Kim Jungyoon, Dai Hongying Daisy, Michaud Tzeyu, Verma Sachi, King Keyonna M, Ewing John W, Mabiala-Maye Grace, Estabrooks Paul
Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE, 68198, USA.
Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
J Cancer Educ. 2025 Apr;40(2):248-255. doi: 10.1007/s13187-024-02506-w. Epub 2024 Sep 23.
Colorectal cancer (CRC) awareness and screening rates are still low in African Americans (AAs), especially for those who do not have regular access to health care. We established a multi-sector community partnership between academia, health system, cancer advocacy, and local county treasurer's office (CTO), to test a pilot CRC screening intervention using a tailored educational brochure and fecal immunochemical test (FIT). Participants were recruited at a local CTO in an urban midwestern region. Once eligible, participants were assigned to 2-by-2 intervention arms by educational strategy (brochure vs. no brochure) and FIT provision strategy (direct provision by onsite staff vs. indirect provision via phone/online request). We compared the effect of different strategies on FIT return rates. Of 1500 individuals approached, 212 were eligible for the study. The final sample consisted of 209 participants who were predominantly men (57%) and AAs (85%). No differences were found in the return rates by educational brochure (24% [brochure] vs. 23% [no brochure]; p = 0.82). In regard to FIT provision strategy, direct FIT provision yielded higher return rates than indirect provision (31% vs. 15%; p = 0.01). When the four groups were compared, direct provision with education brochure yielded the highest return rates (33.9%), followed by direct provision only (27.5%), indirect provision only (18%), and indirect provision with a brochure (12.2%). For community-based CRC screening intervention using stool-based test, the direct provision of FIT kits with educational brochure outperforms the other three strategies.
非裔美国人对结直肠癌（CRC）的认知和筛查率仍然很低，尤其是那些无法定期获得医疗保健服务的人群。我们在学术界、医疗系统、癌症宣传组织和当地县财务官办公室（CTO）之间建立了多部门社区伙伴关系，以测试一项试点CRC筛查干预措施，该措施使用了量身定制的教育手册和粪便免疫化学检测（FIT）。参与者是在中西部城市地区的一个当地CTO招募的。一旦符合条件，参与者根据教育策略（手册与无手册）和FIT提供策略（现场工作人员直接提供与通过电话/在线请求间接提供）被分配到2×2干预组。我们比较了不同策略对FIT返还率的影响。在接触的1500人中，有212人符合研究条件。最终样本包括209名参与者，他们主要是男性（57%）和非裔美国人（85%）。教育手册在返还率方面没有发现差异（24%[手册]对23%[无手册]；p = 0.82）。关于FIT提供策略，直接提供FIT的返还率高于间接提供（31%对15%；p = 0.01）。当比较这四组时，直接提供教育手册的返还率最高（33.9%），其次是仅直接提供（27.5%）、仅间接提供（18%）和间接提供手册（12.2%）。对于使用基于粪便检测的社区CRC筛查干预措施，直接提供带有教育手册的FIT试剂盒的效果优于其他三种策略。
