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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Understanding the impact of colorectal cancer education: a randomized trial of health fairs

Authors: Katherine J. Briant, Lei Wang, Sarah Holte, Adriana Ramos, Nathan Marchello, Beti Thompson

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Regular screening for colorectal cancer (CRC) reduces morbidity and mortality from this disease. A number of factors play a role in the underutilization of CRC screening; populations with the lowest CRC screening rates are least likely to be aware of the need for screening or have knowledge about screening options. The overall purpose of this project was to assess two methods for increasing knowledge about CRC in a health fair context: one, by using a health educator to provide CRC information at a table, or two, to provide a tour through a giant inflatable, walk-through colon model with physical depictions of healthy tissue, polyps, and CRC.

Methods

We participated in six community health fair events, three were randomized to incorporate the use of the inflatable colon, and three used a standard display table method. We used a pre/post-design to look for changes in knowledge about CRC before and after participating in a health fair. We examined descriptive statistics of participants using frequencies and proportions. McNemar’s test for paired binary data was used to test whether there were significant differences in the distribution of correct answer percentage from pre to post and from pre to follow up. Linear regression (GEE) was used to investigate whether there was a significant difference in the change from pre- to post-intervention in the percentage of correct answers on knowledge of tests available to detect CRC and awareness of risk factors for CRC between participants at sites with the inflatable colon compared to participants at sites without the inflatable colon.

Results

Participants (n = 273) were recruited at the six health fairs. Participants in health fairs with the inflatable colon had higher knowledge at post-test than participants in health fairs with tabling activities, that is, without the inflatable colon; however, the difference was not significant. One month follow-up after each health fair showed virtually no recollection of information learned at the health fairs.

