Community Dissemination of an Evidence-based Colorectal Cancer (CRC) Screening Intervention
Condition: Colon Cancer; Rectal Cancer
MeSH terms: Rectal Neoplasms; Colonic Neoplasms
Study type: Interventional

Summary: 
      Filipino Americans have lower rates of colorectal cancer (CRC) screening, later stage of
      diagnosis and poorer survival relative to other racial/ethnic groups. To address this
      disparity, the investigators developed a multi-component intervention to increase CRC
      screening and have determined its efficacy in a randomized trial (Maxwell,et. al., 2010).
      This study aims to determine how an intervention to increase CRC screening can best be
      integrated within the cultural norms and existing structures of churches and community based
      organizations (CBOs) with predominantly Filipino American membership to ensure broad
      dissemination to those in need of screening.

      The investigators will provide our partner CBOs with resources and technical assistance,
      including training of community volunteers as health advisors, to enable them to promote CRC
      screening to their constituents. Using a scientifically rigorous research design, the
      investigators will compare two dissemination strategies: Basic dissemination which consists
      of a single kick-off event during which community health advisors will receive print
      materials and FOBT kits for distribution and training on how to conduct educational
      small-group sessions; and Organizational dissemination aimed at integrating CRC screening
      dissemination into organizational practices and processes that can be sustained after the end
      of the study. The study will be implemented in 20 CBOs and will train 100 community health
      advisors (CHAs). The impact of the two dissemination strategies will be comprehensively
      assessed by collecting data at the CBO level, from the CHAs and from 1000 Filipino American
      participants. The investigators will compare the proportion of Filipino American participants
      who obtain CRC screening by dissemination strategy, but the investigators will also assess
      how many are reached, if the intervention is implemented as planned, how CBOs support the
      screening efforts at their regular activities, and if CBOs and CHAs maintain their efforts
      over the 4 years of the study.

      The investigators hypothesize that CBOs can implement evidence-based strategies to promote
      CRC screening and CHAs in the organizational dissemination arm will reach more participants
      and more screened participants than CHAs in the basic dissemination arm; and organizations in
      the organizational dissemination arm will adopt more CRC screening activities and maintain
      these better than organizations in the basic dissemination arm.
    


Intervention name(s): Educational program and FOBT kits; Educational program and FOBT kits, and technical assistance
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Subjects will participate in a CRC small group educational program and receive FOBT kits from community health advisors who have received a one-time training session.; In addition to subjects' receipt of a CRC small group educational program and FOBT kits, leadership training and technical support will be provided to the community health advisors and selected leaders and members of the organization.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Screening
Keywords: CRC screening; Prevention and early detection of CRC; Filipino; Dissemination