Colorectal Screening in Vietnamese : A Controlled Trial

描述(申请人提供)：该项目旨在通过一项旨在教育越南裔美国公众及其医疗保健提供者的干预措施，增加北加州越南裔美国人的结直肠癌筛查。本研究的目的是降低结直肠癌的发病率和死亡率。结直肠癌是越南裔美国男性的第三大常见癌症，在女性中排名第四。在越南裔美国人中，结直肠癌筛查的比例很低；只有35%的越南人曾接受过粪便潜血测试。该项目的目标是：1)通过多方面干预增加50至74岁越南裔美国人中的结直肠癌筛查；2)在对照试验中跟踪纵向队列，评估干预的有效性；3)确定筛查的预测因素。 基本假设是，年龄在50岁到74岁之间的越南裔美国人的比例1)曾接受过结直肠癌筛查测试；或2)是最新的，因为在干预人群中，结直肠癌筛查将比对照人群增加更多。这项干预将在加利福尼亚州的阿拉米达县和圣克拉拉县进行，为期24个月，德克萨斯州哈里斯县的越南裔美国人作为控制人口。在“路径”概念框架和我们的初步定性和定量研究结果的基础上，该干预措施将通过以下方式促进结直肠癌筛查：1)通过印刷和电子媒体活动传播越南语健康教育信息，接触到越南裔美国人；以及2)向医疗保健提供者提供越南语咨询材料、培训视频和继续医学教育研讨会。我们将利用焦点小组进行形成性研究，开发适合文化的材料(小册子、日历、海报和网站)和通过越南语媒体分发的产品(报纸、电视和广播广告)。我们将通过比较干预前和干预后调查的筛查率来评估干预的有效性。为了检验主要假设，我们将使用z检验来确定干预人群和对照人群之间的变化率(增量)差异是否具有统计学意义。我们还将生成Logistic回归模型，以测试干预的独立效果，并确定结直肠癌筛查的预测因素。

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.