interventions and relationships between SDOH and screening. Five databases were searched for peer-reviewed research articles published in English between 2010 and 2021. The Covidence software platform was used to screen articles and extract data using a standardized template. Data items included study and intervention characteristics, SDOH intervention components and measures, and screening outcomes. The findings were summarized using descriptive statistics and narratives. The review included 144 studies among diverse population groups. SDOH interventions increased screening rates overall by a median of 8.4 percentage points (interquartile interval, 1.8-18.8 percentage points). The objective of most interventions was to increase community demand (90.3%) and access (84.0%) to screening. SDOH interventions related to health care access and quality were most prevalent (227 unique intervention components). Other SDOH, including educational, social/community, environmental, and economic factors, were less common (90, 52, 21, and zero intervention components, respectively). Studies that included analyses of health policy, access to care, and lower costs yielded the largest proportions of favorable associations with screening outcomes. SDOH were predominantly measured at the individual level. This review describes how SDOH have been considered in the design and evaluation of cancer screening interventions and effect sizes for SDOH interventions. Findings may guide future intervention and implementation research aiming to reduce US screening inequities.
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Affiliation(s)
- Ariella R. Korn
- Cancer Prevention Fellowship Program, Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
- Behavioral and Policy Sciences Department, RAND Corporation, Boston, MA
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO
| | - Margarita Correa-Mendez
- Cancer Prevention Fellowship Program, Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Peter DelNero
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Meagan Pilar
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO
| | - Brittney Sandler
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO
| | - Ross C. Brownson
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO
- Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Karen M. Emmons
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - April Y. Oh
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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Bhimla A, Zhu L, Twardus S, Lin T, Vo S, Do P, Ma GX. Examining multilevel neighborhood socioeconomic characteristics associated with colorectal cancer screening in Vietnamese Americans residing in Philadelphia County. Transl Behav Med 2022; 12:489-497. [PMID: 35298654 PMCID: PMC8942106 DOI: 10.1093/tbm/ibab136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most predominant cancers in the USA and ranks third among all cancers in incidence and mortality. Vietnamese Americans exhibit persistently lower screening rates compared to the general U.S. population, due to cultural, economic, and environmental barriers. The impact of environmental factors in particular is not well known, and lack of geographical access may be a significant barrier to accessing screening. This study aims to elucidate build and neighborhood environmental factors affecting CRC screening rates among Vietnamese Americans. A total of 517 Vietnamese Americans 50 years and older residing in Philadelphia County were included in the study. Surveys were collected to determine CRC screening behavior and sociodemographic characteristics. Individual neighborhood characteristics, which included the Walk Score, was obtained based on the participant's address. Neighborhood characteristics were calculated using census-tract level data for the social deprivation index, ethnic composition, and presence of hospitals or federally qualified health centers (FQHC). The generalized linear mixed model revealed that residing in an ethnically dense neighborhood was negatively associated with CRC screening (β = -0.67, SE = 0.29, p = .01), while social deprivation (β = 0.30, SE = 0.27, p = .27) and presence of FQHCs or hospitals (β = 0.16, SE = 0.30, p = .58) were not. Individual neighborhood characteristics including the Walk Score (β = 0.21, SE = 0.26, p = .43) was not associated with CRC screening behavior. Neighborhood characteristics, specifically ethnic density is associated with lower uptake of screening in this population. Future interventions should aim to target specific Vietnamese American and other Asian ethnic neighborhoods that may experience disparities in screening.
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Affiliation(s)
- Aisha Bhimla
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
| | - Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
| | - Shaina Twardus
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
| | - Timmy Lin
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
| | - Sarah Vo
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
| | - Phuong Do
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
| | - Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple
University, Philadelphia, PA, USA
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Chu JN, Stewart SL, Gildengorin G, Wong C, Lam H, McPhee SJ, Chen MS, Bastani R, Maxwell AE, Taylor VM, Nguyen TT. Effect of a media intervention on hepatitis B screening among Vietnamese Americans. ETHNICITY & HEALTH 2022; 27:361-374. [PMID: 31608675 PMCID: PMC7162532 DOI: 10.1080/13557858.2019.1672862] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/03/2019] [Indexed: 06/10/2023]
Abstract
Objective: There is a lack of controlled studies of community-wide interventions to increase screening for hepatitis B (HBV) among Asian Americans, particularly Vietnamese Americans, who disproportionately suffer from HBV-related illnesses. The objective of our study was to develop, implement, and evaluate the effectiveness of a media campaign to promote HBV screening among Vietnamese Americans.Design: We designed and implemented a three-year media campaign promoting HBV screening among Vietnamese Americans. Evaluation consisted of cross-sectional pre- and post-intervention population-based telephone surveys of Vietnamese Americans adults age 18-64 who spoke English or Vietnamese and lived in the Northern California (intervention) or Greater Washington, D.C. (comparison) communities in 2007 or 2011. Statistical analysis was completed in 2012. The main outcome was self-report of HBV testing, defined as participants answering 'Yes' to the question: 'Have you ever had a blood test to check for hepatitis B?'Results: The sample sizes at pre- and post-intervention were 1,704 and 1,666, respectively. Both communities reported increased exposure to HBV-related booklets, radio and television advertisements, and websites. Only the intervention community reported increased exposure to newspaper elements. HBV screening increased in both communities (intervention: 65.3% to 73.1%, p < 0.01, comparison: 57.7% to 66.0%, p < 0.01). In multivariable analyses, there was no intervention effect. In both communities, exposure to media elements (Odds Ratio 1.26 [95% Confidence Interval: 1.21, 1.31] for each additional element) was significantly associated with screening.Conclusions: Among Vietnamese Americans in 2 large communities, HBV screening rates were sub-optimal. Screening increased in both the intensive media intervention and comparison communities, and exposure to HBV-related media messages was associated with increased screening. Efforts to address HBV screening among Vietnamese Americans should include mass media messaging.
