Storytelling for Colorectal Health among Latinos

描述(由申请人提供)：随着拉美裔美国人结直肠癌(CRC)发病率下降速度放缓和死亡率居高不下，开发和测试旨在改善这一人群预防行为的针对文化的计划变得越来越重要。拉丁美洲人中流行的两种已知的CRC危险行为是低水平的体力活动和低蔬菜消费。具体目的1.评估基于叙事理论的干预与标准干预对低收入拉丁裔人群随后的结直肠癌预防行为和筛查的影响。建议进行一项两组随机对照试验，以检验一种新颖的、文化上一致的拉丁裔讲故事(ST)干预与标准的传授学习(DL)干预在社区环境中传达癌症风险、初级预防和筛查信息的效果(900名参与者，每组研究80组约450人)。两个干预组都将收到癌症风险和预防信息，由Lay Health Education(LHEs)提供，根据ARM Of Study和随后的两周会议在12周内进行。结果将在干预后评估，并在6个月后检查维持情况。H1：与那些接触DL干预的人相比，基于他们暴露于ST干预的拉丁裔人在初级CRC预防行为方面将显示出更大的增长。主要终点是(A)每周体力活动分钟，和(B)每日蔬菜摄入量，两者都是用高度可靠、经过验证的仪器测量的。次要终点包括其他与结直肠癌风险相关的行为(钙摄入、红肉消费、肥胖、饮酒、吸烟)和筛查(FOBT和内窥镜检查)。LHEs的特点和核心信息内容将在干预的两个分支中保持一致；只有交付的风格和背景将截然不同。具体目标2.测试具体的基于理论的模型，比较每种干预措施对体力活动和饮食结果的作用。与这种方法相关的理论结构的影响将在两个主要模型中进行测试。首先，我们检验了干预对计划行为理论提出的行为预测因素的影响的差异。然后，将测试拟议的ST干预解释模型的要素，包括交通、身份识别、自我认同和互惠支持因素，以确定调解对结果的影响。

DESCRIPTION (provided by applicant): With slower declines in incidence and continuing high mortality rates associated with colorectal cancer (CRC) among Latinos, developing and testing culturally-specific programs designed to improve prevention behaviors in this population becomes increasingly important. Two known CRC risk behaviors prevalent among Latinos are low levels of physical activity and low consumption of vegetables. Specific Aim 1. To evaluate effects of a narrative theory-based intervention compared to a standard intervention on subsequent CRC prevention behaviors and screening in a low-income Latino population. A two-group randomized, controlled trial is proposed to examine effects of a novel, culturally aligned Latino storytelling (ST) intervention versus a standard didactic learning (DL) intervention communicating cancer risk, primary prevention and screening information in the community setting, (900 participants, ~450 in 80 groups per arm of study). Both intervention groups will receive cancer risk and prevention information, delivered by Lay Health Educators (LHEs), styled according to arm of study and subsequent biweekly sessions over 12 weeks. Outcomes will be assessed post-intervention and 6 months later to examine maintenance. H1: Latinos will show greater increases in primary CRC prevention behaviors based on their exposure to ST intervention relative to those who are exposed to DL intervention. Primary endpoints are (a) minutes of physical activity per week, and (b) daily servings of vegetables, both measured with highly reliable, validated instruments. Secondary endpoints include additional CRC risk-related behaviors (calcium intake, red meat consumption, obesity, alcohol, tobacco use) and screening (FOBT and endoscopy). Characteristics of LHEs and core informational content will be consistent across both arms of intervention; only the style and context of delivery will be radically different. Specific Aim 2. To test specific theory-based models that compares the role of each intervention on the physical activity and dietary outcomes. Influences of theoretical constructs associated with this method will be tested in two primary models. First we examine the difference in effects of interventions on behavior predictive factors suggested by Theory of Planned Behavior. Then elements of a proposed explanatory model of the ST intervention, including transportation, identification, self-identity and reciprocal support factors, will be tested for mediation effects on outcomes.