CLEAN: A community-engaged intervention to increase colorectal cancer screening in Chinese American immigrants

项目摘要/摘要 结直肠癌(CRC)是美国华人癌症死亡的第二大原因。CRC 筛查通过切除癌前息肉来预防癌症并降低死亡率。然而，CRC 在美国，华裔对筛查的利用严重不足，50岁以上的华裔美国人中只有47% 报告说曾经完成过结直肠癌筛查，而非西班牙裔白人的这一比例为73%。考虑到这些 由于存在差异，增加中国移民对癌症预防工作的参与至关重要。研究 表明社区参与的干预措施，如叙事教育和患者导航是有前景的 在脆弱人群中增加结直肠癌筛查的战略。在这项研究中，我们建议开发和 社区参与干预的结直肠癌叙事教育和导航(CLEAN)试点测试 包括叙事教育和患者导航，以改进中国移民的结直肠癌筛查。至 发展清洁，我们将在文化和语言上适应证人关怀，这是一种理论驱动的、以证据为基础的 叙事性团体教育节目。我们还将增强该计划的患者导航功能，以进一步 在这一弱势群体中推广结直肠癌筛查。因此，我们的具体目标是：(1)通过 在文化和语言上适应和加强证人关怀，以支持中国人的结直肠癌筛查 移民；和(2)试点测试清洁支持的可行性、可接受性和初步效果 中国移民中的结直肠癌筛查。这项拟议研究的长期目标是改善预防 在中国移民和其他服务不足的群体中及早发现结直肠癌，最终目标是 缩小癌症差距。这项拟议的研究与王博士的职业目标直接相关 目标，并将用于建立一个研究方案，以实施有效的干预措施，旨在 减少少数族裔患癌症的差异。她的研究活动将辅之以经过深思熟虑的 培训计划，将帮助她在以下方面获得新的知识和技能：(1)社区参与研究，和(2) 并进行随机对照试验设计与分析。鉴于该机构的高质量研究环境 和资源，并在经验丰富的指导团队的指导下，Vang博士将获得支持和 成功实现拟议的研究和培训目标所需的资源。在整个过程中 5年资助期，她将参加与导师的持续会议，完成正式课程 以及在她的机构和其他地方提供的互动培训活动；提交至少5名第一作者 出版手稿；参加科学研究会议，以促进与 研究人员在癌症健康方面存在差异。这一多模式培训计划将为Vang博士提供 实现她的研究目标和成为独立人士的专业目标所需的综合技能 行为健康研究人员。

PROJECT SUMMARY/ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer death among Chinese in the US. CRC screening prevents cancer and reduces mortality through the removal of precancerous polyps. However, CRC screening is severely underutilized by Chinese in the US with only 47% of Chinese Americans over age 50 reporting having ever completed a CRC screening compared to 73% of non-Hispanic whites. Given these disparities, it is critical to increase Chinese immigrants' participation in cancer prevention efforts. Research indicate community engaged interventions, such as narrative education and patient navigation are promising strategies for increasing CRC screening in vulnerable populations. In this study, we propose to develop and pilot test CoLorectal Cancer Narrative Education and Navigation (CLEAN), a community-engaged intervention consisting of narrative education and patient navigation to improve CRC screening in Chinese immigrants. To develop CLEAN, we will culturally and linguistically adapt Witness CARES, a theory-driven, evidence-based narrative group education program. We will also enhance the program with patient navigation to further promote CRC screening in this vulnerable population. Thus, our specific aims are to: (1) Develop CLEAN by culturally and linguistically adapting and enhancing Witness CARES to support CRC screening among Chinese immigrants; and (2) Pilot test the feasibility, acceptability, and preliminary efficacy of CLEAN for supporting CRC screening in Chinese immigrants. The long-term goal of the proposed research is to improve prevention and early detection of CRC in Chinese immigrants and other underserved groups with the ultimate objective of reducing cancer disparities. The proposed research is directly relevant to Dr. Vang's career goals and objectives and will be used to build a program of research to implement effective interventions aimed at reducing cancer disparities in minorities. Her research activities will be complemented with a well-thought out training plan that will help her acquire new knowledge and skills in: (1) community engaged research, and (2) and randomized controlled trials design and analysis. Given the institution's high quality research environment and resources, and with the guidance of the experienced mentoring team, Dr. Vang will have the support and resources necessary to successfully pursue the proposed research and training aims. Over the course of the 5-year funding period, she will participate in ongoing meetings with her mentors, complete formal coursework and interactive training activities offered at her institution and elsewhere; submit a minimum of 5 first author manuscripts for publication; and attend scientific research conferences to foster national networks with researchers in cancer health disparities. This multimodal training plan will provide Dr. Vang with the comprehensive skills needed to achieve her research aims and professional goal of becoming an independent behavioral health researcher.