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Affiliation(s)
- Janet N. Chu
- Division of General Internal Medicine, Department of
Medicine, University of California, San Francisco; San Francisco, CA, USA
| | - Susan L. Stewart
- Department of Public Health Sciences, University of
California, Davis; Davis, CA, USA
| | - Ginny Gildengorin
- Division of General Internal Medicine, Department of
Medicine, University of California, San Francisco; San Francisco, CA, USA
| | - Ching Wong
- Division of General Internal Medicine, Department of
Medicine, University of California, San Francisco; San Francisco, CA, USA
| | - Hy Lam
- Division of General Internal Medicine, Department of
Medicine, University of California, San Francisco; San Francisco, CA, USA
| | - Stephen J. McPhee
- Division of General Internal Medicine, Department of
Medicine, University of California, San Francisco; San Francisco, CA, USA
| | - Moon S. Chen
- Division of Hematology and Oncology, Department of Internal
Medicine, University of California, Davis; Davis, CA, USA
| | - Roshan Bastani
- Department of Health Policy and Management, University of
California, Los Angeles; Los Angeles, CA, USA
| | - Annette E. Maxwell
- Department of Health Policy and Management, University of
California, Los Angeles; Los Angeles, CA, USA
| | - Victoria M. Taylor
- Division of Public Health Sciences, Fred Hutchinson
Cancer Research Center; Seattle, WA, USA
| | - Tung T. Nguyen
- Division of General Internal Medicine, Department of
Medicine, University of California, San Francisco; San Francisco, CA, USA
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9
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Kim SB, Kang M. What are the effects of colorectal cancer screening interventions among Asian Americans? A meta-analysis. ETHNICITY & HEALTH 2022; 27:297-315. [PMID: 31906697 DOI: 10.1080/13557858.2019.1711024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
Objective: Great strides have been made to conduct intervention studies aimed at increasing colorectal cancer (CRC) screening rates that are informed by sound theoretical frameworks and conducted using rigorous methodologies; however, efforts are still gaining wave to understand the efficacy of theory-based interventions among Asian American (AA) population. The purpose of this study was to report the results of a meta-analysis conducted on the effects of CRC screening interventions.Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to evaluate the CRC screening interventions. Literature search was performed on October 2018, and studies published in English and conducted in the United States were eligible for inclusion if they (1) conducted interventions with aims to increase CRC screening rates among AA and (2) utilized a randomized control trial or quasi-experimental study design, (3) reported quantitative screening rates following the intervention, and (4) included a comparison or control group for comparison. No publication year restriction was applied.Result: In total, 14 Odds Ratio (OR) from 16 studies were included in the meta-analysis. Overall, results indicated that AA participants who received the screening interventions aimed at improving screening were 1.78 times more likely to obtain a CRC screening at post-intervention compared to those in the control or comparison group, OR = 1.78 (1.44, 2.11).Conclusion: Understanding the efficacy of interventions designed to promote CRC screening among AA population is imperative to decrease CRC burden and mortality. Although research in this area is limited, this review sheds light on important socio-cultural strategies to developing a CRC screening intervention aimed at increasing screening rates among AA. Findings in this review demonstrate that improvement in screening can be achieved through a variety of ways, but the common feature across all the studies was the culturally responsive foundation of their respective interventions.
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Affiliation(s)
- Sophia B Kim
- Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Minji Kang
- Center for Gendered Innovations in Science and Technology Researches (GISTeR), Korea Federation of Women's Science & Technology Associations, Seoul, Republic of Korea
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10
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Lim KT, Ng CH, Decruz GM, Lim TZ, Devi K, Tan KK, Chong CS. Barriers and facilitators towards colonoscopy: a qualitative systematic review. Eur J Cancer Prev 2021; 30:232-238. [PMID: 32694277 DOI: 10.1097/cej.0000000000000615] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Colonoscopy is integral in the early detection of colorectal cancer (CRC), be it for screening, diagnostic or therapeutic intentions. Despite the presence of multiple screening modalities, colonoscopy remains integral in providing a definitive CRC diagnosis. However, uptake rates remain low worldwide with minimal understanding towards stakeholders' perspectives. This systematic review is the first to outline the barriers and facilitators faced by providers and patients in receiving colonoscopy specifically. METHODS Using PRISMA guidelines, our systematic review consolidates findings from Medline, Embase, CINAHL, PsycINFO and Web of Science Core collection. All perceptions of healthcare providers and screening participants aged 45 and above towards colonoscopy were included. RESULTS Forty-five articles were included in our review. Five major analytical themes were identified - procedural perceptions, personal experiences, thoughts and concerns, societal influences, doctor-patient relationship and healthcare system. The discrepancies in knowledge between patients and providers have evidently reduced in the present decade, potentially attributable to the rising influence of social media. The sharing of providers' personal experiences, involvement of patients' family in colonoscopy recommendations and propagation of patients' positive recounts were also more apparent in the past compared to the present decade, highlighting the need to reevaluate the balance between medical confidentiality and personal touch. Additionally, Asian patients were reportedly more apathetic towards CRC diagnosis due to their strong belief in destiny, a crucial association consistent with present studies. CONCLUSION This study highlights pertinent gaps in our healthcare system, providing crucial groundwork for interventions to be enacted in engendering higher colonoscopy uptake rates.
