CLEAN: A community-engaged intervention to increase colorectal cancer screening in Chinese American immigrants

项目概要/摘要 结直肠癌（CRC）是美国华人癌症死亡的第二大原因。CRC 筛查通过切除癌前息肉来预防癌症并降低死亡率。然而儿童权利委员会 在美国，华人对筛查的利用严重不足，只有47%的华裔美国人年龄超过50岁。 报告曾完成CRC筛查，而非西班牙裔白人为73%。鉴于这些 尽管中国移民在癌症预防方面存在着巨大的差距，但增加中国移民参与癌症预防工作至关重要。研究 表明社区参与的干预措施，如叙事教育和患者导航是有前途的 在弱势群体中增加CRC筛查的战略。在这项研究中，我们建议开发和 结肠直肠癌叙事教育和导航（CLEAN），一种社区参与的干预措施 包括叙事教育和患者导航，以改善中国移民的CRC筛查。到 发展清洁，我们将在文化和语言上适应证人关怀，一个理论驱动的，以证据为基础的 叙事小组教育计划。我们还将通过患者导航来增强该计划， 在这一弱势群体中推广CRC筛查。因此，我们的具体目标是：（1）通过以下方式发展清洁能源： 在文化和语言上调整和加强见证关怀，以支持中国人的CRC筛查 （2）对CLEAN在支持移民中的可行性、可接受性和初步效果进行了初步测试 中国移民的CRC筛查拟议研究的长期目标是改善预防 在中国移民和其他服务不足的群体中早期发现CRC，最终目标是 减少癌症差异。拟议的研究与旺博士的职业目标直接相关， 目标，并将用于建立一个研究计划，以实施有效的干预措施，旨在 减少少数群体的癌症差异。她的研究活动将得到一个深思熟虑的补充， 培训计划，将帮助她获得新的知识和技能：（1）社区参与的研究，和（2） 随机对照试验设计与分析。鉴于该机构的高质量研究环境 和资源，并与经验丰富的指导团队的指导下，博士.旺将有支持， 成功实现拟议的研究和培训目标所需的资源。过程中 5-在一年的资助期内，她将参加与导师的持续会议，完成正式的课程作业， 在她的机构和其他地方提供的互动培训活动;提交至少5个第一作者 参加科学研究会议，以促进国家网络， 癌症健康差异的研究人员。该多式联运培训计划将为旺博士提供 实现她的研究目标和成为一个独立的专业目标所需的综合技能 行为健康研究员

PROJECT SUMMARY/ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer death among Chinese in the US. CRC screening prevents cancer and reduces mortality through the removal of precancerous polyps. However, CRC screening is severely underutilized by Chinese in the US with only 47% of Chinese Americans over age 50 reporting having ever completed a CRC screening compared to 73% of non-Hispanic whites. Given these disparities, it is critical to increase Chinese immigrants' participation in cancer prevention efforts. Research indicate community engaged interventions, such as narrative education and patient navigation are promising strategies for increasing CRC screening in vulnerable populations. In this study, we propose to develop and pilot test CoLorectal Cancer Narrative Education and Navigation (CLEAN), a community-engaged intervention consisting of narrative education and patient navigation to improve CRC screening in Chinese immigrants. To develop CLEAN, we will culturally and linguistically adapt Witness CARES, a theory-driven, evidence-based narrative group education program. We will also enhance the program with patient navigation to further promote CRC screening in this vulnerable population. Thus, our specific aims are to: (1) Develop CLEAN by culturally and linguistically adapting and enhancing Witness CARES to support CRC screening among Chinese immigrants; and (2) Pilot test the feasibility, acceptability, and preliminary efficacy of CLEAN for supporting CRC screening in Chinese immigrants. The long-term goal of the proposed research is to improve prevention and early detection of CRC in Chinese immigrants and other underserved groups with the ultimate objective of reducing cancer disparities. The proposed research is directly relevant to Dr. Vang's career goals and objectives and will be used to build a program of research to implement effective interventions aimed at reducing cancer disparities in minorities. Her research activities will be complemented with a well-thought out training plan that will help her acquire new knowledge and skills in: (1) community engaged research, and (2) and randomized controlled trials design and analysis. Given the institution's high quality research environment and resources, and with the guidance of the experienced mentoring team, Dr. Vang will have the support and resources necessary to successfully pursue the proposed research and training aims. Over the course of the 5-year funding period, she will participate in ongoing meetings with her mentors, complete formal coursework and interactive training activities offered at her institution and elsewhere; submit a minimum of 5 first author manuscripts for publication; and attend scientific research conferences to foster national networks with researchers in cancer health disparities. This multimodal training plan will provide Dr. Vang with the comprehensive skills needed to achieve her research aims and professional goal of becoming an independent behavioral health researcher.