摘要：Objectives. We conducted 1 of the first community-based trials to develop a multicomponent intervention that would increase colorectal cancer screening among an Asian American population. Methods. Filipino Americans (n = 548) nonadherent to colorectal cancer (CRC) screening guidelines were randomized into an intervention group that received an education session on CRC screening and free fecal occult blood test (FOBT) kits; a second intervention group that received an education session but no free FOBT kits; and a control group that received an education session on the health benefits of physical activity. Results. Self-reported CRC screening rates during the 6-month follow-up period were 30%, 25%, and 9% for participants assigned to intervention with FOBT kit, intervention without the kit, and control group, respectively. Participants in either of the 2 intervention groups were significantly more likely to report screening at follow-up than were participants in the control group. Conclusions. A multicomponent intervention that includes an educational group session in a community setting can significantly increase CRC screening among Filipino Americans, even when no free FOBT kits are distributed. Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. 1 Screening using a fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy is recommended for adults older than 49 years to reduce CRC mortality. However, population-based surveys have documented low rates of CRC screening among Asian Americans. 2 For example, data from the 2005 California Health Interview Survey show that only 46% of Filipino Americans are up-to-date with CRC screening compared with 59% of non-Hispanic Whites. 3 Low rates of CRC screening contribute to late-stage diagnosis and poor survival outcomes among Asian Americans compared with non-Hispanic Whites. 4 Despite these disparities, very few interventions to increase CRC screening have been developed and rigorously tested for Asian Americans. 5 The Task Force on Community Preventive Services, a group of public health and prevention experts that oversees systematic reviews of studies, recommends implementation of the following interventions to increase CRC screening on the basis of strong evidence of effectiveness: (1) brochures and other small media that describe screening tests and contain indications for, benefits of, and ways to overcome barriers to screening; (2) interventions to reduce structural barriers, such as distribution of free FOBT kits; and (3) client reminders to advise people they are due or late for screening. The Task Force determined that there is insufficient evidence to determine the effectiveness of small-group education. 6 Small-group educational sessions had been popular among the Filipino community in 1 of our prior studies; 7 therefore, we again offered small-group educational sessions in community settings. In keeping with the Task Force recommendations, we also used print materials and a reminder mailing. In addition, we distributed free FOBT kits in 1 arm of the intervention. In a second intervention arm, we did not distribute free FOBT kits, as this distribution may not be feasible for community organizations that want to continue similar programs after the end of the study. A control arm offered small-group education and print materials on the health benefits of physical activity. We report the effect of the multicomponent intervention on CRC screening rates among Filipino Americans. This is 1 of the first community-based randomized trials designed to increase CRC screening among Asian Americans and the first trial among Filipino Americans.
