USING PHOTOVOICE TO ENGAGE COMMUNITY MEMBERS IN PROMOTING COLORECTAL CANCER AWARE

描述（由申请人提供）：结直肠癌（CRC）是美国癌症死亡的第二大原因，但可以通过筛查进行预防或早期检测。许多种族/少数民族群体和低收入或无保险的人的筛查率较低，诊断阶段较晚，生存率较差。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，开始解决我们社区的差距。这个以社区为基础的前瞻性研究项目是在与伙伴关系的讨论中产生的。社区成员参与了这些想法的概念化，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，以帮助了解社区的需求和CRC的认识，并利用这些发现来开发CRC的认识干预信息。Photovoice项目的参与者将接受培训，使用相机拍摄他们对CRC或CRC筛查在他们生活中的意义的理解。参与者开发一个描述他们选择的照片和小组讨论的个人叙述将随之而来，参与者可以讨论图像的意义和背景。我们将把Photovoice小组分为已经筛查过的人和被诊断患有CRC的人，以便我们可以收集有关预防和早期发现的信息。筛选器和幸存者照片之声小组将在圣刘易斯的两个不同的医疗服务不足的社区（北城和南城）举行。使用这个标题，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，这些信息将通过与已经和没有被筛选的人的焦点小组进行形成性测试。焦点小组将在与照片之声会议相同的社区地点举行。本研究的具体目的是：（1）让社区成员参与参与研究，以使用Photovoice方法识别有关结肠直肠癌预防和早期发现的相关信息和图像;（2）使用Photovoice项目的图像和叙述作为干预信息的基础，这些信息将使用焦点小组进行预先测试。我们预期的长期成果将是建立更强大的社区合作伙伴关系、赋予社区成员倡导自身健康的权力，以及一系列由社区驱动、经过科学评估的CRC干预信息。在解决结直肠癌的差异，这项研究涉及到一个重大的公共卫生问题，并将奠定基础，未来CBPR工作在圣刘易斯社区。 公共卫生相关性：参与者将获得相机，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，然后与其他人会面，讨论他们认为照片所描绘的意义和信息。将由焦点小组对带有叙述性信息的照片进行评价，以确定信息的可爱性、解释性、可信度和显著性，从而为将来的干预试验准备信息。

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.