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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): The overall goal of our proposal is to disseminate an evidence-based intervention designed for one Asian ethnic population to a different Asian ethnic population with overlapping cultural and health beliefs. In collaboration with International Community Health Services (ICHS), a community agency serving many Asian ethnic groups, we have three specific objectives for the proposed research: Replicate an effective colorectal cancer (CRC) screening intervention for Vietnamese Americans that was originally designed for Chinese Americans. Evaluate the dissemination of this replicated intervention through a quasi-experimental study. Collect and examine dissemination process data. Based on principles from Diffusion of Innovation Theory, we proposed to replicate an intervention with a 42% effect size. The replicated intervention will consist of a Vietnamese language video and bilingual pamphlet. We will translate and dub into Vietnamese our award-winning Chinese-language video, "Being a Winner in Life: How to Prevent Colorectal Cancer." The Chinese/English pamphlet will also be translated into Vietnamese. To provide feedback on the translated video script and pamphlet, we will convene 4 focus groups with Vietnamese men and women. Subsequently, we will introduce these materials to the intervention clinic staff at in-service training presentations and specifically recommend that intervention clinic medical assistants distribute the intervention materials. To evaluate the dissemination of this replicated intervention, our quantitative analysis will examine the Reach and Effectiveness based on the RE-AIM framework through a quasi-experimental study over an 18-month period. There are 919 and 802 age-eligible Vietnamese patients at the intervention and control clinic respectively. To determine the Effectiveness of the intervention, the primary outcome will be changes in CRC screening adherence rates at the intervention and control clinics. We will randomly select 25% of the patients from each clinic for pre- and post-intervention chart audits and use the Generalized Estimating Equation to model CRC screening adherence at the two clinics at pre- and post-intervention. Process evaluation will examine Adoption, Implementation, and Maintenance at the intervention clinic. We will collect qualitative data from 10 key informant interviews with ICHS management personnel and intervention clinic staff. In addition, 3 focus groups with medical assistants, the intervention agents, anof two focus groups with Vietnamese patients at the intervention clinic will also be completed.