Small Media Interventions to Increase Colorectal Cancer Screening Among Chinese Americans (SMILES)

There have been few studies of small media interventions to promote colorectal cancer screening among Chinese Americans. Based on the results of strong preliminary studies on the promotion of colorectal cancer screening among Asian American populations, this community-academic research team propose to develop a culturally and linguistically appropriate traditional small media print brochure and a novel small media electronic audio-visual application accessible through mobile applications and through a website to promote CRC screening in English, Cantonese, and Mandarin. The team will test in a randomized controlled trial in 3 healthcare systems the efficacy of a combination of these small media interventions and a mailed patient reminder compared to usual care on increasing CRC screening among Chinese American patients.

Study Overview

• Status: Completed
• Conditions: Colorectal Cancer; Cancer Screening
• Intervention / Treatment: Behavioral: Small Media

Detailed Description

Chinese Americans are the largest group of Asian Americans, the fastest growing racial population in the U.S. Colorectal cancer is the second most common cancer among Chinese Americans. Screening reduces colorectal cancer mortality and is cost-effective but remains underutilized. Asian Americans and Chinese Americans are less likely than non-Hispanic whites to be screened for colorectal cancer. Factors associated with lack of screening among Asian Americans include recent immigration, lower education, lower English fluency, lack of knowledge, patient-physician language discordance, and lack of physician recommendation.

Although small media and client-reminders are effective in increasing colorectal cancer screening in the general population, no randomized controlled trial has assessed the effect of such interventions on Chinese Americans, particularly those who are limited English proficient. Building on an established community-based participatory research network and strong preliminary studies, the team propose to develop a culturally and linguistically appropriate booklet (small print media) and an audio-visual application accessible through mobile devices and a website (small electronic media) to promote screening. Through an innovative approach that links community organizations that have cultural and linguistic expertise to healthcare systems that have many Chinese American patients, the investigators will test the effect of combining these small media materials and a mailed patient reminder on the rate of screening for colorectal cancer screening among Chinese Americans in this Small Media Interventions for Limited English Speakers (SMILES). The investigators have developed English and Chinese (Cantonese and Mandarin) small print and electronic media materials to promote colorectal cancer screening among Chinese Americans. This RCT will compare the efficacy of a combination of mailed patient reminder and small print and electronic media versus usual care among Chinese American patients who are not up-to-date for colorectal cancer screening recruited from 3 healthcare systems in a randomized controlled trial.

• Study Type: Interventional
• Enrollment (Actual): 1707
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • San Francisco, California, United States, 94143
      • University of California San Francisco

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Not up-to-date for colorectal cancer screening; self-identified as Chinese or Chinese American, or Asian who speak Chinese, or Asian born in China.

Exclusion Criteria:

• Not eligible for colorectal cancer screening for any reason.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Small Media; Participants receive bilingual brochures and access to bilingual website about colorectal cancer screening.	Behavioral: Small Media; Bilingual brochures and access to bilingual website
No Intervention: Control; Participants receive no information about colorectal cancer screening from the study during the intervention period, but may receive usual care from health care provider.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Colorectal Cancer Screening	Up-to-date receipt of any colorectal cancer screening	9 months

Collaborators and Investigators

• Sponsor: University of California, San Francisco
• Collaborators: Centers for Disease Control and Prevention; NICOS Chinese Health Coalition; Chinese Community Health Resource Center; Northeast Medical Services; Chinese Hospital Clinics

Study record dates

Study Major Dates

• Study Start (Actual): August 15, 2017
• Primary Completion (Actual): October 30, 2018
• Study Completion (Actual): September 30, 2019

Study Registration Dates

• First Submitted: May 30, 2017
• First Submitted That Met QC Criteria: May 30, 2017
• First Posted (Actual): June 2, 2017

Study Record Updates

• Last Update Posted (Actual): February 11, 2020
• Last Update Submitted That Met QC Criteria: February 7, 2020
• Last Verified: February 1, 2020

More Information

Terms related to this study

• Keywords: Colorectal cancer screening; Asian American; Chinese American; Print materials
• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colorectal Neoplasms
• Other Study ID Numbers: 174519; 3U48DP004998-03S6 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No