From: Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?
Approach | Study Type | Screening type | Population group targeted | Observed changes in screening uptake or intent to screen for CRC |
---|---|---|---|---|
1. Organizational/system changes | Â | Â | Â | Â |
Patient navigators to overcome patient reported barriers from screening to treatment [123] | RCT | Any CRC screening | Low income and non-English speaking | Uptake of CRC screening post-intervention was 27% vs 12% (p‹ 0.001) before intervention. |
Culturally sensitive patient navigators and physician recommendation [124] | RCT | Endoscopy and FOBT | Low income, Hispanic patients attending primary care practice | Completion of endoscopy 6 months post intervention was 15.8% in intervention group vs 5% in control (physician recommendation only) (p= 0.019) Completion of FOBT 3 months post intervention was 42.1% in intervention group vs 25% in control group (p = 0.086) |
Patient navigator combined with reminder letter [125] | Intervention | Any CRC screening | English speaking, Immigrants from Brazil, Portugal & Haiti | 31% of intervention group vs 9% control patients completed screening after 6 months |
2. Targeting of healthcare users | Â | Â | Â | Â |
Culturally appropriate intervention using health educator and bilingual educational material [126] | RCT | FOBT | Chinese Americans | Uptake of FOBT after 6 months was 69.5% intervention group vs 27% control group |
Personalized and tailored interventions [127, 128] Four groups; 1-Tailored intervention 2-Standard intervention 3-Tailored intervention plus phone reminder 4-Control | RCT [128] | Any CRC screening | Mixture of African American (58%) and white | Screening assessed 2 years post intervention: Screening completion among those in the intervention groups ranged from 44-48% vs 33% control group (p‹0.05) [128] |
RCT | Endoscopy | Low SES Latino | Intent to obtain CRC screening via endoscopy increased in those exposed to storytelling compared to those exposed to risk tool based information (p = 0.038) | |
Community based awareness and educational interventions [130] | Participatory using intervention material developed through participatory approach | Any CRC screening | Rural white | Intention to screen increased significantly in those exposed to educational materials and who had not been tested in the last 5 yrs compared to those that had (p = 0.025). |
Community-based participatory [131] Using culturally relevant approach and education held on a ‘family day'. Followed by intensive follow-up and encouragement of participants by letters and phone calls | Participatory | Any CRC screening | Rural Native Hawaiian in Hawaii | Increase in compliance with CRC screening in both men and women. CRC screening 6 months post intervention increased in men from 39% to 75% (p = 0.002) and in women 36% to 76% (p = 0.002) Limitations- small sample size (28 men and 25 women) |
Culturally appropriate education to enhance knowledge and screening [132] Assigned to one of three groups: 1. Cultural & self-empowerment group 2. Traditional group 3. Modified cultural group 4. Control | Experimental/repeated measures | FOBT | African-American Elders | Knowledge assessed at 6 and 12 months. FOBT screening assessed at 12 months and found greater participation in those in Cultural & Self Empowerment group. |
Intensive one-on-one patient education [133] | RCT | FOBT | Ethnically diverse group | Proportion of patients returning FOBT was significantly higher in intensive education group compared with those receiving standard education (65.6% vs 51.3% p‹0.01) |
Telephone support intervention [134] | RCT | Any CRC screening | Minority, low income women | Proportion of women completing CRC screening increased from 39% to 54% in the intervention group and 39% to 50% in the control group (p = 0.13) |
Tailored telephone outreach [135] | RCT | Any CRC screening | Minority | CRC screening compliance 6 months post intervention was 27% in intervention group vs 6.1% in control group (mailed print material) |
Education with Elderly Educators [136] Four educational methods: 1. Elderly Educators 2. Elderly Educators plus Adaption for Aging Changes method 3. Adaption for Aging Changes method 4. Traditional method | 2-by-2 factorial design | FOBT | Socioeconomically disadvantaged African Americans and White | Participation in FOBT was 93% in those receiving combination of Elderly Educators plus Adaption for Aging Changes method, 63% in those exposed to Elderly Educators only and 43% participation in those receiving Adaptation for Aging changes method only and 56% exposed to traditional method. |
Video-based education [137] | RCT | FOBT | Majority had less than high school education | 69.6% of intervention group returned FOBT vs 54.4% in control group (p = 0.035) |