Results of a lay health education intervention to increase colorectal cancer screening among Filipino Americans: A cluster randomized controlled trial

BACKGROUNDFilipino colorectal cancer (CRC) screening rates fall below Healthy People 2020 goals. In this study, the authors explore whether a lay health educator (LHE) approach can increase CRC screening among Filipino Americans ages 50 to 75 years in Hawaii. METHODSA cluster randomized controlled trial from 2012 through 2015 compared an intervention, which consisted of LHEs delivering 2 education sessions and 2 telephone follow-up calls on CRC screening plus a CRC brochure versus an attention control, in which 2 lectures and 2 follow-up calls on nutrition and physical activity plus a CRC brochure were provided. The primary outcome was change in self-reported ever receipt of CRC screening at 6 months. RESULTSAmong 304 participants (77% women, 86% had>10 years of residence in the United States), the proportion of participants who reported ever having received CRC screening increased significantly in the intervention group (from 80% to 89%; P=.0003), but not in the control group (from 73% to 74%; P=.60). After covariate adjustment, there was a significant intervention effect (odds ratio, 1.9; 95% confidence interval, 1.0-3.5). There was no intervention effect on up-to-date screening. CONCLUSIONSThis first randomized controlled trial for CRC screening among Hawaii's Filipinos used an LHE intervention with mixed, but promising, results. Cancer 2018;124:1535-42. (c) 2018 American Cancer Society. Although the uneven cancer burden of Asian Americans has been documented, little is known about colorectal cancer screening practices among Filipinos. To the authors' knowledge, this is the first ever randomized controlled trial of a community-based intervention with Filipino Americans in Hawaii to determine whether a lay health educator approach might increase colorectal cancer screening.