Abstract B1: Dissemination of colorectal cancer screening by Filipino American community health advisors: A feasibility study
Authors: Maxwell Annette E. , Danao Leda L. , Bastani Roshan 
Published: June 2012

Background: Filipino Americans have lower rates of colorectal cancer screening than Non-Hispanic Whites and Filipino American males have poorer 5-year survival after colorectal cancer than other racial/ethnic groups. We have recently shown in a randomized trial that a small-group educational session at community organizations with distribution of print materials and with or without distribution of FOBT kits significantly increased colorectal cancer screening among Filipino Americans. While planning a large dissemination trial, we conducted a pilot study to assess 1) the feasibility to implement a similar intervention using Filipino American community health advisors; and 2) the potential impact that community health advisors can have on colorectal cancer screening among their peers.

Methods: We invited 6 Filipino American organizations in the Greater Los Angeles area to each identify 5 members who were willing to serve as community health advisors and to promote colorectal cancer screening among 30 members per organization who were not up to date with screening. Based on their geographic location, we assigned organizations to one of two arms. We flipped a coin to assign one arm to small-group education and the other arm to one-on-one education. Community health advisors received training to conduct the educational session following a script, and distributed print information and free FOBT kits that were mailed to a community clinic and processed free of cost for participants. A member of the academic staff who was not involved in intervention implementation conducted a brief telephone interview with each participant 4 months after the intervention.

Results: 20 community health advisors from 4 organizations engaged in recruitment and education activities, of which 12 had a graduate degree, many in health related fields, and 4 had a bachelor degree in nursing. They enrolled 123 eligible participants. The majority of the group sessions were only attended by 2–4 persons and sometimes only by 1 person. Community health advisors consistently completed 3 of the 6 forms that were required for each participant (Initial screening questionnaire, FOBT distribution log, and consent to process FOBT). Recruitment and enrollment logs usually listed only participants who were enrolled in the study, but not participants who were not eligible and/or did not consent to participate. Process checklists that indicated the information that was covered in each educational session and post session follow-up logs were also incomplete. All 123 participants completed the follow-up survey, of which 120 reported receipt of colorectal cancer screening. Billing records of the community clinic confirmed 116 self-reported FOBTs.

Conclusions: This pilot study suggests that it is feasible for Filipino American community based organizations to promote colorectal cancer screening among their members when given technical and financial assistance. We learned that the Filipino American community has exceptional resources with respect to community volunteers who often have prior training in the health field; that it may be necessary to allow flexibility regarding the size of the educational groups; that completion of process measures may be problematic and that we need better methods to verify fidelity of intervention implementation. The finding that almost all participants received an FOBT may be due to the fact that neither a co-payment nor a physician visit was required for completion and due to the relatively small workload per advisor, which may have allowed them to be selective in their recruitment.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B1.