Developing a Young Adult-Mediated Intervention to Increase Colorectal Cancer Screening among Rural Screening Age-Eligible Adults

项目总结 结直肠癌(CRC)仍然是美国癌症相关死亡的第二大原因。近期 研究突出了几个地理上的，主要是农村的，结直肠癌发病率和死亡率过高的“热点”。 农村人口和非农村人口之间差异的一个驱动因素是农村地区较低的CRC筛查率。 因此，需要新的方法来改进这些地区的筛查和早期检测。长期的 这项研究的目标是开发一种利用“向上沟通”来改善CRC的干预措施 在农村人口中筛查吸毒率。拟议的R03具体目标将有助于通过以下方式实现这一目标 获得开发年轻人中介干预所需的初步信息， 教育家庭成员鼓励年长的家庭成员进行结直肠癌筛查。这样的一种 干预不仅可以提高适龄成年人的筛查水平，还可以改善癌症 对生活在农村的年轻人本身进行知识、意识和准备情况的筛查。这个 轨道模型将指导深思熟虑地开发和优化干预方法的过程。目标 1和2将使用混合方法收集形成数据，以确定关键干预成分。要完成 目标1，调查数据来自150名年轻人(25-44岁)和150名老年(45-75岁)农村成年人 社区将被收集起来。在目标2中，我们将开发和评估干预组件，以促进 使用n=9个重点小组，就预防和筛查CRC进行有效的向上沟通。我们将迭代 以及基于焦点小组反馈修改干预组件。目标1和目标2的结果将指导 细化干预内容和设计。新干预措施的影响将通过单一的- AIM中的ARM，前测后测试验设计(n=15个成年子女/父母二元组)3.利用和利用家庭 成员可能是农村地区适合文化的癌症传播的一个特别突出的渠道 这可能有助于解决儿童权利中心热点居民未得到满足的需求。总的来说，建议的 研究将产生一种向上沟通干预，有可能改善CRC的健康 农村环境中的识字和筛查能力。

PROJECT SUMMARY Colorectal cancer (CRC) remains the second leading cause of cancer-related death in the United States. Recent studies have highlighted several geographic, primarily rural, “hotspots” for excess CRC incidence and mortality. One driver of these disparities between rural and non-rural populations is low CRC screening rates in rural areas. Thus, novel methods for improving screening and early detection in these areas are needed. The long-term objective of this research is to develop an intervention leveraging “upward communications” to improve CRC screening uptake in rural populations. The proposed R03 specific aims will help achieve this objective by garnering the preliminary information needed to develop a young adult-mediated intervention whereby a younger family member is taught to encourage their older family member to engage in CRC screening. Such an intervention could not only improve screening uptake among age-eligible adults, but could also improve cancer screening knowledge, awareness, and readiness among young adults themselves living in rural settings. The ORBIT model will guide the process of deliberatively developing and optimizing the intervention approach. Aims 1 and 2 will use mixed methods to collect formative data to identify critical intervention components. To complete Aim 1, survey data from n=150 younger (25-44 years old) and n=150 older (45-75 years old) adults living in rural communities will be collected. In Aim 2, we will develop and evaluate intervention components to facilitate effective upward communications about CRC prevention and screening using n=9 focus groups. We will iterate and modify intervention components based on focus group feedback. The results from Aims 1 and 2 will guide the refinement of intervention content and design. The impact of the novel intervention will be assessed via a single- arm, pre-test post-test trial design (n=15 adult child/parent dyads) in Aim 3. Tapping into and leveraging family members may be a particularly salient channel for culturally appropriate cancer communications in rural populations and may help address the unmet needs of CRC hotspot residents. Collectively, the proposed research will produce an upward communications intervention that has the potential to improve CRC health literacy and screening uptake in rural settings.