Abstract A40: Promoting colorectal cancer education: A partnership facilitated program evaluation examining generalizability across diverse populations
Authors: Sanchez Janeth I. , Briant Katherine , Molina Yamile , Espinoza Noah , Marchello Nathan , Palacios Rebecca , Thompson Beti , O'Connell Mary 
Published: October 2015

Background: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men and women with over 96,000 new cases and 50,000 individuals expected to die from the disease in 2014. Cancer mortality rates, however, are higher among certain ethnic populations including Hispanics and American Indians/Alaska Natives (AI/AN). Through education and screening, CRC can be successfully detected early and treated before it progresses to advanced stages. The purpose of this study was to evaluate the effectiveness of a partnership-facilitated colorectal cancer education program across different ethnic populations in two U.S. regions. Pre/post design was used to measure changes in CRC knowledge as well as behavioral intentions to obtain screening and share CRC information obtained with others.

Methods: The National Cancer Institute's National Outreach Network (NON) Community Health Educators (CHE) at New Mexico State University (NMSU) and at the Fred Hutchinson Cancer Research Center (FHCRC), a Comprehensive Partnership to Advance Health Equity (CPACHE) program, collaborated to develop an assessment tool that would evaluate the Inflatable Colon (IC) as a CRC educational tool across diverse ethnic populations. Instrument: NON CHE developed a pre/post-test assessment questionnaire based on literature reviews; questions asked about CRC knowledge, intention to obtain screening, and intention to disseminate CRC information. Procedure: In New Mexico, individuals at an educational institution were recruited to participate in this study, whereas participants in Eastern Washington were recruited at community health events. All study participants received the pre-test prior to touring the IC and the post-test after completing the IC tour.

Results: A total of 1,286 individuals from Southern New Mexico and Eastern Washington participated in this study, 60% were males. We conducted a repeated measures analysis of covariance, including study site, age, education, insurance, regular doctor, and history of CRC as covariates. Analyses found a significant interaction by race/ethnicity and time, F (2, 1181) = 3.29, p = .04. After adjusting for covariates, there were significant differences in CRC knowledge across race/ethnicity, F (2, 1188) = 2.94, p = .05. Hispanic participants had a significantly greater change in knowledge relative to non-Hispanic whites (NHW). There was also a non-significant trend concerning AI/AN participants and NHW. Hispanic and AI/AN participants had greater change in intentions to obtain a CRC screening in the future relative to NHW. Subsequent post-hoc comparisons revealed that, relative to NHWs, Hispanics reported being more likely to intend to discuss CRC with their parents, p = .02, and grandparents, p = 0.003. AI/AN participants were also less likely to report to intend to discuss CRC with their parents, p = .04.

Conclusion: This study examined the generalizability of a partnership-facilitated CRC educational program and assessment tool across different US populations and its effectiveness in increasing CRC knowledge as well as behavioral intention to obtain CRC screening and disseminate CRC information. This study suggests that the IC is an effective educational tool for increasing cancer knowledge and behavioral intentions among diverse ethnic populations. Complementing the IC intervention with access to free CRC screening, such as the FOBT kits, has the potential to address the CRC mortality disparities through the promotion of screening among certain ethnic populations and among those at a higher risk for CRC.

Citation Format: Janeth I. Sanchez, Katherine Briant, Yamile Molina, Noah Espinoza, Nathan Marchello, Rebecca Palacios, Beti Thompson, Mary O'Connell. Promoting colorectal cancer education: A partnership facilitated program evaluation examining generalizability across diverse populations. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A40.