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Affiliation(s)
- Kia Teng Lim
- Yong Loo Lin School of Medicine, National University of Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore
| | | | - Tian Zhi Lim
- Division of Colorectal Surgery, Department of Surgery, National University Hospital
| | - Kamala Devi
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Ker-Kan Tan
- Division of Colorectal Surgery, Department of Surgery, National University Hospital
| | - Choon Seng Chong
- Yong Loo Lin School of Medicine, National University of Singapore
- Division of Colorectal Surgery, Department of Surgery, National University Hospital
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11
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Ma GX, Zhu L, Lin TR, Tan Y, Do P. Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis. Cancer Control 2021; 28:10732748211011077. [PMID: 33896230 PMCID: PMC8204627 DOI: 10.1177/10732748211011077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors – individual, interpersonal, and community – on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. Methods: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. Results: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. Conclusions: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members’ confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.
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Affiliation(s)
- Grace X Ma
- Center for Asian Health, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,Department of Clinical Sciences, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Lin Zhu
- Center for Asian Health, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Timmy R Lin
- Center for Asian Health, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Yin Tan
- Center for Asian Health, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Phuong Do
- Center for Asian Health, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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12
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Kelly C, Pericleous M, Hendy J, de Lusignan S, Ahmed A, Vandrevala T, Ala A. Interventions to improve the uptake of screening across a range of conditions in Ethnic Minority Groups: a systematic review. Int J Clin Pract 2018; 72:e13202. [PMID: 29920875 DOI: 10.1111/ijcp.13202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/15/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Screening programmes are well established in cancer, and are now being implemented in other conditions. An effective screening programme leads to early disease detection and improved outcomes but its impact is dependent on the quality of the test and the proportion of the target population participating. A further consideration is that uptake of screening by minority groups is low. PURPOSE To determine which interventions have successfully increased screening uptake amongst minorities. DATA SOURCES Medline, Cochrane database and the grey literature were searched from 1990 to 1st March 2016. STUDY SELECTION Fifty-five English language studies that assessed uptake of screening in any minority population in the country of study aged over 18 years and that included a comparison arm. DATA EXTRACTION Independent data extraction was undertaken by two researchers (CK and MP), using a predesigned data extraction form (DEF) which assisted retrieval of the core contents of each study and the organisation of material. DATA SYNTHESIS Evidence was organised by screening test and type of intervention. Two authors (CK and MP) extracted data into evidence tables to enable comparison of study characteristics and findings. The heterogeneity of methods precluded a meta-analysis thus results are descriptive. Evidence was also assessed, using the Cochrane Collaboration risk of bias tables. RESULTS This systematic review appraises data from international studies on a variety of minority groups, interventions and screening programmes providing a narrative review of their success and limitations.
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Affiliation(s)
- Claire Kelly
- Department of Gastroenterology and Hepatology, Royal Surrey County Hospital, Guildford, Surrey, UK
- Department of Clinical and Experimental Medicine, FHMS, University of Surrey, Guildford, Surrey, UK
| | - Marinos Pericleous
- Department of Gastroenterology and Hepatology, Royal Surrey County Hospital, Guildford, Surrey, UK
- Department of Clinical and Experimental Medicine, FHMS, University of Surrey, Guildford, Surrey, UK
| | - Jane Hendy
- Brunel Business School, Brunel University, London, UK
| | - Simon de Lusignan
- Department of Clinical and Experimental Medicine, FHMS, University of Surrey, Guildford, Surrey, UK
| | - Ayesha Ahmed
- Brunel Business School, Brunel University, London, UK
| | | | - Aftab Ala
- Department of Gastroenterology and Hepatology, Royal Surrey County Hospital, Guildford, Surrey, UK
- Department of Clinical and Experimental Medicine, FHMS, University of Surrey, Guildford, Surrey, UK
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13
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Young S, Gomez N, Maxwell AE. Providing Health Education to Mixtec Farmworkers in California via Workshops and Radio: A Feasibility Study. Health Promot Pract 2018; 20:520-528. [PMID: 29745264 DOI: 10.1177/1524839918772282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Originating from one of the poorest areas in Mexico, Mixtecs are one of the largest indigenous groups of workers in California. Providing health education to this group is challenging because many do not speak English or Spanish, and indigenous languages are mainly oral, not written. We explored the feasibility of conveying health information through the radio and in promotora-led workshops. The study included an evaluation of the workshops through surveys before the workshop and 4 to 6 months later in a subsample of 96 indigenous women. The number of radio listeners averaged more than 2,000 per month, and 500 community members attended a workshop. Among women who completed pre- and postworkshop assessments (N = 75), there was a statistically significant increase in knowledge of how to get a wellness visit, where to get a free mammogram, and mammography screening guidelines. Women who ever had a mammogram or wellness visit at baseline were significantly more likely to report receipt of this service during the follow-up period than women who never had this service. Educational workshops and radio are promising and culturally appropriate strategies to provide health information in this community. However, many women need additional assistance to navigate access to health care.