Conclusions

The use of an inflatable colon may be an innovative way to help people learn about CRC and CRC screening; however, it is not significantly more effective than conventional table display methods. Further research is needed to associate intention to obtain screening after touring the inflatable colon with actual screening. Future research could explore ways to better retain knowledge at long-term follow-up.
Literature
1.
go back to reference Qaseem A, Denberg TD, Hopkins JRH, Humphrey LL, Levine J, Sweet DE, et al. Screening for Colorectal Cancer: A Guidance Statement From the American College of Physicians. Ann Intern Med. 2012;156(5):378–86.CrossRefPubMed Qaseem A, Denberg TD, Hopkins JRH, Humphrey LL, Levine J, Sweet DE, et al. Screening for Colorectal Cancer: A Guidance Statement From the American College of Physicians. Ann Intern Med. 2012;156(5):378–86.CrossRefPubMed
2.
go back to reference Smith RA, Brooks D, Cokkinides V, Saslow D, Brawley OW. Cancer screening in the United States, 2013. CA Cancer J Clin. 2013;63(2):87–105.CrossRef Smith RA, Brooks D, Cokkinides V, Saslow D, Brawley OW. Cancer screening in the United States, 2013. CA Cancer J Clin. 2013;63(2):87–105.CrossRef
3.
go back to reference Steele CB, Rim SH, Joseph DA, King JB, Seeff LC, Centers for Disease C. Prevention: Colorectal cancer incidence and screening - United States, 2008 and 2010. MMWR Surveill Summ(Washington, DC : 2002). 2013;62 Suppl 3:53–60. Steele CB, Rim SH, Joseph DA, King JB, Seeff LC, Centers for Disease C. Prevention: Colorectal cancer incidence and screening - United States, 2008 and 2010. MMWR Surveill Summ(Washington, DC : 2002). 2013;62 Suppl 3:53–60.
4.
go back to reference Beydoun HA, Beydoun MA. Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States. Cancer Causes Control. 2008;19(4):339–59.CrossRefPubMed Beydoun HA, Beydoun MA. Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States. Cancer Causes Control. 2008;19(4):339–59.CrossRefPubMed
5.
go back to reference Gimeno Garcia AZ, Hernandez Alvarez Buylla N, Nicolas-Perez D, Quintero E. Public awareness of colorectal cancer screening: knowledge, attitudes, and interventions for increasing screening uptake. ISRN oncology. 2014;2014:425787.CrossRefPubMedPubMedCentral Gimeno Garcia AZ, Hernandez Alvarez Buylla N, Nicolas-Perez D, Quintero E. Public awareness of colorectal cancer screening: knowledge, attitudes, and interventions for increasing screening uptake. ISRN oncology. 2014;2014:425787.CrossRefPubMedPubMedCentral
6.
go back to reference Holden DJ, Jonas DE, Porterfield DS, Reuland D, Harris R. Systematic review: enhancing the use and quality of colorectal cancer screening. Ann Intern Med. 2010;152(10):668–76.CrossRefPubMed Holden DJ, Jonas DE, Porterfield DS, Reuland D, Harris R. Systematic review: enhancing the use and quality of colorectal cancer screening. Ann Intern Med. 2010;152(10):668–76.CrossRefPubMed
7.
go back to reference Hastert TA, Beresford SAA, Sheppard L, White E. Disparities in cancer incidence and mortality by area-level socioeconomic status: a multilevel analysis. J Epidemiol Community Health. 2014. Hastert TA, Beresford SAA, Sheppard L, White E. Disparities in cancer incidence and mortality by area-level socioeconomic status: a multilevel analysis. J Epidemiol Community Health. 2014.
8.
go back to reference Dillon DL, Sternas K. Designing a Successful Health Fair to Promote Individual, Family, and Community Health. J Community Health Nurs. 1997;14(1):1–14.CrossRefPubMed Dillon DL, Sternas K. Designing a Successful Health Fair to Promote Individual, Family, and Community Health. J Community Health Nurs. 1997;14(1):1–14.CrossRefPubMed
9.
go back to reference Berwick DM. Screening in health fairs: A critical review of benefits, risks, and costs. Jama. 1985;254(11):1492–8.CrossRefPubMed Berwick DM. Screening in health fairs: A critical review of benefits, risks, and costs. Jama. 1985;254(11):1492–8.CrossRefPubMed
10.
go back to reference Heath JM, Lucic KS, Hollifield D, Kues JR. The health beliefs of health fair participants. J Community Health. 1991;16(4):197–203.CrossRefPubMed Heath JM, Lucic KS, Hollifield D, Kues JR. The health beliefs of health fair participants. J Community Health. 1991;16(4):197–203.CrossRefPubMed
11.
go back to reference Dulin MK, Olive KE, Florence JA, Sliger C. The financial value of services provided by a rural community health fair. J Health Care Poor Underserved. 2006;17(4):821–9.CrossRefPubMed Dulin MK, Olive KE, Florence JA, Sliger C. The financial value of services provided by a rural community health fair. J Health Care Poor Underserved. 2006;17(4):821–9.CrossRefPubMed
13.
go back to reference Hecker EJ. Feria de Salud: Implementation and Evaluation of a Communitywide Health Fair. Public Health Nurs. 2000;17(4):247–56.CrossRefPubMed Hecker EJ. Feria de Salud: Implementation and Evaluation of a Communitywide Health Fair. Public Health Nurs. 2000;17(4):247–56.CrossRefPubMed
