title: Against Colorectal Cancer in Our Neighborhoods, a Community-Based Colorectal Cancer Screening Program Targeting Low-Income Hispanics: Program Development and Costs.
abstract: BACKGROUND
  Colorectal cancer is the second leading cause of cancer-related death in the United States. Despite universal screening recommendations, screening rates in the United States remain suboptimal, especially among the poor, the uninsured, recent immigrants, and Hispanics. This article describes the development of a large community-based colorectal cancer screening program designed to address these disparities.
  
  
  METHODS
  The Against Colorectal Cancer in our Neighborhoods program is a bilingual, evidence-based, theory-guided, multicomponent community screening intervention, targeting the uninsured and developed using a systematic planning process. It combines community health worker-led outreach, bilingual and culturally tailored community education, and no-cost screening with provision of the fecal immunochemical test or colonoscopy and navigation services. A detailed process and outcome evaluation is planned. Program development cost calculated prospectively (in 2011 dollars) using a societal perspective and micro-costing methods was $243,278, of which $180,344 was direct cost.
  
  
  CONCLUSIONS
  The detailed description of the development processes and costs of this health promotion program targeting low-income Hispanics will inform health program decision makers about the resource requirements for planning and developing new programs to reduce disease burden in communities.
authors.affiliation: Texas Tech University Health Sciences Center, El Paso, TX, USA navkiran.shokar@ttuhsc.edu.
authors.forename: Navkiran K
authors.initials: NK
authors.lastname: Shokar
authors.affiliation: Texas Tech University Health Sciences Center, El Paso, TX, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Byrd
authors.affiliation: University of Texas Health Science Center at Houston, TX, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Lairson
authors.affiliation: Texas Tech University Health Sciences Center, El Paso, TX, USA.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Salaiz
authors.affiliation: University of Texas Health Science Center at Houston, TX, USA.
authors.forename: Junghyun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Texas Tech University Health Sciences Center, El Paso, TX, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Calderon-Mora
authors.affiliation: University of Texas, El Paso, TX, USA.
authors.forename: Norma
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: Texas Tech University Health Sciences Center, El Paso, TX, USA.
authors.forename: Melchor
authors.initials: M
authors.lastname: Ortiz
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D003153:Community Health Services / Q000191:economics / Q000379:methods*; D005243:Feces / Q000737:chemistry; D005260:Female; D015438:Health Behavior; D017048:Health Care Costs; D006266:Health Education / Q000191:economics / Q000379:methods*; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D011203:Poverty; D016730:Program Development / Q000191:economics; D015397:Program Evaluation; D013781:Texas
keywords: Latino race/ethnicity; behavioral theories; cancer prevention and screening; community-based participatory research; health disparities; health promotion; program cost