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Affiliation(s)
- Sandra Young
- 1 Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
| | - Norma Gomez
- 1 Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
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14
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Leung DYP, Chen JMT, Lou VWQ, Wong EML, Chan AWK, So WKW, Chan CWH. Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070769. [PMID: 28703752 PMCID: PMC5551207 DOI: 10.3390/ijerph14070769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/04/2017] [Accepted: 07/09/2017] [Indexed: 11/30/2022]
Abstract
Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy simultaneously might also be useful for the effective promotion of colonoscopy among Chinese older adults.
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Affiliation(s)
- Doris Y P Leung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Joanne M T Chen
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China.
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Eliza M L Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Aileen W K Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
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15
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Nguyen TT, Tsoh JY, Woo K, Stewart SL, Le GM, Burke A, Gildengorin G, Pasick RJ, Wang J, Chan E, Fung LC, Jih J, McPhee SJ. Colorectal Cancer Screening and Chinese Americans: Efficacy of Lay Health Worker Outreach and Print Materials. Am J Prev Med 2017; 52:e67-e76. [PMID: 27986352 PMCID: PMC5318244 DOI: 10.1016/j.amepre.2016.10.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/14/2016] [Accepted: 10/03/2016] [Indexed: 12/24/2022]
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.
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Affiliation(s)
- Tung T Nguyen
- 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.
| | - Janice Y Tsoh
- Asian American Research Center on Health, San Francisco, California; Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Kent Woo
- Asian American Research Center on Health, San Francisco, California; NICOS Chinese Health Coalition, San Francisco, California
| | - Susan L Stewart
- Department of Public Health Sciences, University of California, Davis, Davis, California
| | - Gem M Le
- 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
| | - Adam Burke
- Asian American Research Center on Health, San Francisco, California; Department of Health Education, San Francisco State University, San Francisco, California
| | - Ginny Gildengorin
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Rena J Pasick
- 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
| | - Jun Wang
- Asian American Research Center on Health, San Francisco, California; The American College of Traditional Chinese Medicine, San Francisco, California
| | - Elaine Chan
- Department of Psychiatry, University of California, San Francisco, San Francisco, California; NICOS Chinese Health Coalition, San Francisco, California
| | - Lei-Chun Fung
- Asian American Research Center on Health, San Francisco, California; Chinatown Public Health Center, Department of Public Health, San Francisco, California
| | - Jane Jih
- 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
| | - Stephen J McPhee
- 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
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16
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Brenner AT, Ko LK, Janz N, Gupta S, Inadomi J. Race/Ethnicity and Primary Language: Health Beliefs about Colorectal Cancer Screening in a Diverse, Low-Income Population. J Health Care Poor Underserved 2017; 26:824-38. [PMID: 26320917 DOI: 10.1353/hpu.2015.0075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Colorectal cancer (CRC) is an important cause of cancer death in adults in the U.S.; screening is effective but underutilized, particularly among minorities. The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to CRC screening differ by race/ethnicity and primary language. Data were from the baseline surveys of 933 participants (93.5%) in a randomized trial promoting CRC screening in San Francisco. Composite scores for each construct were created from multiple items, dichotomized for analysis, and analyzed using multivariate logistic regression. Most participants were Asian (29.7%) or Hispanic (34.3%), and many were non-English speakers. Non-English speaking Hispanics (p<.001) and English-speaking Asians (p=.002) reported lower perceived susceptibility than non-Hispanic Whites (NHW). Non-English speaking Hispanics reported more and non-English speaking Asians fewer perceived barriers (psychological and structural) than NHW. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations.
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17
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Davis SN, Christy SM, Chavarria EA, Abdulla R, Sutton SK, Schmidt AR, Vadaparampil ST, Quinn GP, Simmons VN, Ufondu CB, Ravindra C, Schultz I, Roetzheim RG, Shibata D, Meade CD, Gwede CK. A randomized controlled trial of a multicomponent, targeted, low-literacy educational intervention compared with a nontargeted intervention to boost colorectal cancer screening with fecal immunochemical testing in community clinics. Cancer 2016; 123:1390-1400. [PMID: 27906448 DOI: 10.1002/cncr.30481] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The objective of the current study was to improve colorectal cancer (CRC) screening uptake with the fecal immunochemical test (FIT). The current study investigated the differential impact of a multicomponent, targeted, low-literacy educational intervention compared with a standard, nontargeted educational intervention. METHODS Patients aged 50 to 75 years who were of average CRC risk and not up-to-date with CRC screening were recruited from either a federally qualified health center or a primary care community health clinic. Patients were randomized to the intervention condition (targeted photonovella booklet/DVD plus FIT kit) or comparison condition (standard Centers for Disease Control and Prevention brochure plus FIT kit). The main outcome was screening with FIT within 180 days of delivery of the intervention. RESULTS Of the 416 participants, 54% were female; the participants were racially and ethnically diverse (66% white, 10% Hispanic, and 28% African American), predominantly of low income, and insured (the majority had county health insurance). Overall, the FIT completion rate was 81%, with 78.1% of participants in the intervention versus 83.5% of those in the comparison condition completing FIT (P = .17). In multivariate analysis, having health insurance was found to be the primary factor predicting a lack of FIT screening (adjusted odds ratio, 2.10; 95% confidence interval, 1.04-4.26 [P = .04]). CONCLUSIONS The multicomponent, targeted, low-literacy materials were not found to be significantly different or more effective in increasing FIT uptake compared with the nontargeted materials. Provision of a FIT test plus education may provide a key impetus to improve the completion of CRC screening. The type of educational material (targeted vs nontargeted) may matter less. The findings of the current study provide a unique opportunity for clinics to adopt FIT and to choose the type of patient education materials based on clinic, provider, and patient preferences. Cancer 2017;123:1390-1400. © 2016 American Cancer Society.
