Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Differences in Behavioral Outcomes Between First-Year and Second-Year Participants in a Community-based Colorectal Cancer Education Intervention

Huang, Jia-Yan;Shi, Lu

  • Published : 20111200
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Abstract

Introduction: Colorectal cancer (CRC) is the third most prevalent cancer in China, and the fifth most lethal among all cancers. Community-based health education is helpful for health planners to promote cancer screening, yet relatively few studies tapped the temporal pattern of intervention effectiveness in a multiyear CRC education program. Using data from a two-year CRC community education, this study was aimed at exploring whether the health education intervention effectiveness differs between first-year and the second-year participants. Method: A two-year health education intervention was carried out in four communities in Shanghai, China. The health education focused on raising awareness about CRC, the principles of fecal occult blood test (FOBT) screening, and instruction about use of the FOBT kit. Local community health service centers conducted the lectures once a month. All adult residents were invited to attend these lectures. At the end of the first year and the second year, structured in-person interviews were conducted for the residents who attended the lectures. There were 205 enrollees who completed the first-year interviews and 836 enrollees who completed the second-year interviews. Logistic regression was used to compare the attitudinal and behavioral outcomes of enrollees in years 1 and 2. Result: Of the 1041 respondents, 24.5% had received FOBT during the program period, while 12% had received colonoscopy check, both substantially higher than the background screening rate in Shanghai. Respondents in year 2 were less willing to take FOBT than those in year 1 (O.R.=0.618, p<0.01), but there was no significant difference in terms of willingness to take colonoscopy after adjustment for covariates in logistic regression. Multiple logistic regression also showed that respondents in year 2 were significantly less likely to take FOBT than those in year 1 (O.R.=0.263, p<0.01) and a similar tendency was noted for colonoscopy (O.R.=0.600, p=0.074). Conclusion: The CRC screening rate after the health education compared favorably with the background screening rate, yet the decline in screening rate in year 2 indicates that further study is needed to understand the determinants of intervention effectiveness.

