Preferences for CPSTF-Recommended Intervention Approaches for Increasing Cancer Screening Among Screen-Eligible Adults in Zuni Pueblo, USA

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Abstract

We identified preferences toward Community Preventive Services Task Force (CPSTF)-recommended intervention approaches among screen-eligible Zuni Pueblo members in New Mexico, USA and assessed if there were significant differences in those preferences, with the goal of informing the selection of intervention approaches for use in the Zuni Pueblo. We utilize data from a population-based survey (n = 280) focused on 15 CPSTF-recommended intervention approaches designed to improve screening for cervical, breast, and/or colorectal cancer screening. Model-adjusted results suggest some intervention approaches garnered significantly higher support than others. We offer six, data-driven recommendations for consideration by public health practitioners as they endeavor to improve cancer prevention in the Zuni Pueblo. This study provides a replicable model for other public health practitioners and health services researchers to incorporate community preferences in community-level intervention approach selection.

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The method of generalized estimating equations (GEE) is often used to analyze longitudinal and other correlated response data, particularly if responses are binary. However, few descriptions of the method are accessible to epidemiologists. In this paper, the authors use small worked examples and one real data set, involving both binary and quantitative response data, to help end-users appreciate the essence of the method. The examples are simple enough to see the behind-the-scenes calculations and the essential role of weighted observations, and they allow nonstatisticians to imagine the calculations involved when the GEE method is applied to more complex multivariate data.

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Testing a culturally appropriate, theory-based intervention to improve colorectal cancer screening among Native Hawaiians.

Frank Braun, C Gotay, Kwun M. Fong … (2005)

We tested an intervention based on social learning theory (SLT) to improve colorectal cancer (CRC) screening among Native Hawaiians, a group with low CRC screening rates. Sixteen Hawaiian civic clubs agreed to randomization. Eight control clubs received a culturally targeted presentation, a free Fecal Occult Blood Test (FOBT), and a reminder call. Eight experimental clubs also received culturally targeted education and free testing; but, in line with SLT, education was delivered by a Native Hawaiian physician and Native Hawaiian CRC survivor, and members received an FOBT demo, were challenged to involve a family member in screening, and were telephoned multiple times to address change-related emotions and barriers. One hundred twenty-one members age 50 and older from 16 clubs participated. At the club level, screening rates were modestly increased in four experimental clubs and six control clubs. Surprisingly, 64% of participants reported being up to date with CRC screening at baseline. Only 13 individuals (five in experimental arm and eight in the control arm) were screened for the first time through this intervention, increasing the percent screened from 59% to 67% in the experimental group and from 69% to 85% in the control group. Although individuals in the experimental arm were more likely to rate the intervention as culturally appropriate, both arms realized similar and significant gains in CRC knowledge, attitudes, intent, and self-efficacy. For Native Hawaiian individuals belonging to a network of civic clubs, an intervention based on SLT delivered by a Native Hawaiian physician and CRC survivor was less effective at further increasing compliance than was a culturally targeted educational session delivered by a non-Hawaiian nurse. That CRC screening compliance was high prior to our intervention suggests that we targeted a very health conscious segment of the Native Hawaiian population. Future work should focus on underserved segments of this indigenous group.

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A trial of 3 interventions to promote colorectal cancer screening in African Americans.

Jonathan D Blumenthal, Charlye D Majett, Samuel E Tekyi-Mensah … (2010)

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. CRC incidence and mortality rates are higher among blacks than among whites, and screening rates are lower in blacks than in whites. For the current study, the authors tested 3 interventions that were intended to increase the rate of CRC screening among African Americans. The following interventions were chosen to address evidence gaps in the Centers for Disease Control and Prevention's Guide to Community Preventive Services: one-on-one education, group education, and reducing out-of-pocket costs. Three hundred sixty-nine African-American men and women aged > or =50 years were enrolled in this randomized, controlled community intervention trial. The main outcome measures were postintervention increase in CRC knowledge and obtaining a screening test within 6 months. There was substantial attrition: Two hundred fifty-seven participants completed the intervention and were available for follow-up 3 months to 6 months later. Among completers, there were significant increases in knowledge in both educational cohorts but in neither of the other 2 cohorts. By the 6-month follow-up, 17.7% (11 of 62 participants) of the Control cohort reported having undergone screening compared with 33.9% (22 of 65 participants) of the Group Education cohort (P = .039). Screening rate increases in the other 2 cohorts were not statistically significant. The current results indicated that group education could increase CRC cancer screening rates among African Americans. The screening rate of <35% in a group of individuals who participated in an educational program through multiple sessions over a period of several weeks indicated that there still are barriers to overcome.

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Author and article information

Contributors

Nicholas Edwardson

Journal

Journal ID (nlm-ta): Prev Med Rep

Title: Preventive Medicine Reports

ISSN (Electronic): 2211-3355

Publication date PMC-release: 01 October 2023

Publication date Collection: December 2023

Publication date (Electronic): 01 October 2023

Volume: 36

Electronic Location Identifier: 102453

Affiliations

[a ]University of New Mexico, School of Public Administration, USA

[b ]University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, USA

[c ]Department of Internal Medicine and University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, USA

[d ]Departments of Pediatrics and Family and Community Medicine and University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, USA

Author notes

[* ]Corresponding author at: MSC05 3100, Albuquerque, NM 87131, USA. nedwardson@ 123456unm.edu

Article

Publisher Item ID: S2211-3355(23)00344-3 Publisher ID: 102453

DOI: 10.1016/j.pmedr.2023.102453

PMC ID: 10568296

PubMed ID: 37840594

SO-VID: 3ba9eed2-6a55-4df1-9fad-87698d41f5ba

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 27 July 2023

Date revision received : 22 September 2023

Date accepted : 29 September 2023

Preferences for CPSTF-Recommended Intervention Approaches for Increasing Cancer Screening Among Screen-Eligible Adults in Zuni Pueblo, USA

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Most cited references 7

Statistical analysis of correlated data using generalized estimating equations: an orientation.

Testing a culturally appropriate, theory-based intervention to improve colorectal cancer screening among Native Hawaiians.

A trial of 3 interventions to promote colorectal cancer screening in African Americans.

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