Virginia Research Day 2021

Screen to Save: Results from NCI’s Colorectal Cancer Outreach and Screening Initiative to Promote Knowledge of Colorectal Cancer in Hispanic Populations Basurto, Camille, MS, OMS-II. DeJesus, Jose, BS. Escobar, Betsy, MD, MPH. Garcia, Marisela, BS, (Center of Community Alliance for Research and Education, CCARE, Duarte, CA). Milla, Maria, MPH, MA. Llavona, Josheili, MS Mentors: San Miguel, Sandra, MPH (National Cancer Institute, Rockville, MD). Schwartz, Elena, MD, PhD, (Johns Hopkins University, Rockville, MD). Associate Dean for Research | Department of Molecular and Cellular Sciences

Data Analysis • The S2S program was delivered to 3,881 individuals; 1,544 were Hispanics. Eleven NCI-funded sites authorized the data to be shared, including 1,022 individual data. After selecting participants 50 to 75 years old, data from 718 individuals were analyzed. • The change in test scores was analyzed using an analysis of covariance (ANCOVA) model with terms for pre-training scores intervention type and the interaction between intervention type and pre-training scores. • Differences between geographic regions were also evaluated using a similar ANCOVA model. Table 2- LS Means (SE) for the Change from Pre- to Post- Test Scores By Intervention Method & Pairwise Comparisons

Introduction • Colorectal cancer (CRC) is the third leading cause of cancer death among Hispanics in the United States. • Hispanics with CRC are diagnosed at more advanced and at less treatable stages when compared to non-Hispanic whites, in part due to lower CRC screening rates. • The Screen to Save (S2S), an NCI Colorectal Cancer Outreach and Screening Initiative was implemented to expand awareness and promote knowledge of CRC in racial/ethnic and rural populations. • The primary aim of this study is to evaluate the impact of the S2S and the effectiveness of educational outreach to advance knowledge and awareness of CRC in Hispanic populations. Methods • CRCHD worked with 11 Partnerships to Advance Cancer Health Equity (PACHE) and collaborated with 38 National Outreach Network (NON) sites to deliver evidence-based CRC education screening to high-risk groups. • Educational materials were delivered in Spanish and English. • Participants completed a 14-question test before and after receiving educational materials delivered utilizing: PowerPoints, Flip Charts, and/or Inflatable Colons. Figure 1 – Pre- and Post-Intervention Test Scores

 The change in test scores did not differ significantly across regions (P =0.1294). Conclusions The results indicate that educational intervention significantly improved test scores regardless of the type of intervention received and the region of intervention. These findings suggest that the community-outreach design provides an effective way to deliver CRC education in a culturally sensitive manner and can provide a way for high-risk groups to receive CRC screening information. Figure 2 – Mean Change from Pre- to Post-Intervention Test Scores by Geographic Region

PowerPoint

Inflatable Colon

Flip Chart

PowerPoint + Flip Chart

Intervention Method

5

LS Mean (SE)

Pairwise Comparisons

1 vs 2 1 vs 3 1 vs 4

2 vs 3 2 vs 4

3 vs 4

4

3

. PowerPoint (1) Inflatable Chart (2) Flip Chart (3) PowerPoint + Flip Chart (4)

1.28 (0.187)

2

1.66 (0.173)

P=0.1412

2.64 (0.127)

P<0.0001

P<.0001

1

0

1.64 (0.572)

P=0.5544 P=0.9726 P=0.0878

Region 2

Region 3

Region 4

Region 5

Results  Test scores averaged 11.6 on a 0-18 scale before the delivery of educational materials.  Results of ANCOVA modeling show that the change from pre- to post-intervention scores was significantly different (P <0.0001) among the four types of education methods.  The FlipChart intervention had the largest change in overall test scores.  FlipChart was significantly different from the PowerPoint and the Inflatable Colon intervention (LS mean ±SD = 2.6 ± 0.13, 1.3 ±0.19, and 1.66 ± 0.17, respectively).

The results furthermore argue that the FlipChart method provides the most efficacious way to provide CRC education. Limitations of the study include the sample size of some regions and the application of only certain educational interventions in some regions. References 1. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2014 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2017. Available at: http://www.cdc.gov/uscs. 2. Chien C, Morimoto LM, Tom J, Li CI. Differences in colorectal carcinoma stage and survival by race and ethnicity. Cancer. 2005;104:629–39. 3. American Cancer Society. Colorectal Cancer Facts & Figures 2017-2019. Atlanta: 2015 4. Surveillance, Epidemiology, and End Results (SEER) Program ( www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2015 Sub (1973–2013) - Linked to County Attributes - Total U.S., 1969–2014 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2016, based on the November 2015 submission.

15

PowerPoint (N=160)

Inflatable Colon(N=189)

Flip Chart (N=350)

PowerPoint + Flip Chart (N=19)

14

13

12

11

10

Pre-test

Post-Test

Intervention Method

N

Mean (SD) Pre-Training Score

Mean (SD) Post-Training Score

PowerPoint

160 189 350

11.5 (3.65) 12.1 (3.94) 11.3 (3.43) 12.6 (3.11)

12.8 (3.14) 13.5 (4.14) 14.1 (2.17) 14.2 (3.41)

Inflatable Chart

Flip Chart

PowerPoint + Flip Chart

19

153 2 0 2 1 R e s e a r c h R e c o g n i t i o n D a y