Abstract B046: Incorporating Latino patient input in patient-facing materials for a mailed fecal test outreach program
Authors: Thompson Jamie , Davis Melinda , Michaels LeAnn , Rivelli Jennifer , Castro Marta , Younger Brittany , Castillo Melissa , Reich Sacha , Coronado Gloria 
Published: September 2020

Abstract
Colorectal cancer screening rates are disproportionately low among Latinos. In 2015, only 63% of eligible adults, and 50% of Latinos, were up-to-date with colon cancer screening recommendations. One factor thought to contribute to the low screening rate is that patient-facing health information for Latinos is difficult to understand and patients face challenges in taking health action. As part of the Participatory Research to Advance Colon Cancer Prevention (PROMPT) study, we used boot camp translation (BCT), a community based participatory strategy, to elicit input from stakeholders and refine materials for a clinic-based mailed fecal immunochemical test (FIT) outreach program. Eligible patient participants were Latino, ages 50 to 75 years, able to speak English or Spanish, and willing to participate in an in-person meeting and follow-up phone calls. Separate sessions were held for English- and Spanish-speaking participants. The in-person session included presentations by a national expert on colon cancer prevention and screening messages, and interactive small group sessions to discuss optimal timing and modality for delivering reminders to a mailed FIT program. The phone calls consisted of iterative conversations to refine bilingual materials to encourage screening. BCT participants desired messages that increased awareness about colon cancer and prevention, stressed the importance of screening, emphasized the motivating influence of family, and used personalized statements such an “I” or “we” in letters or automated phone calls. These preferences were incorporated into outreach materials. (Samples will be provided.) 1-Patient Introductory Letter Included in the FIT Kit Mailing. Revisions recommended by BCT participants included 1) details about colon cancer and the need for prevention, 2) emphasis on a free test, 3) inclusion of a photograph of a multigenerational Latino family, 4) the addition of a colon diagram for visual appeal and education, and 5) messages about how screenings can save lives. The group also wanted emphasis on the test being “simple” and “something you can do at home.” 2-Educational Fact Sheet. We also developed a bilingual fact sheet using participant-preferred messages and simple infographics from the BCT expert presentation. The fact sheet presented statistics about colon cancer diagnoses and deaths, and answered the following questions: “What is colon cancer? When should I get tested? How do I get tested?” 3-FIT Kit Wordless Instructions. We found that patients generally preferred simple, wordless instructions, reporting they were less intimidating and helpful as they showed the small amount of fecal matter needed for the test. We developed FIT wordless instructions based on these findings and included the document with the mailing. Using BCT, we successfully incorporated feedback from English- and Spanish-speaking Latino patients to design and enhance culturally relevant materials to promote FIT testing among patients served by community clinics.
Citation Format: Jamie Thompson, Melinda Davis, LeAnn Michaels, Jennifer Rivelli, Marta Castro, Brittany Younger, Melissa Castillo, Sacha Reich, Gloria Coronado. Incorporating Latino patient input in patient-facing materials for a mailed fecal test outreach program [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B046.