Abstract A017: Evaluation of ¡Salud! por la Vida, an educational intervention to increase colorectal cancer screening in federally qualified health centers in Puerto Rico
Authors: Jiménez-González Jomarie , Betancourt-Vélez Fernando E. , Valencia-Torres Ileska M. , Sánchez-Cabrera Yara , Pericchi-Guerra Luis R. , Fernández María E. , Colón-López Vivian 
Published: December 2023

Introduction: Colorectal cancer (CRC) is the leading cause of cancer-related deaths in Puerto Rico (PR) and third among Hispanics in the United States (US). Screening rates in PR are relatively low compared to the mainland US.      Objective: To evaluate the effectiveness of “¡Salud! por la Vida”, an evidence-based educational intervention designed to increase CRCS.   Methods: The educational intervention “¡Salud! por la Vida” (SPLV) was implemented in 10 Federally Qualified Health Clinics (FQHC) in PR to increase CRC screening (CRCS) rates in non-adherent patients aged 50 to 75. SPLV was conducted as a group randomized controlled trial from July 2017 to July 2020. The intervention included a baseline survey collecting 198 variables and a follow-up survey 4 to 6 months later, which included 148 variables to measure the effectiveness of the educational program in increasing CRCS. The initial surveys had some changes to improve the data entry process. Consequently, the database required an updated data analysis consisting of data exploration, data cleaning, and statistical analysis. Prior to calculating results, data cleaning included identifying missing variables, inconsistencies in the data, and missing data. The final dataset for this project concerns participants who completed the follow-up survey, divided into intervention and control groups. The analysis calculated basic demographics in proportions, such as age, education, sex, marital status, annual income, health insurance coverage, and first-degree family history of CRC. Furthermore, the two groups were compared regarding CRCS rates, specifically those of colonoscopy, fecal occult blood test (FOBT), and having completed any CRCS.    Results: A total of 445 individuals participated in the study. At baseline, 332 were from the control group and the rest from the intervention group. The follow-up survey was completed by 295 participants in the control group and 78 participants in the intervention group, for a total of 373 at follow-up. The mean age of participants who completed the study was 58.9, with 68.9% of participants being women. 70.5% had an education of high school or less, 45.3% were married or living together, 93% earned less than $20,000 a year, 87.9% had government health insurance, and 88.2% had no first-degree family history of CRC. CRCS tests were completed by 60.2% of those in the intervention group and 38.3% of control group participants (p-value 0.001).  FOBTs were done by 55.1% and 36.9% of the intervention and control group participants, respectively (p-value 0.005). In the intervention group, 10% of the participants completed a colonoscopy, while in the control group, 3% had completed a colonoscopy (p-value 0.02).    Conclusion: CRCS rates were higher in the intervention groups, for both colonoscopy (p-value 0.008) and FOBT (p-value 0.003), as well as any CRCS test (p-value 0.0004). The SPLV intervention significantly increased CRC screening rates and provided evidence to disseminate this educational effort to FQHCs in PR.

Citation Format: Jomarie Jiménez-González, Fernando E. Betancourt-Vélez, Ileska M. Valencia-Torres, Yara Sánchez-Cabrera, Luis R. Pericchi-Guerra, María E. Fernández, Vivian Colón-López. Evaluation of ¡Salud! por la Vida, an educational intervention to increase colorectal cancer screening in federally qualified health centers in Puerto Rico [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A017.