14.
go back to reference Rydholm L, Kirkhorn SR. A study of the impact and efficacy of health fairs for farmers. J Agric Saf Health. 2005;11(4):441–8.CrossRefPubMed Rydholm L, Kirkhorn SR. A study of the impact and efficacy of health fairs for farmers. J Agric Saf Health. 2005;11(4):441–8.CrossRefPubMed
15.
go back to reference Diwan S, Perdue M, Lee SE, Grossman BR: Health Promotion Practice and Interprofessional Education in Aging: Senior Wellness Fairs. Gerontology & Geriatrics Education 2015:1–22. Diwan S, Perdue M, Lee SE, Grossman BR: Health Promotion Practice and Interprofessional Education in Aging: Senior Wellness Fairs. Gerontology & Geriatrics Education 2015:1–22.
16.
go back to reference Briant KJ, Espinoza N, Galvan A, Carosso E, Marchello N, Linde S, Copeland W, Thompson B: An Innovative Strategy to Reach the Underserved for Colorectal Cancer Screening. Journal of cancer education : the official journal of the American Association for Cancer Education 2014. Briant KJ, Espinoza N, Galvan A, Carosso E, Marchello N, Linde S, Copeland W, Thompson B: An Innovative Strategy to Reach the Underserved for Colorectal Cancer Screening. Journal of cancer education : the official journal of the American Association for Cancer Education 2014.
17.
go back to reference Redwood D, Provost E, Asay E, Ferguson J, Muller J. Giant inflatable colon and community knowledge, intention, and social support for colorectal cancer screening. Prev Chronic Dis. 2013;10:E40.CrossRefPubMedPubMedCentral Redwood D, Provost E, Asay E, Ferguson J, Muller J. Giant inflatable colon and community knowledge, intention, and social support for colorectal cancer screening. Prev Chronic Dis. 2013;10:E40.CrossRefPubMedPubMedCentral
18.
go back to reference Sanchez JI, Palacios R, Cole A, O'Connell MA. Evaluation of the walk-through inflatable colon as a colorectal cancer education tool: results from a pre and post research design. BMC Cancer. 2014;14:626.CrossRefPubMedPubMedCentral Sanchez JI, Palacios R, Cole A, O'Connell MA. Evaluation of the walk-through inflatable colon as a colorectal cancer education tool: results from a pre and post research design. BMC Cancer. 2014;14:626.CrossRefPubMedPubMedCentral
20.
go back to reference Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.CrossRefPubMed Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.CrossRefPubMed
21.
go back to reference Houts PS, Doak CC, Doak LG, Loscalzo MJ. The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Couns. 2006;61(2):173–90.CrossRefPubMed Houts PS, Doak CC, Doak LG, Loscalzo MJ. The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Couns. 2006;61(2):173–90.CrossRefPubMed
22.
go back to reference Hassinger JP, Holubar SD, Pendlimari R, Dozois EJ, Larson DW, Cima RR. Effectiveness of a multimedia-based educational intervention for improving colon cancer literacy in screening colonoscopy patients. Dis Colon Rectum. 2010;53(9):1301–7.CrossRefPubMed Hassinger JP, Holubar SD, Pendlimari R, Dozois EJ, Larson DW, Cima RR. Effectiveness of a multimedia-based educational intervention for improving colon cancer literacy in screening colonoscopy patients. Dis Colon Rectum. 2010;53(9):1301–7.CrossRefPubMed
23.
go back to reference Levy BT, Daly JM, Xu Y, Ely JW. Mailed fecal immunochemical tests plus educational materials to improve colon cancer screening rates in Iowa Research Network (IRENE) practices. J Am Board Fam Med. 2012;25(1):73–82.CrossRefPubMed Levy BT, Daly JM, Xu Y, Ely JW. Mailed fecal immunochemical tests plus educational materials to improve colon cancer screening rates in Iowa Research Network (IRENE) practices. J Am Board Fam Med. 2012;25(1):73–82.CrossRefPubMed
24.
go back to reference Meade CD, McKinney WP, Barnas GP. Educating patients with limited literacy skills: the effectiveness of printed and videotaped materials about colon cancer. Am J Public Health. 1994;84(1):119–21.CrossRefPubMedPubMedCentral Meade CD, McKinney WP, Barnas GP. Educating patients with limited literacy skills: the effectiveness of printed and videotaped materials about colon cancer. Am J Public Health. 1994;84(1):119–21.CrossRefPubMedPubMedCentral
25.
go back to reference Cooper CP, Gelb CA, Hawkins NA. How many “Get Screened” messages does it take? Evidence from colorectal cancer screening promotion in the United States, 2012. Prev Med. 2014;60:27–32.CrossRefPubMed Cooper CP, Gelb CA, Hawkins NA. How many “Get Screened” messages does it take? Evidence from colorectal cancer screening promotion in the United States, 2012. Prev Med. 2014;60:27–32.CrossRefPubMed
26.
27.
go back to reference Seo DC. Lessons learned from a black and minority health fair's 15-month follow-up counseling. J Natl Med Assoc. 2011;103(9–10):897–906.CrossRefPubMed Seo DC. Lessons learned from a black and minority health fair's 15-month follow-up counseling. J Natl Med Assoc. 2011;103(9–10):897–906.CrossRefPubMed
