Lay Health Worker Outreach in Increasing Colorectal Cancer Screening in Asian Americans

PRIMARY OBJECTIVES:

I. Evaluate the efficacy of lay health worker (LHWs) outreach on colorectal cancer (CRC) screening among 3 Asian American groups (Filipinos, Hmong, and Koreans) in a cluster randomized controlled trial (RCT) comparing CRC education delivered by LHWs (intervention) to a CRC brochure and nutrition education (control).

II. Examine the processes through which LHWs communicate with, connect to, and convince community members from 3 Asian American cultures of the importance of CRC screening using mixed methods.

OUTLINE: Lay health workers (LHWs) are randomized to 1 of 2 groups.

GROUP I (CRC EDUCATION): LHWs undergo training over 3 days and recruit 15 participants from their social network. Participants attend a CRC educational session conducted by an LHW over 90 minutes at month 1 and 3. Participants receive phone calls from the LHW at months 2 and 4 reminding them about CRC screening.

GROUP II (CRC BROCHURE): LHWs undergo training over 3 days and recruit 15 participants from their social network. Participants attend a lecture on healthy nutrition for cardiovascular health presented by a professional health educator at months 1 and 3. After the first meeting, participants receive a brochure on CRC screening. Participants receive phone calls from the LHW at months 2 and 4 regarding changes in their nutritional behavior. Participants may attend an optional post-intervention LHW outreach session on CRC screening.

After completion of the study, patients are followed up at 2 months.

• Educational Intervention (Other), also known as Education for Intervention, Intervention by Education, Intervention through Education, Intervention, Educational: Attend CRC education session
• Educational Intervention (Other), also known as Education for Intervention, Intervention by Education, Intervention through Education, Intervention, Educational: Attend healthy nutrition session
• Informational Intervention (Other): Receive CRC screening brochure
• Survey Administration (Other): Ancillary studies
• Telephone-Based Intervention (Behavioral): Receive telephone reminder about CRC screening
• Telephone-Based Intervention (Behavioral): Receive telephone reminder about healthy nutrition

Primary outcomes

• Proportion of participants who report ever having had a CRC screening test [Baseline to 6 months]: Bivariable and multivariable analyses of the binary outcomes (CRC screening ever, up-to-date, and intention) will be conducted using generalized linear models to evaluate the efficacy of the intervention. A linear model with identity link function will be used with group (intervention or control), time (pre- or post-), and group-by-time interaction to test for a difference in the change from pre- to post-intervention between the 2 groups, thus measuring the efficacy of the intervention.

Secondary outcomes

• Proportion of participants who are up-to-date for CRC screening [At 6 months]: Bivariable and multivariable analyses of the binary outcomes (CRC screening ever, up-to-date, and intention) will be conducted using generalized linear models to evaluate the efficacy of the intervention.
• Proportion of participants who intend to obtain CRC screening in the next 6 months [At 6 months]: Bivariable and multivariable analyses of the binary outcomes (CRC screening ever, up-to-date, and intention) will be conducted using generalized linear models to evaluate the efficacy of the intervention.

Sex: All, ages: 50 Years to 75 Years, accepts healthy volunteers

Inclusion Criteria:

* LHW: self-identified as Filipino, Hmong, or Korean Americans
* LHW: age 18 or older
* LHW: are fluent in a Filipino language (Tagalog or Ilocano), Hmong, Korean, or English
* LHW: Live in the relevant area and intend to stay there for the next 12 months
* PARTICIPANTS: Self-identified as Filipino, Hmong, or Korean Americans
* PARTICIPANTS: speak a language that the LHW can speak such as Tagalog, Ilocano, Hmong, Korean, or English
* PARTICIPANTS: live in relevant area and intend to stay there for at least 12 months
* PARTICIPANTS: Are willing to participate in a study about health behaviors involving nutrition or CRC screening

Exclusion Criteria:

* Personal history of CRC
* Medical problems which may prevent them from attending 2 educational sessions

• Tung Nguyen, Principal investigator, University of California, San Francisco

NIH grants: U54CA153499