Adaptation of an evidence-based intervention to promote colorectal cancer screening: a quasi-experimental study

Implementation Science

Roshan Bastani⁷  Vicky Taylor⁵  Mei-Po Yip¹  Alan Kuniyuki³  Yutaka Yasui²  Alan Chun⁶  Shin-Ping Tu⁴ 

[1] Department of Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA;School of Public Health, University of Alberta, 3-27 University Terrace, 8303-112 St, Edmonton T6G 2T4, Alberta, Canada;Department of Epidemiology, University of Washington, 4333 Brooklyn Avenue NE, Seattle WA98195, USA;Department of Health Services, University of Washington, Seattle, WA, USA;Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M3-B232, P.O. Box 19024, Seattle, WA 98109-1024, USA;International Community Health Services, 720 8th Avenue South, Seattle, WA 98104, USA;Department of Health Services, UCLA School of Public Health, 650 Charles Young Dr., A2-125 CHS, Box 956900, Los Angeles, CA 90095, USA

关键词: Evidence-based intervention;    Implementation;    Adaptation;   

Others  :  1146873
DOI  :  10.1186/1748-5908-9-85

 received in 2013-07-12, accepted in 2014-06-23,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Tu et al.; licensee BioMed Central Ltd.

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