Adaptation of a Mailed-FIT Kit and Patient Navigation Intervention to Increase Colorectal Cancer (CRC) Screening Among Spanish-Speaking Hispanic/Latino Patients
Restricted accessResearch articleFirst published online June, 2022
Adaptation of a Mailed-FIT Kit and Patient Navigation Intervention to Increase Colorectal Cancer (CRC) Screening Among Spanish-Speaking Hispanic/Latino Patients
Hispanic/Latino populations experience significant barriers to colorectal cancer (CRC) screening. ProCRCScreen is a multicomponent CRC screening program that can help primary care clinics improve CRC screening rates, but it needs adaptation to better meet the health care needs of Spanish-speaking Hispanic/Latino populations.
Methods:
We conducted four focus groups with 22 Spanish-speaking Latino patients and used inductive qualitative content analysis to identify potential program adaptations.
Results:
We identified lack of social support for CRC screening and confusion about completing stool-based testing as important barriers to CRC screening. Participants recommended increased specificity of the fecal immunochemical test (FIT) instructions to increase the likelihood of successful test completion, especially for first-time screening. They also endorsed patient navigation for support in completing CRC screening.
Discussion:
We adapted the informational materials and workflows for the ProCRCScreen program. Future research to test the adapted program is needed.
BerryD. L.HalpennyB.BoscoJ. L.BruyereJ.SandaM. G. (2015). Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men. BMC Medical Informatics and Decision Making, 15(1), 1–12.
2.
BrennerA. T.GetrichC. M.PignoneM.RhyneR. L.HoffmanR. M.McWilliamsA.de HernandezB. U.WeaverM. A.TappH.HarbiK.ReulandD. (2014). Comparing the effect of a decision aid plus patient navigation with usual care on colorectal cancer screening completion in vulnerable populations: study protocol for a randomized controlled trial. Trials, 15(1), 1–8.
3.
Burnett-HartmanA. N.MehtaS. J.ZhengY.GhaiN. R.McLerranD. F.ChubakJ.QuinnV. P.SkinnerC. S.CorleyD. A.InadomiJ. M.DoubeniC. A., & PROSPR Consortium. (2016). Racial/ethnic disparities in colorectal cancer screening across healthcare systems. American Journal of Preventive Medicine, 51(4), e107–e115.
4.
CameronK. A.FrancisL.WolfM. S.BakerD. W.MakoulG. (2007). Investigating Hispanic/Latino perceptions about colorectal cancer screening: A community-based approach to effective message design. Patient Education and Counseling, 68(2), 145–152.
5.
CampbellM. K.QuintilianiL. M. (2006). Tailored interventions in public health: Where does tailoring fit in interventions to reduce health disparities?American Behavioral Scientist, 49(6), 775–793.
6.
CareyvaB.JohnsonM.SifriR.DiCarloM.DaskalakisC.ShaakK.PaytonC.StelloB.MyersR. (2020). RE-AIM evaluation of a multilevel decision support and navigation intervention for colorectal cancer screening in Hispanic primary care patients. 1–16. https://doi.org/10.21203/rs.3.rs-35219/v1
7.
CastañedaS. F.BhartiB.Espinoza-GiacintoR. A.SanchezV.O’ConnellS.MuñozF.MercadoS.MezaM. E.RojasW.TalaveraG. A.GuptaS. (2018). Evaluating two evidence-based intervention strategies to promote CRC screening among Latino adults in a primary care setting. Journal of Racial and Ethnic Health Disparities, 5(3), 530–535.
8.
ColeA. M.EsplinA.BaldwinL. M. (2015). Adaptation of an evidence-based colorectal cancer screening program using the consolidated framework for implementation research. Preventing Chronic Disease, 12(3), 1–10.
9.
CoronadoG. D.FariasA.ThompsonB.GodinaR.OderkirkW. (2006). Attitudes and beliefs about colorectal cancer among Mexican Americans in communities along the US-Mexico border. Ethnicity & Disease, 16(2), 421–427.
