Multilevel and multicomponent intervention to promote colorectal cancer screening among underserved Vietnamese Americans: A cluster randomized trial

Research Square Pub Date : 2024-02-08 DOI:10.21203/rs.3.rs-3934937/v1

Grace X. Ma, Lin Zhu, Yin Tan, Phuong Do, Guercie Guerrier, Min Qi Wang, Minhhuyen Nguyen, Tam Tran, Philip Pham

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Abstract

Abstract Purpose The fecal immunochemical test (FIT) is a non-invasive method for colorectal cancer (CRC) screening, particularly effective in underserved Vietnamese American communities with low screening rates. This study reports on a culturally tailored multilevel intervention, incorporating FIT, aimed at increasing CRC screening among these populations aged 50 or above in the Greater Philadelphia metropolitan area. Methods From 2017 to 2020, we conducted a two-arm cluster randomized controlled trial to test the efficacy of a culturally tailored, multicomponent multilevel intervention aimed at increasing CRC screening uptake via enhanced self-awareness and self-efficacy, improved access to care, and changes in social norms and removal of stigma. The intervention group received multicomponent, multilevel CRC intervention including provision of a FIT self-sampling kit, with intervention approaches informed by the Centers for Disease Control's Clinical Preventive Services (CPS) Guidelines for adults 50+. The control group received only the CPS education. Results The study sample consisted of 746 eligible Vietnamese American participants recruited from 20 community-based organizations, with 95% having limited English proficiency. At 12-month follow-up, the intervention group showed substantially higher rates of FIT completion (89.56% vs. 7.59%, p < .001) and any CRC testing (91.48% vs. 42.41%, p < .001) compared to the control group. Conclusion The results suggest that the community-based, culturally-tailored multilevel intervention, which incorporates with FIT self-testing, effectively enhances CRC screening among low-income Vietnamese Americans. Additionally, these results underscore the significance of community-oriented strategies, like collaborating with relevant community-based organizations, in achieving CRC screening targets.

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多层次、多成分干预措施，促进服务不足的越南裔美国人接受大肠癌筛查：分组随机试验

摘要目的粪便免疫化学检验（FIT）是一种无创的结肠直肠癌（CRC）筛查方法，对筛查率低、服务不足的越南裔美国人社区尤为有效。本研究报告了一项结合 FIT 的文化定制多层次干预措施，旨在提高大费城都市区 50 岁或以上人群的 CRC 筛查率。方法从 2017 年到 2020 年，我们开展了一项双臂群组随机对照试验，以检验文化定制的多成分多层次干预措施的效果，该干预措施旨在通过增强自我意识和自我效能、改善就医途径、改变社会规范和消除耻辱感来提高 CRC 筛查的接受率。干预组接受多成分、多层次的 CRC 干预，包括提供 FIT 自我采样包，干预方法参考了美国疾病控制中心的《50 岁以上成人临床预防服务（CPS）指南》。对照组只接受 CPS 教育。结果研究样本包括从 20 个社区组织招募的 746 名符合条件的美籍越南人，其中 95% 的人英语水平有限。在 12 个月的随访中，干预组的 FIT 完成率（89.56% vs. 7.59%，p < .001）和任何 CRC 检测率（91.48% vs. 42.41%，p < .001）均大大高于对照组。结论结果表明，以社区为基础、根据文化定制的多层次干预措施，结合 FIT 自我检测，有效地提高了低收入越裔美国人的 CRC 筛查率。此外，这些结果还强调了以社区为导向的策略（如与相关社区组织合作）对实现 CRC 筛查目标的重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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