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Affiliation(s)
- Stacy N Davis
- Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, New Jersey.,Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Shannon M Christy
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Enmanuel A Chavarria
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Rania Abdulla
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Steven K Sutton
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Alyssa R Schmidt
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Susan T Vadaparampil
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Gwendolyn P Quinn
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Vani N Simmons
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | | | | | - Ida Schultz
- Premier Community HealthCare Group Inc, Dade City, Florida
| | - Richard G Roetzheim
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - David Shibata
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Cathy D Meade
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Clement K Gwede
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
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18
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Christy SM, Davis SN, Williams KR, Zhao X, Govindaraju SK, Quinn GP, Vadaparampil ST, Lin HY, Sutton SK, Roethzeim RR, Shibata D, Meade CD, Gwede CK. A community-based trial of educational interventions with fecal immunochemical tests for colorectal cancer screening uptake among blacks in community settings. Cancer 2016; 122:3288-3296. [PMID: 27420119 DOI: 10.1002/cncr.30207] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/03/2016] [Accepted: 05/27/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Intervention studies among individuals in diverse community settings are needed to reduce health disparities in colorectal cancer (CRC) screening and mortality rates. The current study compared the efficacy of 2 intervention conditions promoting CRC screening among black individuals. METHODS Black individuals ages 50 to 75 years (N = 330) were recruited in community settings in 4 Tampa Bay counties. After obtaining consent and conducting a baseline interview to assess sociodemographic and health-related variables, participants received either a culturally targeted CRC photonovella booklet plus a fecal immunochemical test (FIT) kit or a standard CRC screening brochure plus an FIT kit. The primary outcome was FIT kit screening uptake. RESULTS FIT screening uptake at 6 months was 86.7% overall (90.3% in the brochure group and 81.9% in the photonovella group). Controlling for baseline between-group differences, there was no influence of intervention on FIT kit uptake (P = .756). Significant predictors of not returning an FIT kit included being unable to work (P = .010), having higher religious belief scores (P = .015), and living farther from the cancer center (P = .015). CONCLUSIONS Providing FIT kits and educational print materials to black individuals in community settings resulted in high rates of CRC screening. The study also identified subgroups of participants who were less likely to return an FIT kit and provides insight for future interventions. Cancer 2016;122:3288-3296. © 2016 American Cancer Society.
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Affiliation(s)
- Shannon M Christy
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Stacy N Davis
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kimberly R Williams
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Xiuhua Zhao
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Swapomthi K Govindaraju
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Gwendolyn P Quinn
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Susan T Vadaparampil
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Hui-Yi Lin
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Steven K Sutton
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Richard R Roethzeim
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - David Shibata
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Cathy D Meade
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Clement K Gwede
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, Florida. .,Morsani College of Medicine, University of South Florida, Tampa, Florida.
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19
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Maxwell AE, Danao LL, Cayetano RT, Crespi CM, Bastani R. Implementation of an evidence-based intervention to promote colorectal cancer screening in community organizations: a cluster randomized trial. Transl Behav Med 2016; 6:295-305. [PMID: 27282431 PMCID: PMC4927441 DOI: 10.1007/s13142-015-0349-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
UNLABELLED The implementation of evidence-based strategies to promote colorectal cancer (CRC) screening remains challenging. The aim of this study is to evaluate two strategies to implement an evidence-based intervention to promote CRC screening in Filipino American community organizations. Twenty-two community organizations were randomized to either a basic or enhanced implementation strategy. In both arms, community health advisors recruited participants non-adherent to CRC screening guidelines, conducted educational sessions, distributed print materials and free fecal occult blood test kits, reminded participants to get screened, and mailed letters to participants' providers. In the enhanced arm, leaders of the organizations participated in implementation efforts. While the effectiveness was similar in both arms of the study (screening rate at 6-month follow-up was 53 % in the enhanced arm, 49 % in the basic arm), 223 participants were screened in the enhanced arm versus 122 in the basic arm. The enhanced implementation strategy reached 83 % more participants and achieved a higher public health impact. TRIAL REGISTRATION NCT01351220 (ClinicalTrials.gov).
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, CA, USA.
- , 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Leda L Danao
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, CA, USA
| | - Reggie T Cayetano
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, CA, USA
| | - Catherine M Crespi
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, CA, USA
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, CA, USA
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Anker AE, Feeley TH, McCracken B, Lagoe CA. Measuring the Effectiveness of Mass-Mediated Health Campaigns Through Meta-Analysis. JOURNAL OF HEALTH COMMUNICATION 2016; 21:439-56. [PMID: 26953782 DOI: 10.1080/10810730.2015.1095820] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A meta-analytic review was undertaken to examine the effects of mass communication campaigns on changes in behavior, knowledge, and self-efficacy in the general public. A review of the academic literature was undertaken and identified 1,638 articles from 1966 through 2012. Using strict inclusion criteria, we included 63 studies for coding and analyses. Results from these efforts indicated that campaigns produced positive effects in behavior change (r = .05, k = 61) and knowledge (r = .10, k = 26) but failed to produce significant increases in self-efficacy (r = .02, k = 14). Several moderators (e.g., health topic, the theory underlying the campaign) were examined in relation to campaign principles that are prescribed to increase campaign effects. The major findings are reviewed, and the implications for future campaign design are discussed.
