Screening for colortectal cancer in an Asian Community Center

描述(申请人提供)：结直肠癌是亚裔美国人癌症死亡的主要原因。这一少数民族的筛查率低于高加索人口。筛查率低的原因尚不确定，但可能包括语言和文化障碍。如果针对亚裔美国人的干预不是针对语言和文化的，那么他们可能不会有效。具体的针对性干预是复杂的，因为亚裔美国人的国籍来源是多样化的。可能发生在初级保健提供者办公室的结肠癌筛查干预措施，如果存在语言或文化障碍、缺乏信任或如果个人不定期拜访其提供者，则可能不会成功。我们建议在一个独特的环境中研究结直肠癌教育干预：一个亚洲健康和服务中心，在俄勒冈州波特兰为13,000多人提供服务。这是一种新的筛查模式，它利用了社区中心存在的信任和文化意识，而不依赖于初级保健提供者。800名亚裔美国人，年龄在50岁到75岁之间，至少5年没有接受过任何结肠筛查，他们将被随机分配到社区中心进行对照或教育干预。教育干预将由双语工作人员以受试者的主要语言提供，并将解决结肠癌筛查的文化障碍。所有受试者都将在社区中心获得FOBT卡。主要目的将是确定干预组在12个月内完成FOBT测试的比率是否高于对照组。二次分析将评估结肠癌筛查对知识和信念的影响，探索四个亚洲亚群(中国人、韩国人、越南人和柬埔寨/老挝移民)之间的差异，并评估FOBT阳性和阴性的适当随访。这项拟议的研究提供了一种创新的方法，在筛查率处于历史低位的服务不足的社区提高筛查率。此外，该提案采用了社区中心模式，可以推广到美国的其他社区中心。我们建议在一个独特的环境中研究结直肠癌教育干预：一个亚洲健康和服务中心，在俄勒冈州波特兰为13,000多人提供服务。这是一种新的筛查模式，它利用了社区中心存在的信任和文化意识，而不依赖于初级保健提供者。

DESCRIPTION (provided by applicant): Colorectal cancer is a leading cause of cancer death among Asian Americans. Screening rates in this ethnic minority are lower than the Caucasian population. The reasons for low screening rates are uncertain, but could include language and cultural barriers. Interventions that target Asian Americans may not be effective if they are not language and culture specific. Specific targeted interventions are complicated because the national origin of Asian Americans is diverse. Colon cancer screening interventions which might occur in the primary care provider office, may not be successful if there are language or cultural barriers, lack of trust, or if individuals do not regularly visit their provider. We propose to study a colorectal cancer educational intervention in a unique setting: an Asian Health and Service Center, which serves more than 13,000 individuals in Portland, Oregon. This is a new paradigm for screening, which takes advantage of the trust and cultural awareness that exists at the community center and does not rely on the primary care provider. 800 Asian Americans, age 50 to 75 years, who have not had any colon screening for at least 5 years, will be randomly assigned to a control arm or an educational intervention which will take place at the community center. The educational intervention will be provided by bilingual staff in the primary language of the subject, and will address cultural barriers to colon cancer screening. All subjects will be offered FOBT cards at the community center. The primary aim will be to determine if rates of completed FOBT testing are higher in the intervention group within 12 months, compared to controls. Secondary analyses will evaluate the impact on knowledge and beliefs of colon cancer screening, explore differences among four Asian subgroups (Chinese, Korean, Vietnamese and Cambodian/Laotian immigrants), and evaluate the appropriate follow-up of the positive and negative FOBT. The proposed study provides an innovative approach to improving screening rates in an underserved community with historically low screening rates. Moreover, the proposal employs a community center model, which could be generalized to other community centers in the United States. We propose to study a colorectal cancer educational intervention in a unique setting: an Asian Health and Service Center, which serves more than 13,000 individuals in Portland, Oregon. This is a new paradigm for screening, which takes advantage of the trust and cultural awareness that exists at the community center and does not rely on the primary care provider.