Grant Number:	1R01CA166785-01 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:	2012

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). PUBLIC HEALTH RELEVANCE: Colorectal Cancer (CRC) is one of the most important causes of cancer deaths (second to lung cancer), with persistent disparities documented by race/ethnicity. This project seeks to demonstrate the effectiveness of an intervention proven efficacious among African Americans, and to document its utility by describing its transition from research to real world settings. Successfully implementing the core elements of the intervention will increase CRC screening among African Americans and will help reduce CRC incidence and mortality.




Colorectal Cancer Knowledge and Screening Change in African Americans: Implementation Phase Results of the EPICS Cluster RCT.
Authors: Ansa B.E. , Alema-Mensah E. , Sheats J.Q. , Mubasher M. , Akintobi T.H. .
Source: Ajpm Focus, 2023 Dec; 2(4), p. 100121.
EPub date: 2023-06-13 00:00:00.0.
PMID: 37790949
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Patient-Centered Medical Home Status and Preparedness to Assess Resident Milestones: A CERA Study.
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Source: Primer (leawood), 2018 May; 2, .
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Health-related quality of life of African-American female breast cancer survivors, survivors of other cancers, and those without cancer.
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Evaluation of Colorectal Cancer Incidence Trends in the United States (2000-2014).
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Patterns of Internet-based health information seeking in adult survivors of childhood cancer.
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Social networks as predictors of colorectal cancer screening in African Americans.
Authors: Alema-Mensah E. , Smith S.A. , Claridy M. , Ede V. , Ansa B. , Blumenthal D.S. .
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Community engagement to address socio-ecological barriers to physical activity among African American breast cancer survivors.
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Community-Based Participatory Research to Promote Healthy Diet and Nutrition and Prevent and Control Obesity Among African-Americans: a Literature Review.
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TEACH Kitchen: A Chronological Review of Accomplishments.
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Persons Who Failed to Obtain Colorectal Cancer Screening Despite Participation in an Evidence-Based Intervention.
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Patient perspectives of an individualized diabetes care management plan.
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Application of a faith-based integration tool to assess mental and physical health interventions.
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Factors associated with body mass index among African American breast cancer survivors.
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Toward the Elimination of Colorectal Cancer Disparities Among African Americans.
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Determinants Of Adherence To Physical Activity Guidelines Among Overweight And Obese African American Breast Cancer Survivors: Implications For An Intervention Approach
Authors: Smith S.A. , Ansa B.E. , Yoo W. , Whitehead M.S. , Coughlin S.S. .
Source: Ethnicity & Health, 2016-11-14 00:00:00.0; , p. 1-13.
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Trends In Hiv Testing Among Adults In Georgia: Analysis Of The 2011-2015 Brfss Data
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Reducing Disparities By Way Of A Cancer Disparities Research Training Program
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Exploration Of Barriers And Facilitators To Publishing Local Public Health Findings: A Mixed Methods Protocol
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Determinants Of Adherence To Nutrition-related Cancer Prevention Guidelines Among African American Breast Cancer Survivors
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Engaging African Americans in developing an intervention to reduce breast cancer recurrence: A brief report.
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Source: Journal Of The Georgia Public Health Association, 2016 Summer; 6(1), p. 76-79.
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A systematic review of lifestyle interventions for chronic diseases in rural communities.
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