Community-based colorectal cancer intervention in underserved Korean Americans |
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| Authors: | Grace X Ma Steve Shive Yin Tan Wanzhen Gao Joanne Rhee Micah Park Jaesool Kim Jamil I Toubbeh |
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| Institution: | 1. Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;2. Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;3. VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA;4. UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA;5. University of Utrecht, The Netherlands;6. University of California Los Angeles, Los Angeles, CA, USA;1. Clinical Research & Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America;2. Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America;3. Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA, United States of America;4. Division of Gastroenterology, University of California, San Francisco, San Francisco, CA, United States of America;5. University of California San Francisco Medical Library, University of California, San Francisco, San Francisco, CA, United States of America;6. Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America;7. Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States of America |
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| Abstract: | Background: Despite evidence of a decline in both incidence and prevalence of colorectal cancer nationwide, it remains the second most commonly diagnosed cancer and the third highest cause of mortality among Asian Americans, including Korean Americans. This community-based and theoretically guided study evaluated a culturally appropriate intervention program that included a bilingual cancer educational program among Korean Americans including information on CRC risks, counseling to address psychosocial and access barriers, and patient navigation assistance. Methods: A two-group quasi-experimental design with baseline and post-intervention assessment and a 12-month follow-up on screening was used in the study. Korean Americans (N = 167) were enrolled from six Korean churches. The intervention group received culturally appropriate intervention program addressing accessibility and psychosocial barriers, and navigation assistance for screening. The control group received general health education that included cancer-related health issues and screening. Results: There was a significant difference (p < 0.05) between the post-intervention and control groups in awareness of CRC risk factors. There was also a significant improvement in the pre–post across HBM measures in the intervention group for perceived susceptibility (p < 0.05) and benefits and barriers to screening (p < 0.001). At baseline, 13% of participants in the intervention group and 10% in control group reported having had a CRC cancer screening test in the previous year. At the 12-month post-intervention follow-up, 77.4% of participants in the intervention group had obtained screening compared to 10.8% in the control group. Conclusion: While health disparities result from numerous factors, a culturally appropriate and church-based intervention can be highly effective in increasing knowledge of and access to, and in reducing barriers to CRC screening among underserved Koreans. |
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