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Grant Details

Grant Number: 5R01CA166785-02 Interpret this number
Primary Investigator: Smith, Selina
Organization: Morehouse School Of Medicine
Project Title: Efficacy-to-Effectiveness Transition of an Educational Program to Increase Colore
Fiscal Year: 2013
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Abstract

DESCRIPTION (provided by applicant): African Americans have the highest incidence and mortality and are less likely than whites to have screening for colorectal cancer (CRC). We recently completed a five-year randomized controlled community intervention trial that demonstrated the efficacy of a small group education intervention (now named EPICS or Educational Program to Increase Colorectal Cancer Screening) that doubled the CRC screening rate compared to the control group rate. EPICS was then put into practice in partnership with the local health department and was equally effective. We are now disseminating the intervention across the state of Georgia. In this application we propose a national dissemination and implementation study. We propose using Rogers' Diffusion of Innovation Theory and Glasgow's RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework to pursue the following specific aims: 1) test passive and active approaches to disseminating EPICS to increase screening rates for colorectal cancer among African Americans; 2) measure the extent to which EPICS is accepted by community coalitions and the fidelity of implementation in various settings and 3) estimate the potential translatability and public health impact of EPICS. Diffusion of Innovations Theory will guide the process of EPICS dissemination and RE-AIM will be used to assess this dissemination and its impact. For this study we propose a cluster randomized controlled trial of 20 community coalitions from across the United States, assigned to one of four conditions: (1, passive) web-based access to facilitator training materials and toolkits without technical assistance (TA); (2, passive) the sam as 1, but with TA; (3, active) in-person access (IP) to facilitator training materials and toolkits without TA and (4, active) IP access to facilitator training materials and toolkits with TA. Each community coalition will partner with three settings for implementation: a church, clinic and community site. African Americans, 50-74 years of age, who are not current on CRC screening are eligible for study participation (n=7,200 or n=360 eligible individuals per community coalition). This assumes a sample size of 1800 per study arm, a significance level of 5% (i.e. alpha = 0.05), and a two-sided two-group chi-square test of proportions. Assuming that we observe in our study an increase in screening rates of colorectal cancer among participants in active arms compared to screening rates among participants in the passive arms, we will have greater than 99% power to detect statistically significant differences in the proportions. All statistical tests proposed for this study will be two-sided and will be performed using a significance level of 5% (i.e., alpha=0.05).

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Publications

Advancing breast cancer survivorship among African-American women.
Authors: Coughlin SS, Yoo W, Whitehead MS, Smith SA
Source: Breast Cancer Res Treat, 2015 Aug 25;null, p. null.
EPub date: 2015 Aug 25.
PMID: 26303657
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The Insulin-like Growth Factor Axis, Adipokines, Physical Activity, and Obesity in Relation to Breast Cancer Incidence and Recurrence.
Authors: Coughlin SS, Smith SA
Source: Cancer Clin Oncol, 2015;4(2), p. 24-31.
PMID: 26251693
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Efficacy to effectiveness transition of an Educational Program to Increase Colorectal Cancer Screening (EPICS): study protocol of a cluster randomized controlled trial.
Authors: Smith SA, Blumenthal DS
Source: Implement Sci, 2013 Aug 7;8, p. 86.
EPub date: 2013 Aug 7.
PMID: 23924263
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Community health workers support community-based participatory research ethics: lessons learned along the research-to-practice-to-community continuum.
Authors: Smith SA, Blumenthal DS
Source: J Health Care Poor Underserved, 2012 Nov;23(4 Suppl), p. 77-87.
PMID: 23124502
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