Asians are one of the fastest growing and most culturally diverse minority populations in the United States. Studies have consistently shown that Asian Americans are less likely to receive breast and cervical cancer screening tests than any other racial/ethnic sub-group. However, little is known about the colorectal cancer screening behavior of Asian Americans. The National Cancer Institute's plan for reducing health disparities prioritizes new interventions research to identify and overcome sociocultural as well as health care system barriers to the adoption of colorectal cancer screening. The overall goal of this research is to increase the uptake of fecal occult blood testing (FOBT) by Chinese Americans. Specific objective are as follows: collect qualitative and quantitative information about the FOBT behavior of Chinese men and women; develop a culturally and linguistically appropriate clinic-based FOBT intervention program for individuals of Chinese descent; and conduct a randomized, controlled trail to evaluate the effectiveness and feasibility of the FOBT intervention program. The study will be conducted at the International District Clinic in Seattle where over 50 percent of the patients are of Chinese ethnicity. It will emphasize community involvement and will use the Adherence Model as an over-arching theoretical framework. Chinese clinic patients aged 50-79 years will be eligible for study participation. In-depth interviews and focus groups will be used to gather qualitative data. This information will guide the development of intervention components and a quantitative survey instrument. Approximately 421 under-utilizers of FOBT will be randomized to intervention or control status. The FOBT intervention program will be delivered by a nurse during the routine clinic visits, and will include the use of audiovisual as well as print health education materials. The main outcome of our randomized controlled trial will be FOBT completion within six months of randomization. Outcome evaluation will be based on chart audit and survey data. Quantitative analyses will address factors associated with FORT participation, the validity and reliability of our survey instrument, the accuracy of FOBT self- report, intermediate trial outcomes, and process measures with respect to the intervention program.
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