10.
CoronadoG. D.SanchezJ.PetrikA.KapkaT.DeVoeJ.GreenB. (2014). Advantages of wordless instructions on how to complete a fecal immunochemical test: Lessons from patient advisory council members of a federally qualified health center. Journal of Cancer Education, 29(1), 86–90.
11.
CoronadoG. D.SchneiderJ. L.SanchezJ. J.PetrikA. F.GreenB. (2015). Reasons for non-response to a direct-mailed FIT kit program: Lessons learned from a pragmatic colorectal-cancer screening study in a federally sponsored health center. Translational Behavioral Medicine, 5(1), 60–67.
12.
CreswellJ. W.PothC. N. (2016). Qualitative inquiry and research design: Choosing among five approaches. SAGE.
13.
DenzinN. K. (2005). The discipline and practice of qualitative research. In DenzinN. K.LincolnY. S. (Eds.), Handbook of qualitative research (pp. 1–42). SAGE.
14.
DockterA. G.AngelosG. C. (2020). Molecular-based alternatives for colorectal cancer screening during the COVID-19 pandemic. Surgical Technology International, 36, 143–147.
15.
DominicO. G.ChinchilliV.WassermanE.CurryW. J.KambicD. M.CaicedoC. H.RamirezA. G.OchoaJ. A.LengerichE. J. (2020). Impact of social support on colorectal cancer screening among adult Hispanics/Latinos: A randomized community-based study in central Pennsylvania. Cancer Prevention Research, 13(6), 531–542.
16.
D’OvidioV.LucidiC.BrunoG.LisiD.MiglioresiL.BazuroM. E. (2020). Impact of COVID-19 pandemic on colorectal cancer screening program. Clinical Colorectal Cancer, 20(1), e5–e11.
17.
Downe-WamboldtB. (1992). Content analysis: Method, applications, and issues. Health Care for Women International, 13(3), 313–321.
18.
GetrichC. M.SussmanA. L.HelitzerD. L.HoffmanR. M.WarnerT. D.SánchezV.SolaresA.RhyneR. L., & RIOS Net Clinicians. (2012). Expressions of machismo in colorectal cancer screening among New Mexico Hispanic subpopulations. Qualitative Health Research, 22(4), 546–559.
19.
GoldmanR. E.DiazJ. A.KimI. (2009). Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: Stigma and misperceptions. Qualitative Health Research, 19(11), 1559–1568.
20.
GreenB. B.AndersonM. L.ChubakJ.BaldwinL. M.TuzzioL.CatzS.ColeA.VernonS. W. (2016). Colorectal cancer screening rates increased after exposure to the patient-centered medical home (PCMH). The Journal of the American Board of Family Medicine, 29(2), 191–200.
21.
HooperM. W.NápolesA. M.Pérez-StableE. J. (2020). COVID-19 and racial/ethnic disparities. JAMA, 323(24), 2466–2467.
22.
JandorfL.EllisonJ.VillagraC.WinkelG.VarelaA.Quintero-CanettiZ.CastilloA.ThélémaqueL.KingS.DuHamelK. (2010). Understanding the barriers and facilitators of colorectal cancer screening among low income immigrant Hispanics. Journal of Immigrant and Minority Health, 12(4), 462–469.
23.
KoL. K.ReulandD.JollesM.ClayR.PignoneM. (2014). Cultural and linguistic adaptation of a multimedia colorectal cancer screening decision aid for Spanish-speaking Latinos. Journal of Health Communication, 19(2), 192–209.
24.
KoL. K.RodriguezE.YoonJ.RavindranR.CopelandW. K. (2016). A brief community-based nutrition education intervention combined with food baskets can increase fruit and vegetable consumption among low-income Latinos. Journal of Nutrition Education and Behavior, 48(9), 609–617.
