Christou et al. BMC Public Health 2010, 10:373 http://www.biomedcentral.com/1471-2458/10/373 Page 15 of 21 Table 5 Interventions for improving uptake of CRC screening in disadvantaged and minority groups Approach Study Type Screening type Population group targeted Observed changes in screening uptake or intent to screen for CRC Chinese Americans Uptake of FOBT after 6 months was 69.5% intervention group vs 27% control group Endoscopy Low SES Latino RCT RCT RCT 1. Organizational/system changes Patient navigators to overcome patient reported barriers from screening to treatment [123] Culturally sensitive patient navigators and physician recommendation [124] Patient navigator combined with reminder letter [125] Intervention 2. Targeting of healthcare users Culturally appropriate intervention using health educator and bilingual educational material [126] Personalized and tailored interventions RCT [128] [127,128] Four groups; 1-Tailored intervention 2-Standard intervention 3-Tailored intervention plus phone reminder 4-Control Storytelling to promote CRC screening [110,129] RCT Community based awareness and educational interventions [130] Community-based participatory [131] Using culturally relevant approach and education held on a ‘family day’. Followed by intensive follow-up and encouragement of participants by letters and phone calls Culturally appropriate education to enhance knowledge and screening [132] Assigned to one of three groups: 1. Cultural & self-empowerment group 2. Traditional group 3. Modified cultural group 4. Control Intensive one-on-one patient education [133] Participatory using intervention material developed through participatory approach Participatory Experimental/repeated measures FOBT African-American Elders RCT FOBT Ethnically diverse group Any CRC screening Endoscopy and FOBT Any CRC screening FOBT Any CRC screening Any CRC screening Any CRC screening Low income and non-English speaking Low income, Hispanic patients attending primary care practice English speaking, Immigrants from Brazil, Portugal & Haiti Mixture of African American (58%) and white Rural white Uptake of CRC screening post-intervention was 27% vs 12% (p‹ 0.001) before intervention. Completion of endoscopy 6 months post intervention was 15.8% in intervention group vs 5% in control (physician recommendation only) (p= 0.019) Completion of FOBT 3 months post intervention was 42.1% in intervention group vs 25% in control group (p = 0.086) 31% of intervention group vs 9% control patients completed screening after 6 months Screening assessed 2 years post intervention: Screening completion among those in the intervention groups ranged from 44-48% vs 33% control group (p‹0.05) [128] Intent to obtain CRC screening via endoscopy increased in those exposed to storytelling compared to those exposed to risk tool based information (p = 0.038) Intention to screen increased significantly in those exposed to educational materials and who had not been tested in the last 5 yrs compared to those that had (p = 0.025). Knowledge assessed at 6 and 12 months. FOBT screening assessed at 12 months and found greater participation in those in Cultural & Self Empowerment group. Proportion of patients returning FOBT was significantly higher in intensive education group compared with those receiving standard education (65.6% vs 51.3% p‹0.01) Rural Native Increase in compliance with CRC screening Hawaiian in Hawaii in both men and women. CRC screening 6 months post intervention increased in men from 39% to 75% (p = 0.002) and in women 36% to 76% (p = 0.002) Limitations- small sample size (28 men and 25 women)