Colorectal Screening in Vietnamese : A Controlled Trial

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DESCRIPTION (provided by applicant): This project is designed to increase colorectal cancer screening among Vietnamese Americans in Northern California through an intervention focused on educating Vietnamese American public and their health care providers. The objective of this study is to reduce morbidity and mortality caused by colorectal cancer. Colorectal cancer is the third most common cancer in Vietnamese American men and the fourth in women. The rate of colorectal screening is low among Vietnamese Americans; only 35 percent of Vietnamese have ever had a fecal occult blood test. The aims of this project are: 1) increase colorectal cancer screening among Vietnamese Americans ages 50 to 74 through a multifaceted intervention; and 2) evaluate the effectiveness of the intervention by following longitudinal cohorts in a controlled trial; 3) identify predictors of screening. The primary hypotheses are that the proportions of Vietnamese Americans ages 50 to 74 who 1) have ever had a colorectal cancer screening test; or 2) are up-to-date for colorectal cancer screening will increase more in the intervention population than in the control. The intervention will be carried out over 24 months in Alameda and Santa Clara Counties, California with Vietnamese Americans in Harris County, Texas serving as the control population. Building on the "Pathways" conceptual framework and our preliminary qualitative and quantitative research findings, the intervention will promote colorectal cancer screening by: 1) reaching Vietnamese Americans through a print and electronic media campaign that will distribute Vietnamese language health education information; and 2) reaching health care providers with Vietnamese-language counseling materials, training videos, and continuing medical education seminars. We will conduct formative research using focus groups to develop culturally appropriate materials (booklets, calendars, posters, and a web site) and products for distribution through Vietnamese-language media (newspaper, television, and radio advertisements). We will evaluate the effectiveness of the intervention by comparing rates of screening using pre- and post intervention surveys. To test the primary hypotheses we will use z-tests to determine if the differences in the change in rates (deltas) between the intervention and control populations are statistically significant. We will also generate logistic regression models to test the independent effects of the intervention and to identify predictors for colorectal cancer screening.