American Samoa Indigenous Samoan Partnership to Initiate REsearch Excellence (INSPIRE) in Colorectal Cancer Health Literacy

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Project Abstract Very little information regarding the health status of American Samoans are available, and the research infrastructure in America Samoa (AS) requires a sufficient foundation and capacity building to conduct large-scale population health research. The purpose of this project is to: (1) build the research capacity in America Samoa to conduct population health research, and (2) to support a pilot health research project that aims to increase colorectal cancer screening literacy among American Samoans so that initial data will be available and serve as the foundation for future research efforts in America Samoa. This project is a collaborative community and research engaged effort that reflects the community-identified priorities in AS addressing a research gaps in health promotion and cancer prevention. The percentage of American Samoan adults aged 50-75 obtaining CRC screening is far below the US national average, i.e., 7% of American Samoans vs. 58.2% of US adults. Assessment of health literacy levels has been recommended in specific populations and to use assessment results in developing targeted and tailored promotional programs. The proposed Indigenous Samoan Program to Initiate Research Excellence (INSPIRE) – CRC Literacy. (INSPIRE) aims to: (1) strengthen research capacity by providing technical assistance on research protocol, IRB training, and development of an easily accessed cancer data repository, (2) adapt/pilot the Short form Test of Functional Health Literacy – Adults (STOFHLA) and administer revision to a representative sample of older adults recruited through Respondent Driven Sampling methods, and (3) informed by STOFHLA results, develop and implement a culturally competent, linguistically appropriate, and theory-informed screening intervention, use of a 2 group pre-post control group comparison, with measurement of Knowledge-Attitude- Behavior (KAB) survey at several points of evaluation and assessment of the primary outcome namely, timely completion of Fecal Occult Blood Test (FOBT). INSPIRE efforts will be led by the AS Community Cancer Coalition in partnership with LBJ Tropical Medical Center (LBJTMC), the AS Department of Health and dedicated technical assistance from consultants associated with the University of Hawai`i and Azusa Pacific University in California, with consultant expertise in health literacy, RDS, cancer screening research, STOFHLA, community-based participatory approaches, multi-modal research/evaluation strategies, and history of positive collaboration with AS partners. This effort should result in increased screening use and contribute to building a foundation for future translational research. INSPIRE-produced research is significant for AS because it lays a much needed foundation for systematic public health research. Further, INSPIRE research will contribute to advancement in the science of health literacy and health promotions with/for resource-poor, yet tradition-rich Indigenous communities thereby, offering the hopeful prospect of eliminating socially-constructed and harmful health inequalities.