Storytelling for Colorectal Health among Latinos

描述（由申请人提供）：随着拉丁美洲人中与结直肠癌（CRC）相关的发病率下降缓慢和死亡率持续高企，开发和测试旨在改善这一人群预防行为的特定文化项目变得越来越重要。拉丁美洲人中普遍存在的两种已知的CRC风险行为是低水平的体力活动和低蔬菜消费。具体目标1。在低收入拉丁裔人群中，评价基于叙事理论的干预与标准干预对随后CRC预防行为和筛查的影响。一项两组随机对照试验旨在研究一种新的、文化上一致的拉丁裔讲故事（ST）干预与一种标准的教学式学习（DL）干预在社区环境中传达癌症风险、一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）。两个干预组将接受癌症风险和预防信息，由非专业健康教育者（LHE）提供，根据研究组和随后的12周双周会议进行风格化。将在干预后和6个月后评估结果，以检查维护情况。H1：拉丁美洲人将显示出更大的增加，在初级CRC预防行为的基础上，他们暴露于ST干预相对于那些谁是暴露于DL干预。主要终点是（a）每周体育活动的分钟数，以及（B）每日蔬菜的食用量，两者都是用高度可靠、经过验证的仪器测量的。次要终点包括额外的CRC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）。LHE的特征和核心信息内容将在两种干预手段中保持一致;只有交付的风格和背景将完全不同。具体目标2。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。将在两个主要模型中测试与此方法相关的理论结构的影响。首先，我们研究了干预措施对计划行为理论提出的行为预测因素的影响。然后，建议的解释模型的ST干预，包括交通，识别，自我认同和相互支持的因素，将被测试的中介效果的结果。

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.