title: Adaptation of an evidence-based intervention to promote colorectal cancer screening: a quasi-experimental study.
abstract: BACKGROUND
  To accelerate the translation of research findings into practice for underserved populations, we investigated the adaptation of an evidence-based intervention (EBI), designed to increase colorectal cancer (CRC) screening in one limited English-proficient (LEP) population (Chinese), for another LEP group (Vietnamese) with overlapping cultural and health beliefs.
  
  
  METHODS
  Guided by Diffusion of Innovations Theory, we adapted the EBI to achieve greater reach. Core elements of the adapted intervention included: small media (a DVD and pamphlet) translated into Vietnamese from Chinese; medical assistants distributing the small media instead of a health educator; and presentations on CRC screening to the medical assistants. A quasi-experimental study examined CRC screening adherence among eligible Vietnamese patients at the intervention and control clinics, before and after the 24-month intervention. The proportion of the adherence was assessed using generalized linear mixed models that account for clustering under primary care providers and also within-patient correlation between baseline and follow up.
  
  
  RESULTS
  Our study included two cross-sectional samples: 1,016 at baseline (604 in the intervention clinic and 412 in the control clinic) and 1,260 post-intervention (746 in the intervention and 514 in the control clinic), including appreciable overlaps between the two time points. Pre-post change in CRC screening over time, expressed as an odds ratio (OR) of CRC screening adherence by time, showed a marginally-significant greater increase in CRC screening adherence at the intervention clinic compared to the control clinic (the ratio of the two ORs=1.42; 95% CI 0.95, 2.15). In the sample of patients who were non-adherent to CRC screening at baseline, compared to the control clinic, the intervention clinic had marginally-significant greater increase in FOBT (adjusted OR=1.77; 95% CI 0.98, 3.18) and a statistically-significantly greater increase in CRC screening adherence (adjusted OR=1.70; 95% CI 1.05, 2.75).
  
  
  CONCLUSIONS
  Theoretically guided adaptations of EBIs may accelerate the translation of research into practice. Adaptation has the potential to mitigate health disparities for hard-to-reach populations in a timely manner.
authors.affiliation: Department of Medicine, Virginia Commonwealth University, 1201 East Marshall Street, Richmond, VA 23298, USA. sptu@vcu.edu.
authors.forename: Shin-Ping
authors.initials: SP
authors.lastname: Tu
authors.forename: Alan
authors.initials: A
authors.lastname: Chun
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Alan
authors.initials: A
authors.lastname: Kuniyuki
authors.forename: Mei-Po
authors.initials: MP
authors.lastname: Yip
authors.forename: Vicky
authors.initials: V
authors.lastname: Taylor
authors.forename: Roshan
authors.initials: R
authors.lastname: Bastani
mesh_terms: D000368:Aged; D002681:China / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D014744:Vietnam / Q000208:ethnology; D014861:Washington / Q000453:epidemiology