Abstract B085: Promoting colorectal cancer screening among underserved Vietnamese Americans through a multilevel community-based randomized controlled trial
Authors: Ma Grace X , Zhu Lin , Tan Yin , Do Phuong , Guerrier Guercie , Wang Min Qi , Nguyen Minhhuyen T , Tran Tam , Pham Philip 
Published: September 2024

Abstract
Introduction: Early detection through routine screening is also necessary to improve the mortality rate of colorectal cancer (CRC). However, testing is up to date in only 63% of eligible adults, and rates are lower among minority race/ethnicity groups and the underinsured. Fecal immunochemical test (FIT) is non-invasive, home-based screening kit that has been an important and cost-effective option in resource-limited settings. Vietnamese Americans were disproportionally affected by CRC, yet screening rates in this population were suboptimal. Reducing this disparity requires efforts to address upstream factors such as systemic discrimination, sociocultural norms, interpersonal factors, in addition to individual-level barriers to CRC care. Methods: From 2017 to 2020, we conducted a large-scale community-based randomized controlled trial of a culturally appropriate multilevel intervention to increase colorectal cancer (CRC) screening among 801 underserved Vietnamese Americans aged 50 or older from 20 community-based organizations (CBOs) in the greater Philadelphia metropolitan area. Specifically, the intervention is conducted at three levels: (1) individual-level: education through group workshops and other medium, automated text messaging reminders, as well as patient navigation; (2) interpersonal-level: engagement of participants’ families and friends; (3) CBO-level: CBO leaders engagement and promotion of CRC screening, displaying CRC screening promotion poster at CBO facility, and organizational role improvement. Results: The study sample consist of 801 eligible Vietnamese American participants, among whom, 746 completed the 12-month follow-up survey. Most (95%) of the participants had limited English proficiency. Analyses of baseline data revealed links between CRC screening uptake and several contextual and environmental factors, including neighborhood Asian ethnic density, social deprivation, and built environment, indicating systemic and community-level barriers to CRC care. Our multilevel intervention was effective in promoting the uptake of CRC screening in the target population. At 12-month follow-up, participants from the intervention group had significantly higher rates of having had a FIT test than those in the control group (89.56% v 7.59%, p &lt; .001) or any CRC test (91.48% vs 42.41%, p &lt; .001). Furthermore, the intervention was effective in increasing CRC-screening related self-efficacy, de-stigmatizing CRC and CRC screening and improving social norm among participants in the intervention arm. Conclusion: In conclusion, by improving social norms and elevation CBO/community engagement in relation to CRC care, our project significantly improved CRC screening uptake among Vietnamese Americans. Implementing community-based strategies like partnering with relevant community- based organizations are important for meeting CRC screening targets.
Citation Format: Grace X Ma, Lin Zhu, Yin Tan, Phuong Do, Guercie Guerrier, Min Qi Wang, Minhhuyen T Nguyen, Tam Tran, Philip Pham. Promoting colorectal cancer screening among underserved Vietnamese Americans through a multilevel community-based randomized controlled trial [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B085.