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Affiliation(s)
- Ashley E Anker
- a Department of Communication , University at Buffalo, The State University of New York , Buffalo , New York , USA
| | - Thomas Hugh Feeley
- a Department of Communication , University at Buffalo, The State University of New York , Buffalo , New York , USA
| | - Bonnie McCracken
- a Department of Communication , University at Buffalo, The State University of New York , Buffalo , New York , USA
| | - Carolyn A Lagoe
- b Department of Communication, Film, & Media Studies , University of New Haven , New Haven , Connecticut , USA
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A Media and Clinic Intervention to Increase Colorectal Cancer Screening in Ohio Appalachia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:943152. [PMID: 26509172 PMCID: PMC4609808 DOI: 10.1155/2015/943152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/29/2015] [Accepted: 08/16/2015] [Indexed: 12/25/2022]
Abstract
Objective. To test the effectiveness of a colorectal cancer (CRC) screening intervention among adults living in Ohio Appalachia. Methods. We conducted a group-randomized trial of a county-level intervention among adults living in 12 Ohio Appalachian counties who received a media campaign and clinic intervention focused on either CRC screening or fruits and vegetables. Participants' percentage within CRC screening guidelines was assessed with cross-sectional surveys conducted annually for four years, and validated with medical record review of screening. Results. On average, screening data were obtained on 564 intervention and 559 comparison participants per year. There was no difference in the Wave 4 CRC screening rates of intervention and comparison counties (35.2% versus 31.4%). Multivariate analyses found that high perceived risk of CRC, willingness to have a CRC test if recommended by a doctor, doctor recommendation of a CRC screening test, and patient-physician communication about changes in bowel habits, family history of CRC, and eating fruits and vegetables were significant (p < 0.05) predictors of being within CRC screening guidelines. Conclusions. The intervention was not effective in increasing CRC rates among Ohio Appalachian adults. Future research should determine how media and clinic-based interventions can be modified to improve CRC screening rates among this underserved population.
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Nguyen BH, Stewart SL, Nguyen TT, Bui-Tong N, McPhee SJ. Effectiveness of Lay Health Worker Outreach in Reducing Disparities in Colorectal Cancer Screening in Vietnamese Americans. Am J Public Health 2015; 105:2083-9. [PMID: 26270306 DOI: 10.2105/ajph.2015.302713] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We conducted a cluster randomized controlled study of a lay health worker (LHW) intervention to increase colorectal cancer (CRC) screening rates among Vietnamese Americans, who typically have lower rates than do non-Hispanic Whites. METHODS We randomized 64 LHWs to 2 arms. Each LHW recruited 10 male or female participants who had never had CRC screening (fecal occult blood test, sigmoidoscopy, or colonoscopy). Intervention LHWs led 2 educational sessions on CRC screening. Control LHWs led 2 sessions on healthy eating and physical activity. The main outcome was self-reported receipt of any CRC screening at 6 months after the intervention. We conducted the study from 2008 to 2013 in Santa Clara County, California. RESULTS A greater proportion of intervention participants (56%) than control participants (19%) reported receiving CRC screening (P < .001). When controlling for demographic characteristics, the intervention odds ratio was 5.45 (95% confidence interval = 3.02, 9.82). There was no difference in intervention effect by participant gender. CONCLUSIONS LHW outreach was effective in increasing CRC screening in Vietnamese Americans. Randomized controlled trials are needed to test the effectiveness of LHW outreach for other populations and other health outcomes.
