Storytelling for Colorectal Health among Latinos

描述（由申请人提供）：随着拉丁美洲人结直肠癌（CRC）发病率的缓慢下降和持续的高死亡率，开发和测试旨在改善该人群预防行为的文化特异性项目变得越来越重要。在拉丁美洲人中流行的两种已知的结直肠癌风险行为是低水平的身体活动和低蔬菜消费。具体目标评价基于叙事理论的干预与标准干预对低收入拉丁裔人群后续结直肠癌预防行为和筛查的影响。提出了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）干预与在社区环境中传播癌症风险、初级预防和筛查信息的标准教学学习（DL）干预的效果（900名参与者，每组研究80组约450人）。两个干预组都将收到由非专业健康教育者（LHEs）提供的癌症风险和预防信息，这些信息根据研究部门的风格进行，随后每两周进行一次，为期12周。将在干预后和6个月后评估结果以检查维持情况。H1：与接受DL干预的人群相比，接受ST干预的拉美裔人在原发性结直肠癌预防行为方面的增加更大。主要终点是(a)每周体力活动分钟数，(b)每日蔬菜摄入量，两者都是用高度可靠的、经过验证的仪器测量的。次要终点包括额外的结直肠癌风险相关行为（钙摄入、红肉消费、肥胖、酒精、烟草使用）和筛查（FOBT和内窥镜检查）。LHEs的特征和核心信息内容将在干预的两个方面保持一致；只有演讲的风格和语境会完全不同。具体目标2。为了测试特定的基于理论的模型，比较每种干预措施对身体活动和饮食结果的作用。与此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，我们考察了计划行为理论提出的干预对行为预测因素的影响差异。然后，提出的ST干预解释模型的要素，包括运输，认同，自我认同和相互支持因素，将测试对结果的中介效应。

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.