25.
KoL. K.TaylorV. M.MohamedF. B.DoH. H.GebeyawF. A.IbrahimA.AliA. A.WinerR. L. (2019). “We brought our culture here with us”: A qualitative study of perceptions of HPV vaccine and vaccine uptake among East African immigrant mothers. Papillomavirus Research, 7, 21–25.
26.
LairsonD. R.KimJ.ByrdT.SalaizR.ShokarN. K. (2018). Cost-effectiveness of community interventions for colorectal cancer screening: low-income Hispanic population. Health Promotion Practice, 19(6), 863–872.
27.
LissD. T.BakerD. W. (2014). Understanding current racial/ethnic disparities in colorectal cancer screening in the United States: The contribution of socioeconomic status and access to care. American Journal of Preventive Medicine, 46(3), 228–236.
28.
MehtaS. J.JensenC. D.QuinnV. P.SchottingerJ. E.ZauberA. G.MeesterR.LaiyemoA. O.FedewaS.GoodmanM.FletcherR. H.LevinT. R.CorleyD. A.DoubeniC. A. (2016). Race/ethnicity and adoption of a population health management approach to colorectal cancer screening in a community-based healthcare system. Journal of General Internal Medicine, 31(11), 1323–1330.
29.
MorganD. L. (1993). Qualitative content analysis: A guide to paths not taken. Qualitative Health Research, 3(1), 112–121.
30.
Natale-PereiraA.MarksJ.VegaM.MouzonD.HudsonS. V.Salas-LopezD. (2008). Barriers and facilitators for colorectal cancer screening practices in the Latino community: Perspectives from community leaders. Cancer Control, 15(2), 157–165.
31.
PasickR. J.HiattR. A.PaskettE. D. (2004). Lessons learned from community-based cancer screening intervention research. Cancer: Interdisciplinary International Journal of the American Cancer Society, 101(S5), 1146–1164.
32.
SidaniS.IbrahimS.LokJ.FanL.FoxM.GurugeS. (2017). An integrated strategy for the cultural adaptation of evidence-based interventions. Health, 9(04), 738.
33.
SiegelR. L.MillerK. D.JemalA. (2017). Cancer statistics, 2017. CA; A Cancer Journal for Clinicians, 67, 7–30.
34.
SingalA. G.GuptaS.TiroJ. A.SkinnerC. S.McCallisterK.SandersJ. M.BishopW. P.AgrawalD.MayorgaC. A.AhnC.LoewenA. C.SantiniN. O.HalmE. A. (2016). Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: A randomized controlled trial in a safety-net health system. Cancer, 122(3), 456–463.
35.
ThompsonJ. H.DavisM. M.MichaelsL.RivelliJ. S.CastilloM. L.YoungerB. M.CastroM.ReichS. L.CoronadoG. D. (2019). Patient-refined messaging for a mailed colorectal cancer screening program: Application of boot camp translation in a Latino-based community health center. Journal of the American Board of Family Medicine: JABFM, 32(3), 307.
ViramontesO.BastaniR.YangL.GlennB. A.HerrmannA. K.MayF. P. (2020). Colorectal cancer screening among Hispanics in the United States: Disparities, modalities, predictors, and regional variation. Preventive Medicine, 138, 106146.
38.
WalshJ. M.KaplanC. P.NguyenB.GildengorinG.McPheeS. J.Pérez-StableE. J. (2004). Barriers to colorectal cancer screening in Latino and Vietnamese Americans: Compared with Non-Latino White Americans. Journal of General Internal Medicine, 19(2), 156–166.
39.
YlitaloK. R.CampB. G.MeyerM. R. U.BarronL. A.BenavidezG.HessB.LaschoberR.GriggsJ. O. (2019). Barriers and facilitators of colorectal cancer screening in a federally qualified health center (FQHC). The Journal of the American Board of Family Medicine, 32(2), 180–190.
