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Evaluating Two Evidence-Based Intervention Strategies to Promote CRC Screening Among Latino Adults in a Primary Care Setting

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Regular use of colorectal cancer screening can reduce incidence and mortality, but participation rates remain low among low-income, Spanish-speaking Latino adults. We conducted two distinct pilot studies testing the implementation of evidence-based interventions to promote fecal immunochemical test (FIT) screening among Latinos aged 50–75 years who were not up-to-date with CRC screening (n = 200) at a large Federally Qualified Health Center (FQHC) in San Diego, CA. One pilot focused on an opportunistic clinic visit “in-reach” intervention including a 30-min session with a patient navigator, review of an educational “flip-chart,” and a take-home FIT kit with instructions. The second pilot was a system-level “outreach” intervention consisting of mailed materials (i.e., FIT kit, culturally and linguistically tailored instructions, and a pre-paid return envelope). Both received follow-up calls to promote screening completion and referrals for additional screening and treatment if needed. The primary outcome was FIT kit completion and return within 3 months assessed through electronic medical records. The in-reach pilot consisted of mostly insured (85%), women (82%), and Spanish-speaking (88%) patients. The outreach pilot consisted of mostly of Spanish-speaking (73%) women (64%), half of which were insured (50%). At a 3-month follow-up, screening completion was 76% for in-reach and 19% for outreach. These data demonstrate that evidence-based strategies to promote CRC screening can be implemented successfully within FQHCs, but implementation (particularly of mailed outreach) may require setting and population-specific optimization. Patient, provider, and healthcare system related implementation approaches and lessons learned from this study may be implemented in other primary care settings.

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Acknowledgements

This research was made possible by the SDSU/UCSD Cancer Center Comprehensive Partnership NCI U54 CA13238406A1 (Arredondo, PI) and U54 CA13237906A1 (Martinez, PI); NCI R21 CA112368 (Talavera, PI); Redes en Acción NCI U54 CA153511 (Ramirez, PI/Talavera, PI); California Colorectal Cancer Coalition (C4); “Primary Care Systems” Walgreen’s for Change/American Cancer Society (ACS) award. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH, C4, or the ACS. Special thanks go to patients at San Ysidro Health Center, Inc. who made this research possible.

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Authors and Affiliations

  1. South Bay Latino Research Center, Graduate School of Public Health, San Diego State University, 450 4th Ave, Suite 400, Chula Vista, CA, 91910, USA

    Sheila F. Castañeda, Rebeca Aurora Espinoza-Giacinto & Gregory A. Talavera

  2. Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA

    Balambal Bharti & Samir Gupta

  3. San Ysidro Health Center, Inc., San Diego, CA, USA

    Valerie Sanchez, Shawne O’Connell, Fatima Muñoz, Sylvia Mercado, Marie Elena Meza & Wendy Rojas

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  1. Sheila F. Castañeda
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  2. Balambal Bharti
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  3. Rebeca Aurora Espinoza-Giacinto
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  6. Fatima Muñoz
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  10. Gregory A. Talavera
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  11. Samir Gupta
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Corresponding author

Correspondence to Sheila F. Castañeda.

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The authors declare that they have no conflicts of interest.

Ethical Standards Statement

This research study involved human subjects and was approved by the San Diego State University and San Ysidro Health Center, Inc. institutional review boards. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.

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Castañeda, S.F., Bharti, B., Espinoza-Giacinto, R.A. et al. Evaluating Two Evidence-Based Intervention Strategies to Promote CRC Screening Among Latino Adults in a Primary Care Setting. J. Racial and Ethnic Health Disparities 5, 530–535 (2018). https://doi.org/10.1007/s40615-017-0395-4

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  • DOI: https://doi.org/10.1007/s40615-017-0395-4

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