Keywords

References

  1. Baron RC, Rimer BK, Coates RJ, et al (2008). Methods for conducting systematic reviews of evidence on effectiveness and economic efficiency of interventions to increase screening for breast, cervical, and colorectal cancers. Am J of Prev Med, 35, S26 -33. https://doi.org/10.1016/j.amepre.2008.04.003
  2. Breslow RA, Rimer BK, Baron RC, et al (2008). Introducing the Community Guide's reviews of evidence on interventions to increase screening for breast, cervical, and colorectal cancers. Am J of Prev Med, 35, S14-20. https://doi.org/10.1016/j.amepre.2008.04.005
  3. Bujanda L, Sarasqueta C, Zubiaurre L, et al (2007). Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer. Gut, 56, 1714-8. https://doi.org/10.1136/gut.2007.120709
  4. Centers for Disease Control and Prevention (2008). Use of colorectal cancer tests-United States, 2002, 2004, and 2006. Morbidity Mortality Weekly Report, 57, 253-8.
  5. China Ministry of Health (2008). Health Statistics Report. Retrieved August 15 2011, from Http://ww.moh.gov.
  6. China Ministry of Health (2010). 2010 Health Statistics Yearbook. Beijing: People's Medical Publishing House.
  7. Department of Health and Human Services (2007). United States Cancer Statistics: 2004 Incidence and Mortality. Atlanta, GA: US Department of Health and Human Services, CEDC, National Cancer Institute.
  8. Edwards BK, Ward E, Kohler BA, et al (2010). Annual report to the nation on the status of cancer, 1975-2006, Featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer, 116, 544-73. https://doi.org/10.1002/cncr.24760
  9. Fang H, He DD, Zhou J, Cao LL (2010). Effect evaluation of health education on early detection of common malignant tumors in Minhang District. Health Educ Health Promot, 5, 104-7.
  10. Garman KS, Jeffreys AM, Coffman C, et al (2006). Colorectal cancer screening, comorbidity, and follow-up in elderly patients. Am J of Prev Med, 332, 159-63.
  11. Gong YM, Chen YY, Zheng Y, Huang JY (2011). Evaluation on health education of cancer prevention in community population. Chinese Health Qual Manage, 18, 92-5.
  12. Hart AR, Barone TL, Gay SP, et al (1997). The effect on compliance of a health education leaflet in colorectal cancer screening in general practice in central. J Epidemiol Community Health, 51, 187-91. https://doi.org/10.1136/jech.51.2.187
  13. Hewitson P, Glasziou P, Watson E, et al (2008). Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hem-occult): an update. Am J Gastroenterology, 103, 1541-9. https://doi.org/10.1111/j.1572-0241.2008.01875.x
  14. Hewitson P, Ward AM, Heneghan C, et al (2011). Primary care endorsement letter and a patient leaflet to improve participation in colorectal cancer screening: results of a factorial randomised trial. British J Cancer, 105, 475-80. https://doi.org/10.1038/bjc.2011.255
  15. Homes EP, Corrigan PW, Williams P, Canar J, Kubiak MA (1999). Changing attitudes about schizophrenia. Schizophrenia Bulletin, 25, 447-56. https://doi.org/10.1093/oxfordjournals.schbul.a033392
  16. Jerant A, Kravitz RL, Rooney M, et al (2007). Effects of a tailored interactive multimedia computer program on determinants of colorectal cancer screening: A randomized controlled pilot study in physician offices. Patient Educ Couns, 66, 67-74. https://doi.org/10.1016/j.pec.2006.10.009
  17. Kaliyaperumal K (2004). Guideline for conducting a knowledge, attitude and practice (KAP) study. AECS Illumination, 4, 7-9.
  18. Khankari K, Eder M, Osbom CY, et al (2007). Improving Colorectal Cancer screening among the medically underserved: a piot study within a federally qualified health center. J Gen Intern Med, 22, 1410-4. https://doi.org/10.1007/s11606-007-0295-0
  19. Koo JH, Arasaratnam MM, Liu K, et al (2010). Knowledge, perception and practices of colorectal cancer screening in an ethnically diverse population. Cancer Epidemiol, 34, 604-10. https://doi.org/10.1016/j.canep.2010.05.013
  20. Lewis C, Pignone M, Schild LA, et al (2010). Effectiveness of a patient- and practice-level colorectal cancer screening intervention in health plan members. Cancer, 116, 1664-73. https://doi.org/10.1002/cncr.24962
  21. Li Y, Chen W, Chen XN (2011). Application effect of community health education on the high risk population of colorectal cancer. Clinic Med Engineering, 18, 921-2.
