Abstract
Purposes: Vietnamese Americans have lower colorectal cancer (CRC) screening rates than non-Hispanic whites. The purposes of this study were to increase CRC screening in Vietnamese Americans and thereby to reduce CRC screening disparities in Vietnamese Americans.
Procedures: Using a Community-Based Participatory Research (CBPR) approach and a cluster randomized controlled design, Lay Health Workers (LHWs) recruited participants aged 50-74 years for an intervention (I) (n=316) or control arm (C) (n=311). At pre-intervention all participants self-reported not having been screened for CRC as an eligibility criterion. LHWs delivered 2 educational sessions about CRC screening to the intervention arm participants; the control arm attended sessions about healthy eating and physical activities. Effectiveness was measured using pre-intervention (Pre) and post-intervention (Post) surveys. Outcomes were: 1) self-reported behavior: having ever had CRC screening; 2) recognition: having ever heard of colon cancer; 3) perceived susceptibility: worrying about getting colon cancer and having ever thought might get colon cancer; 4) beliefs: believing colon cancer can be cured if founded early; and 5) knowledge: having heard of colon polyps and knowing the recommended age to begin CRC screening. Generalized estimating equations (GEE) models were used to test the effectiveness of the intervention while accounting for correlated data.
Results: The intervention group was significantly more likely than the control group to report having had CRC screening at post-test (56% v 19%, p<.0001). In addition, the intervention group had significantly greater increases in the proportion who had heard of colon cancer, believed that colon cancer can be cured if found early, heard of colon polyps, and knew the age to begin CRC screening. The two groups had similar increases in the proportion of participants who ever thought they might get colon cancer, and controls had a greater increase in the proportion who worried about getting colon cancer.
Conclusions: LHW outreach was effective in increasing CRC screening among Vietnamese Americans. The intervention also increased recognition, beliefs in the efficacy of screening, and knowledge of CRC and CRC screening. Self-reported behavior should be validated using objective measures.
Citation Format: Bang H. Nguyen, Susan L. Stewart, Tung T. Nguyen, Stephen J. McPhee, Mai T. Tran, Alene L. Pham, Ngoc Bui-Tong. Effectiveness of lay health worker outreach in reducing colorectal cancer screening disparities in Vietnamese Americans. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B03.