Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
School of Nursing, Jilin University, Changchun, China.
Dis Colon Rectum. 2020 Jun;63(6):850-858. doi: 10.1097/DCR.0000000000001611.
Low implementation of colorectal cancer screening in ethnic minorities is the main reason for racial and ethnic disparities in colorectal cancer morbidity and mortality. Peer support is widely used for promoting health care in ethnic minorities. However, whether it improves their acceptance to undergo the screening remains controversial.
We performed a meta-analysis of the currently available studies to further explore its effectiveness.
This meta-analysis was undertaken using PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO for randomized controlled trials.
We included studies that compared peer support interventions among ethnic minorities versus other interventions to promote uptake of colorectal cancer screening.
Thirteen studies comprising 8090 participants met the eligibility criteria. Peer support intervention can increase colorectal cancer screening implementation and raise awareness and intention to undergo the screening in ethnic minorities more significantly than fecal occult blood test outreach, print, and usual care. Subgroup analysis showed that peer support intervention achieved great results in Asian Americans and intervention of peer counseling.
The results of subgroup analysis had substantial heterogeneity, which may decrease the precision of our estimates.
Peer support can significantly improve the awareness about and the intention for receiving colorectal cancer screening in ethnic minorities and is an ideal choice for promoting the screening among ethnic minorities, particularly in a diverse community. Peer support intervention is recommended to promote the implementation of screening in Asian Americans. Peer counseling is worth promoting; however, church-based peer counseling programs require enhanced management to maintain their fidelity.
结直肠癌筛查在少数民族中的实施率较低，是导致结直肠癌发病率和死亡率存在种族和民族差异的主要原因。同伴支持被广泛用于促进少数民族的医疗保健。然而，它是否能提高他们接受筛查的意愿仍存在争议。
我们对现有的研究进行了荟萃分析，以进一步探讨其效果。
本荟萃分析使用了 PubMed、Embase、Scopus、Cochrane 对照试验中心注册库、护理和联合健康文献累积索引以及 PsycINFO，检索了随机对照试验。
我们纳入了比较同伴支持干预与少数民族其他干预措施以促进结直肠癌筛查接受率的研究。
符合纳入标准的研究共有 13 项，涉及 8090 名参与者。与粪便潜血试验外展、印刷品和常规护理相比，同伴支持干预能更显著地增加结直肠癌筛查的实施率，并提高少数民族对筛查的认识和意愿。亚组分析显示，同伴支持干预在亚裔美国人和同伴咨询干预中取得了很好的效果。
亚组分析的结果存在很大的异质性，可能会降低我们估计的准确性。
同伴支持可以显著提高少数民族对结直肠癌筛查的认识和接受意愿，是促进少数民族进行筛查的理想选择，特别是在多元化的社区中。建议采用同伴支持干预来促进亚裔美国人的筛查实施。同伴咨询值得推广；然而，基于教会的同伴咨询计划需要加强管理以保持其保真度。
