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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Blumenthal
Daniel S
DS
Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, USA. dblumenthal@msm.edu
Smith
Selina A
SA
Majett
Charlye D
CD
Alema-Mensah
Ernest
E
D001741:Black or African American; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000208:ethnology*; D003266:Continuity of Patient Care; D055088:Early Detection of Cancer; D005260:Female; D005381:Financing, Organized; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic