USING PHOTOVOICE TO ENGAGE COMMUNITY MEMBERS IN PROMOTING COLORECTAL CANCER AWARE

描述(申请人提供)：结直肠癌(CRC)是美国第二大癌症死亡原因，但通过筛查可以预防或及早发现。许多种族/少数民族群体和低收入或没有保险的人筛查率较低，诊断较晚，生存较差。鉴于公众对儿童权利公约和筛查的认识较低，开始解决儿童权利公约差距的一种方法是通过社区参与。我们已经建立了结直肠癌伙伴关系，以开始解决我们社区的差异。这个以社区为基础的参与性研究(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，以帮助了解社区对儿童权利公约的需求和认识，并利用这些发现来制定儿童权利意识干预信息。PhotoVoice项目的参与者将接受培训，使用相机拍摄他们对CRC或CRC筛查在他们生活中意义的描述。参与者制定个人叙述，描述他们选择的照片，随后将进行小组讨论，参与者可以讨论图像的含义和背景。我们将把PhotoVoice小组分为经过筛查的人和被诊断为CRC的人，这样我们就可以收集关于预防和早期发现的信息。Screener和Survior PhotoVoice小组将在圣路易斯的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。利用这个题目，总共将举行四个PhotoVoice小组，每个小组有12名参与者。在PhotoVoice项目之后，根据PhotoVoice参与者的决定，我们将使用参与性过程来选择一些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对已经和没有经过筛选的人进行形成性测试。焦点小组将在与PhotoVoice会议相同的社区地点举行。这项研究的具体目的是：(1)让社区成员参与研究，以确定有关使用PhotoVoice方法预防和早期发现结直肠癌的相关信息和图像；以及(2)使用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。我们预期的长期结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，以及一套社区驱动的、经过科学评估的儿童权利公约干预信息。在解决结直肠癌差异方面，这项研究涉及一个重大的公共卫生问题，并将为圣路易斯社区未来的CBPR工作奠定基础。 与公共健康相关：参与者将被提供相机，并被要求拍摄反映健康问题(结直肠癌、筛查)在他们生活中的意义或影响的照片，然后将与其他人会面，讨论他们认为照片所描绘的意义和信息。焦点小组将评估带有叙事信息的照片的可爱性、解释力、可信度和信息的显着性，以准备信息用于未来的干预试验。

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.