  22. Ling BS, Schoen RE, Trauth JM, et al (2009). Physicians encouraging colorectal screening: a randomized controlled trial of enhanced office and patient management on compliance with colorectal cancer screening. Arch Intern Med, 169, 47-55. https://doi.org/10.1001/archinternmed.2008.519
  23. Liu G, Kong Z (2008). Screening study of colorectal cancer. Med Recapitulate, 14, 3249-52.
  24. Liu GW, Cai QC (2009). The progress of Screening and early diagnosis of colorectal cancer. Modern Oncol, 17, 770-4.
  25. Ma GX, Shive S, Tan Y, et al (2009). Community-based colorectal cancer intervention in underserved Korean Americans. Cancer Epidemiol, 33, 381-5. https://doi.org/10.1016/j.canep.2009.10.001
  26. Mandel JS, Bond JH, Church TR, et al (1993). Reducing mortality from colorectal cancer by screening for fecal occult blood. New England J Med, 328, 1365-71. https://doi.org/10.1056/NEJM199305133281901
  27. Mandel JS, Church TR, Bond JH, et al (2000). The effect of fecal occult-blood screening on the incidence of colorectal cancer. New England J Med, 343, 1603-7. https://doi.org/10.1056/NEJM200011303432203
  28. Menon U, Szalacha LA, Belue R, et al (2008). Interactive, Culturally sensitive education on CCS. Med Care, 46, S44-50. https://doi.org/10.1097/MLR.0b013e31818105a0
  29. Miller DP, Brownlee CD, McCoy TP, et al (2007). The effect of health literacy on knowledge and receipt of colorectal cancer screening: a survey study. BMC Family Practice, 8, 16-22. https://doi.org/10.1186/1471-2296-8-16
  30. Morrow JB (2009). A systematic review of community-based colorectal cancer screening randomized controlled trials with multi-ethnic groups. Retrieved August 15 2011, from http://digitalcommons.library.tmc.edu/dissertations/AAI1467440.
  31. Myers RE, Ross E, Jepson C, et al (1994). Modeling adherence to colorectal cancer screening. Preventive Med, 23, 142-51. https://doi.org/10.1006/pmed.1994.1020
  32. Nguyen BH, McPhee SJ, Stewart SL, et al (2010). Effectiveness of a controlled trial to promote colorectal cancer screening in Vietnamese Americans. Am J of Prev Med, 100, 870-6.
  33. Palme RC, Emmons KM, Fletcher RH, et al (2007). Familial risk and colorectal cancer screening health beliefs and attitudes in an insured population. Prev Med, 45, 336-41. https://doi.org/10.1016/j.ypmed.2007.07.021
  34. Peris M, Espinas JA, Munoz L, et al (2007). Lessons learnt from a population-based pilot programme for colorectal cancer screening in Catalonia (Spain). J Med Screen, 14, 81-6. https://doi.org/10.1258/096914107781261936
  35. Price-Haywood EG, Roth KG, Shelby K, Cooper LA (2009). Cancer risk communication with low health literacy patients: a continuing medical education program. J Gen Intern Med, 25, 126-9.
  36. Segnan N, Senore C, Andreoni B, et al (2007). Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology, 132, 2304-12. https://doi.org/10.1053/j.gastro.2007.03.030
  37. Severino G, Wilson C, Turnbull D, et al (2009). Attitudes towards and beliefs about colorectal cancer and screening using the faecal occult blood test within the Italian-Australian community. Asian Pac J Cancer Prev, 10, 387-94.
  38. Shapiro JA, Seeff LC, Thompson TD, et al (2008). Colorectal cancer test use from the 2005 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev, 17, 1623-30. https://doi.org/10.1158/1055-9965.EPI-07-2838
  39. Simon SR, Zhang F, Soumerai SB, et al (2010). Failure of automated telephone outreach with speech recognition to improve colorectal cancer screening. Arch Intern Med, 170, 264-70. https://doi.org/10.1001/archinternmed.2009.522
  40. Tu SP, Taylor V, Yasui Y, et al (2006). Promoting culturally appropriate colorectal cancer screening through a health educator. Cancer, 107, 959-66. https://doi.org/10.1002/cncr.22091
  41. Walsh JM, Salazar R, Nguyen TT, et al (2010). Healthy colon, healthy life: a novel colorectal cancer screening intervention. Am J of Prev Med, 39, 1-14. https://doi.org/10.1016/j.amepre.2010.02.020
  42. Wang FY, Li TP, Wu JG, Lu JH (2009). Health management and cancer integrated prevention. Chinese Health Service Manage, 26, 275-7.
  43. Wang DR, Feng ZY (2009). Enlightenment of American managed health care on the community health education in China. Modern Preve Med, 36, 4648-9.
  44. Zheng S, Cai SR (2003). Colorectal cancer epidemiology and prevention study in China. Chinese-German J Clinic Oncol, 2, 72-6. https://doi.org/10.1007/BF02855647
  45. Zheng S, Zhang SZ, Cai SR, et al (2009). Protocol and practice for colorectal cancer screening. China Cancer, 18, 700-4.