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Affiliation(s)
- Bang H Nguyen
- Bang H. Nguyen is with the Cancer Prevention Institute of California, Fremont and the Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA. Susan L. Stewart is with the Department of Public Health Sciences, University of California School of Medicine, Davis. Tung T. Nguyen and Stephen J. McPhee are with the Department of Medicine, University of California, San Francisco. Ngoc Bui-Tong is with the Vietnamese Reach for Health Coalition, Fremont, CA
| | - Susan L Stewart
- Bang H. Nguyen is with the Cancer Prevention Institute of California, Fremont and the Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA. Susan L. Stewart is with the Department of Public Health Sciences, University of California School of Medicine, Davis. Tung T. Nguyen and Stephen J. McPhee are with the Department of Medicine, University of California, San Francisco. Ngoc Bui-Tong is with the Vietnamese Reach for Health Coalition, Fremont, CA
| | - Tung T Nguyen
- Bang H. Nguyen is with the Cancer Prevention Institute of California, Fremont and the Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA. Susan L. Stewart is with the Department of Public Health Sciences, University of California School of Medicine, Davis. Tung T. Nguyen and Stephen J. McPhee are with the Department of Medicine, University of California, San Francisco. Ngoc Bui-Tong is with the Vietnamese Reach for Health Coalition, Fremont, CA
| | - Ngoc Bui-Tong
- Bang H. Nguyen is with the Cancer Prevention Institute of California, Fremont and the Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA. Susan L. Stewart is with the Department of Public Health Sciences, University of California School of Medicine, Davis. Tung T. Nguyen and Stephen J. McPhee are with the Department of Medicine, University of California, San Francisco. Ngoc Bui-Tong is with the Vietnamese Reach for Health Coalition, Fremont, CA
| | - Stephen J McPhee
- Bang H. Nguyen is with the Cancer Prevention Institute of California, Fremont and the Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA. Susan L. Stewart is with the Department of Public Health Sciences, University of California School of Medicine, Davis. Tung T. Nguyen and Stephen J. McPhee are with the Department of Medicine, University of California, San Francisco. Ngoc Bui-Tong is with the Vietnamese Reach for Health Coalition, Fremont, CA
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Kimura A, Sin MK, Spigner C, Tran A, Tu SP. Barriers and facilitators to colorectal cancer screening in Vietnamese Americans: a qualitative analysis. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:728-734. [PMID: 24756545 PMCID: PMC4334440 DOI: 10.1007/s13187-014-0646-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Vietnamese Americans are the fourth largest Asian ethnic group in the USA. Colorectal cancer (CRC) ranks as one of the most common cancers in Vietnamese Americans. However, CRC screening rates remain low among Vietnamese Americans, with 40 % of women and 60 % of men reporting never having a sigmoidoscopy, colonoscopy, or fecal occult blood test (FOBT). We partnered with a Federally Qualified Health Center (FQHC) in Seattle, WA, to conduct focus groups as part of a process evaluation. Using interpreters, we recruited and conducted three focus groups comprised of six women screened for CRC, six women not screened for CRC, and seven men screened for CRC, which made up a total of 19 FQHC patients of Vietnamese descent between 50 and 79 years old. Three team members analyzed transcripts using open coding and axial coding. Major themes were categorized into barriers and facilitators to CRC screening. Barriers include lack of health problems, having comorbidities, challenges with medical terminology, and concerns with the colonoscopy. Participants singled out the risk of perforation as a fear they have toward colonoscopy procedures. Facilitators include knowledge about CRC and CRC screening, access to sources of information and social networks, and physician recommendation. Our focus groups elicited information that adds to the literature and has not been previously captured through published surveys. Findings from this study can be used to develop more culturally appropriate CRC screening interventions and improve upon existing CRC screening programs for the Vietnamese American population.
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Affiliation(s)
- Amanda Kimura
- Department of Medicine, University of Washington, 325 9th Avenue Seattle, WA 98104
| | - Mo-Kyung Sin
- College of Nursing, Seattle University, 901 12th Avenue Seattle, WA 98122
| | - Clarence Spigner
- Department of Health Services, University of Washington, 1959 NE Pacific Street Seattle, WA 98195
| | | | - Shin-Ping Tu
- Department of Health Services, University of Washington, 1959 NE Pacific Street Seattle, WA 98195
- Department of Medicine, Virginia Commonwealth University, 1201 East Marshall Street, VA 23298
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Lee HY, Tran M, Jin SW, Bliss R, Yeazel M. Motivating underserved Vietnamese Americans to obtain colorectal cancer screening: evaluation of a culturally tailored DVD intervention. Asian Pac J Cancer Prev 2014; 15:1791-6. [PMID: 24641410 DOI: 10.7314/apjcp.2014.15.4.1791] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is a leading cause of cancer death among Vietnamese Americans, yet screening remains underutilized. We investigated the effectiveness of a culturally tailored DVD intervention in promoting CRC screening among unscreened Vietnamese Americans age 50 and over. MATERIALS AND METHODS Using a community-based participatory research approach, we conducted a trial comparing twenty-eight subjects who received a mailed DVD in Vietnamese, with twenty-eight subjects who received a mailed brochure in Vietnamese. Subjects completed telephone surveys at baseline, One-month, and one-year. The primary outcome was receipt of screening. Secondary measures were participants' knowledge, attitudes, and beliefs about CRC screening. Two focus groups explored the intervention's acceptability and effectiveness. RESULTS At one year, CRC screening rates of 57.1% and 42.9% were observed in experimental and control group respectively (p=0.42), Subjects in both groups showed increased knowledge about CRC after one month. Focus group findings revealed that the DVD was an effective method of communicating information and would help promote screening. CONCLUSIONS The findings suggest that culturally tailored, linguistically appropriate content is more important than the type of media used. This relatively low intensity, low cost intervention utilizing a DVD can be another useful method for outreach to the often hard-to-reach unscreened population.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, USA E-mail :
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Cooper CP, Gelb CA, Hawkins NA. How many "Get Screened" messages does it take? Evidence from colorectal cancer screening promotion in the United States, 2012. Prev Med 2014; 60:27-32. [PMID: 24333876 DOI: 10.1016/j.ypmed.2013.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 11/30/2013] [Accepted: 12/03/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Colorectal cancer screening has been widely promoted in the United States. We investigated the association between reported exposure to screening information during the past year and screening participation and knowledge. METHOD Data from the 2012 HealthStyles Fall survey of U.S. adults were examined using adjusted logistic regression to examine the frequency of exposure to screening information as a predictor of screening participation and knowledge; analyses were limited to participants aged ≥50years with no history of colorectal cancer or polyps (N=1714). RESULTS Nearly half of the participants (44.9%) reported exposure to colorectal cancer screening information during the previous year. The most common sources of screening information were news reports, advertisements, and health care providers. Screening participation and knowledge consistently increased with the reported frequency of exposure to screening information, and these associations generally persisted when demographic variables were controlled. Compared with unexposed participants, significant gains in screening participation were associated with exposure to screening information 2-3 times (Adj. OR=1.84, p=0.001), 4-9 times (Adj. OR=2.00, p=0.001), and ≥10 times (Adj. OR=3.03, p<0.001) in the adjusted model. CONCLUSIONS Increasing public exposure to screening promotion messages may augment screening participation and knowledge.
