Abstract
BackgroundColorectal cancer (CRC) screening, such as fecal occult blood test (FOBT), is an effective way to prevent CRC, one of the most common cancers worldwide. However, studies found that South Asian ethnic minorities tend not to utilize CRC screening, whose importance on CRC prevention shall be educated among those from ethnic minorities, especially older adults. The purpose of this study is to develop and implement a family-based, multimedia intervention to augment the knowledge of CRC prevention among older South Asian adults in Hong Kong and enhance their motivation for undergoing FOBT. The acceptability and effectiveness of the intervention will be assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.MethodsA cluster randomized controlled trial will be carried out. Three hundred and twenty South Asian dyads, comprising an older adult aged between 50 and 75 and a younger family member aged between 18 and 49, will be recruited in ten districts in Hong Kong through community organizations that provide support services for South Asians in local communities. Dyads will be randomly allocated to either the intervention or wait-list control group. Intervention dyads will receive intervention, whose contents are based on the health belief model, via multiple forms of media including PowerPoint presentation, video clip and health information booklet. Control dyads will receive intervention after post-intervention data are collected. For dyads in both groups, an appointment with a family doctor will be arranged for those willing to undergo FOBT. Outcomes will be assessed at baseline and post-intervention. Data will be analysed using the Generalised Linear Models Procedure in an intention-to-treat manner.DiscussionFindings of this study will provide evidence of the benefits of utilizing multimedia and family-based approaches in intervention development to enhance the effectiveness of health promotion interventions for ethnic minorities. Further, the findings would provide reference to the potential incorporation of the intervention in the existing support services for South Asian ethnic minorities in local communities.Trial registrationThis trial is registered at the ISRCTN Registry (ISRCTN72829325) on 19th July 2018.
Highlights
Colorectal cancer (CRC) screening, such as fecal occult blood test (FOBT), is an effective way to prevent CRC, one of the most common cancers worldwide
Studies had revealed a number of factors that could contribute to this phenomenon, including lack of knowledge of CRC and its preventive measures, embarrassment, lack of recommendations on physicians and limited access to healthcare [17,18,19,20]. These findings suggest that development and implementation of educational interventions dedicated to enhancing the knowledge of ethnic minorities on CRC prevention, as well as their self-efficacy and motivation to utilize CRC screening would be necessary to increase their uptake of screening
To evaluate whether this intervention is effective in encouraging the uptake of CRC screening and FOBT among older South Asian adults in Hong Kong through the five dimensions in the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework developed by Glasgow et al in 1999 [28]
Summary
Colorectal cancer (CRC) screening, such as fecal occult blood test (FOBT), is an effective way to prevent CRC, one of the most common cancers worldwide. The purpose of this study is to develop and implement a family-based, multimedia intervention to augment the knowledge of CRC prevention among older South Asian adults in Hong Kong and enhance their motivation for undergoing FOBT. The Hong Kong government has launched a pilot scheme to encourage utilization of CRC screening services among individuals aged between 50 and 75, who are encouraged to visit their family doctors for an FOBT. Those with detectable amount of blood in their stool will be asked to undergo colonoscopy examination for further assessment of signs of CRC [8]
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