28.
go back to reference Wilson EA, Wolf MS, Curtis LM, Clayman ML, Cameron KA, Eigen KV, et al. Literacy, cognitive ability, and the retention of health-related information about colorectal cancer screening. J Health Commun. 2010;15 Suppl 2:116–25.CrossRefPubMed Wilson EA, Wolf MS, Curtis LM, Clayman ML, Cameron KA, Eigen KV, et al. Literacy, cognitive ability, and the retention of health-related information about colorectal cancer screening. J Health Commun. 2010;15 Suppl 2:116–25.CrossRefPubMed
29.
go back to reference McAlearney AS, Reeves KW, Dickinson SL, Kelly KM, Tatum C, Katz ML, et al. Racial differences in colorectal cancer screening practices and knowledge within a low-income population. Cancer. 2008;112(2):391–8.CrossRefPubMedPubMedCentral McAlearney AS, Reeves KW, Dickinson SL, Kelly KM, Tatum C, Katz ML, et al. Racial differences in colorectal cancer screening practices and knowledge within a low-income population. Cancer. 2008;112(2):391–8.CrossRefPubMedPubMedCentral
30.
go back to reference Gansler T, Henley SJ, Stein K, Nehl EJ, Smigal C, Slaughter E. Sociodemographic determinants of cancer treatment health literacy. Cancer. 2005;104(3):653–60.CrossRefPubMed Gansler T, Henley SJ, Stein K, Nehl EJ, Smigal C, Slaughter E. Sociodemographic determinants of cancer treatment health literacy. Cancer. 2005;104(3):653–60.CrossRefPubMed
31.
go back to reference Stein K, Zhao L, Crammer C, Gansler T. Prevalence and sociodemographic correlates of beliefs regarding cancer risks. Cancer. 2007;110(5):1139–48.CrossRefPubMed Stein K, Zhao L, Crammer C, Gansler T. Prevalence and sociodemographic correlates of beliefs regarding cancer risks. Cancer. 2007;110(5):1139–48.CrossRefPubMed
32.
go back to reference Wilkinson AV, Vasudevan V, Honn SE, Spitz MR, Chamberlain RM. Sociodemographic characteristics, health beliefs, and the accuracy of cancer knowledge. J Cancer Educ. 2009;24(1):58–64.CrossRefPubMedPubMedCentral Wilkinson AV, Vasudevan V, Honn SE, Spitz MR, Chamberlain RM. Sociodemographic characteristics, health beliefs, and the accuracy of cancer knowledge. J Cancer Educ. 2009;24(1):58–64.CrossRefPubMedPubMedCentral
33.
go back to reference Stacy R, Torrence W, Mitchell C. Perceptions of knowledge, beliefs, and barriers to colorectal cancer screening. J Cancer Educ. 2008;23(4):238–40.CrossRefPubMed Stacy R, Torrence W, Mitchell C. Perceptions of knowledge, beliefs, and barriers to colorectal cancer screening. J Cancer Educ. 2008;23(4):238–40.CrossRefPubMed
34.
go back to reference Gonzalez SA, Ziebarth TH, Wang J, Noor AB, Springer DL. Interventions promoting colorectal cancer screening in the Hispanic population: a review of the literature. J Nurs Scholarsh. 2012;44(4):332–40.CrossRefPubMed Gonzalez SA, Ziebarth TH, Wang J, Noor AB, Springer DL. Interventions promoting colorectal cancer screening in the Hispanic population: a review of the literature. J Nurs Scholarsh. 2012;44(4):332–40.CrossRefPubMed
35.
go back to reference Jandorf L, Ellison J, Villagra C, Winkel G, Varela A, Quintero-Canetti Z, et al. Understanding the barriers and facilitators of colorectal cancer screening among low income immigrant hispanics. J Immigr Minor Health. 2010;12(4):462–9.CrossRefPubMedPubMedCentral Jandorf L, Ellison J, Villagra C, Winkel G, Varela A, Quintero-Canetti Z, et al. Understanding the barriers and facilitators of colorectal cancer screening among low income immigrant hispanics. J Immigr Minor Health. 2010;12(4):462–9.CrossRefPubMedPubMedCentral
36.
go back to reference Moralez EA, Rao SP, Livaudais JC, Thompson B. Improving knowledge and screening for colorectal cancer among Hispanics: overcoming barriers through a PROMOTORA-led home-based educational intervention. J Cancer Educ. 2012;27(3):533–9.CrossRefPubMed Moralez EA, Rao SP, Livaudais JC, Thompson B. Improving knowledge and screening for colorectal cancer among Hispanics: overcoming barriers through a PROMOTORA-led home-based educational intervention. J Cancer Educ. 2012;27(3):533–9.CrossRefPubMed
37.
go back to reference Wang J, Moehring J, Stuhr S, Krug M. Barriers to colorectal cancer screening in Hispanics in the United States: an integrative review. Appl Nurs Res. 2013;26(4):218–24.CrossRefPubMed Wang J, Moehring J, Stuhr S, Krug M. Barriers to colorectal cancer screening in Hispanics in the United States: an integrative review. Appl Nurs Res. 2013;26(4):218–24.CrossRefPubMed
Metadata
Title
Understanding the impact of colorectal cancer education: a randomized trial of health fairs
Authors
Katherine J. Briant
Lei Wang
Sarah Holte
Adriana Ramos
Nathan Marchello
Beti Thompson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2499-2

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