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Affiliation(s)
| | - Cynthia A Gelb
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Nikki A Hawkins
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Nguyen-Truong CKY, Lee-Lin F, Gedaly-Duff V. Contributing Factors to Colorectal Cancer and Hepatitis B Screening Among Vietnamese Americans. Oncol Nurs Forum 2013; 40:238-51. [DOI: 10.1188/13.onf.238-251] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bethune R, Marshall MJ, Mitchell SJ, Oppong C, Cartmel MT, Arumugam PJ, Gee AS, Daniels IR. Did the 'Be Clear on Bowel Cancer' public awareness campaign pilot result in a higher rate of cancer detection? Postgrad Med J 2013; 89:390-3. [PMID: 23572594 DOI: 10.1136/postgradmedj-2012-131014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To assess the impact of a 7-week public bowel cancer awareness campaign pilot by reviewing the number of 2-week referrals from general practitioners (GPs) to hospital, endoscopic procedures and new cancers diagnosed throughout the five acute hospitals in The Peninsular Cancer Network, UK. DESIGN A retrospective before and after study. SETTING The Peninsula Cancer Network in the South West of England, UK. MAIN OUTCOME MEASURES For the period July 2010-July 2011, data were collected on the number of 2-week referrals, number of endoscopic procedures performed and number of new cancers diagnosed. The average for the 6 months before the campaign was compared with the immediate 3 months and then the fourth to sixth months following the campaign. Student's t test was used to compare the means of the three groups. RESULTS There was a statistically significant increase in the number of 2-week referrals from GPs to hospital in the 3 months following the campaign but this effect disappeared after that. There was no statistical increase in the number of endoscopic procedures or new cancers diagnosed following the awareness campaign. CONCLUSIONS The pilot 'Be Clear on Cancer' awareness campaign had a significant effect on the number of patients being referred from GPs to hospital; however, the effect was short lived and had returned to baseline by 3 months. The campaign had no effect on the number of new cancers diagnosed, which was the stated underlying aim of the pilot.
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Affiliation(s)
- Rob Bethune
- Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
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Chapman K, Nicholls K, Sullivan MM, Crutchfield S, Shaw T, Perkins A, Reed E. Colorectal cancer screening practices in Alabama: a survey of primary care physicians. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:687-694. [PMID: 22829231 DOI: 10.1007/s13187-012-0392-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In order to inform efforts to increase screening rates for colorectal cancer (CRC), we conducted a survey of Alabama primary care physicians regarding CRC screening practices, educational preferences, and perceptions of obstacles to screening. A mail survey of 2,378 Alabama physicians in Family Medicine, Internal Medicine, and Obstetrics & Gynecology was conducted. Many physicians are not fully up-to-date with current CRC screening practices that could improve patient compliance with screening guidelines. One example is the potential use of high-sensitivity stool tests, such as the fecal immunochemical test, instead of the no longer recommended low-sensitivity guaiac fecal occult blood tests. In addition, enhanced multimedia and web-based approaches to educating physicians and patients could be more fully utilized. Further, greater use of health information technologies could increase screening rates. Enhancing primary care physicians' knowledge of screening modalities and increasing their use of electronic technology could significantly improve colorectal cancer screening outcomes.
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Affiliation(s)
- Kathryn Chapman
- Cancer Prevention Program, Alabama FITWAY Colorectal Cancer Prevention Program, Bureau of Family Health Services, Alabama Department of Public Health, 36104, Montgomery, AL, USA
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Nguyen BH, Pham JT, Chew RA, McPhee SJ, Stewart SL, Doan HT. Effectiveness of continuing medical education in increasing colorectal cancer screening knowledge among Vietnamese American physicians. J Health Care Poor Underserved 2010; 21:568-81. [PMID: 20453357 DOI: 10.1353/hpu.0.0290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Colorectal cancer (CRC) screening rates are lower in Vietnamese Americans than in non-Hispanic Whites. Most Vietnamese Americans have ethnically concordant physicians and are willing to have CRC screening if their physicians recommend it. We conducted two continuing medical education (CME) seminars with participants recruited from the Vietnamese Physician Association of Northern California to increase their CRC screening knowledge. We used pre- and post-CME surveys to evaluate the CMEs and per-item McNemar's tests to assess changes in knowledge. Correct responses increased significantly from pre- to post-CME for all five items on CRC burden and four of 11 items on screening guidelines and practices at the first CME and for five of seven items on screening guidelines and practices at the second CME. Continuing medical education seminars were effective in increasing CRC screening knowledge among Vietnamese American physicians. This increase may lead to physicians' recommending and their patients' completing CRC screening tests.
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Affiliation(s)
- Bang H Nguyen
- Northern California Cancer Center, Fremont, California 94538, USA.
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