USING PHOTOVOICE TO ENGAGE COMMUNITY MEMBERS IN PROMOTING COLORECTAL CANCER AWARE

描述（由申请人提供）：结直肠癌（CRC）是美国癌症死亡的第二大原因，但它可以通过筛查来预防或早期发现。许多种族/少数民族群体和低收入或没有保险的人的筛查率较低，诊断较晚，生存率较差。鉴于公众对结直肠癌和筛查的认识较低，开始解决结直肠癌差异的一种方法是通过社区参与。我们已经建立了结直肠癌合作伙伴关系，开始解决我们社区的差异。这个基于社区的参与性研究（CBPR）项目是在与伙伴关系的讨论中产生的。社区成员参与了这些想法的概念化，并参与了研究实施、分析和传播的几个阶段。在这项研究中，我们建议实施一个Photovoice项目，以帮助了解社区对CRC的需求和意识，并利用这些发现来开发CRC意识干预信息。Photovoice项目的参与者将接受培训，使用相机拍摄他们对CRC或CRC筛查在他们生活中的意义的描述。参与者发展个人叙述，描述他们所选择的照片和小组讨论将随之而来，参与者可以讨论图像的意义和背景。我们将把Photovoice小组分为接受过筛查的人和被诊断为结直肠癌的人，这样我们就可以收集有关预防和早期发现的信息。筛选者和幸存者Photovoice小组将在圣路易斯两个不同的医疗服务不足的社区（北部城市和南部城市）举行。在此基础上，将举办四个Photovoice组，每组12人。在Photovoice项目结束后，由Photovoice参与者自行决定，我们将采用参与式流程选择一些Photovoice产品作为潜在的干预信息。然后，这些信息将通过焦点小组进行形成性测试，小组成员中有接受过筛查的，也有没有接受过筛查的。焦点小组将在与Photovoice会议相同的社区地点举行。本研究的具体目的是：(1)利用Photovoice方法让社区成员参与研究，识别有关结直肠癌预防和早期发现的相关信息和图像；(2)使用来自Photovoice项目的图像和叙述作为干预信息的基础，这些信息将通过焦点小组进行预先测试。我们预期的长期成果将是更强有力的社区伙伴关系，社区成员有权倡导自己的健康，以及一套由社区推动、经过科学评估的crc干预信息。在解决结直肠癌差异方面，本研究涉及一个重要的公共卫生问题，并将为圣路易斯社区未来的CBPR工作奠定基础。

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the second leading cause of cancer death in the United States, but it can be prevented or detected early through screening. Many racial/ethnic minority groups and those who are low income or uninsured have lower rates of screening, later stage of diagnosis, and poorer survival. Given the low public awareness about CRC and screening, one way to begin addressing CRC disparities is through community engagement. We have established a colorectal cancer partnership to begin addressing the disparities in our community. This Community-Based Participatory Research (CBPR) project emerged out of discussions with the Partnership. Community members were involved in the conceptualization of the ideas and are involved in several phases of the research implementation, analysis, and dissemination. In this study, we propose to implement a Photovoice project to help understand community needs and awareness of CRC and use those findings to develop CRC awareness intervention messages. Participants in the Photovoice project will be trained to use cameras to photograph their depictions of the meaning of CRC or CRC screening in their lives. Participants develop an individual narrative describing their selected photographs and group discussions will ensue where participants can discuss the meaning and context of the images. We will separate Photovoice groups into persons who have been screened and persons who have been diagnosed with CRC so that we can gather messages about prevention as well as early detection. Screener and survivor Photovoice groups will be held in two different medically underserved neighborhoods (north city and south city) in Saint Louis. Using this rubric, a total of four Photovoice groups will be held with 12 participants each. After the Photovoice project and at the discretion of the Photovoice participants, we will use a participatory process to select some of the Photovoice products for use as potential intervention messages. Such messages will then undergo formative testing using focus groups with people who have and have not been screened. Focus groups will be held in the same neighborhood locations as were the Photovoice sessions. The Specific Aims of this study are: (1) Engage community members in participatory research to identify relevant messages and images about colorectal cancer prevention and early detection using a Photovoice approach; and (2) Use the images and narratives from the Photovoice project as the basis for intervention messages that will be pre- tested using focus groups. Our expected long-term outcomes will be a stronger community partnership, community members empowered to advocate for their health, and a set of community-driven scientifically- evaluated CRC-intervention messages. In addressing colorectal cancer disparities, this study involves a significant public health issue and will lay the foundation for future CBPR work in the Saint Louis community. PUBLIC HEALTH RELEVANCE: Participants will be provided with cameras and asked to take photographs that reflect the meaning or impact of the health issue (colorectal cancer, screening) in their lives and then will meet with others to discuss the meaning and messages that they feel the photographs portray. Photographs with accompanying narrative messages will be evaluated for likability, interpretation, credibility, and salience of messages by focus groups to prepare messages for use in future intervention trials.