背景:结直肠癌筛查,包括粪便免疫组织化学测试,是早期发现结直肠癌的有效方法。然而,南亚少数民族对粪便免疫组织化学检测的摄取较低,因为他们对大肠癌筛查的了解有限,并面临障碍。量身定制的教育和适当的消息传递有可能向该人群传达结直肠癌筛查的重要性。
目的:本研究旨在评估基于家庭的多媒体干预的可接受性和有效性,以提高南亚老年人对结直肠癌筛查的认识,并增加对粪便免疫化学试验的吸收。
方法:一项具有等待列表对照组的集群随机对照试验。
方法:在南亚社区中心和非政府组织招募了三百二十个南亚老年人及其年轻家庭成员,为香港六个地区的本地南亚人提供支持服务。
方法:集群随机化过程中二元组的分组分配是基于招募它们的地区的分组分配。干预包括多媒体健康演讲,传达结直肠癌筛查的重要性,以及年轻家庭成员在鼓励年长亲属接受筛查方面的支持。站点协调员协助参与者进行粪便免疫组织化学测试。主要结果是南亚老年人对粪便免疫组织化学测试的摄取增加。次要结果包括年轻的家庭成员鼓励他们的年长亲属接受粪便免疫组织化学测试,以及他们准备协助他们的亲属进行测试。干预的可接受性是通过对干预的满意度来衡量的。
结果:与对照组相比,干预二元组参与粪便免疫组织化学检测的老年人比例明显更高(71.8%vs6.8%,p<0.001)。在干预组中,年轻家庭成员鼓励老年人接受粪便免疫组织化学测试的意愿没有观察到明显的组内变化。他们也不愿意帮助老年人这样做,尽管在对照组中观察到两种结局均下降.大多数参与者(>86%)对干预措施感到满意。
结论:我们的研究结果表明,在南亚老年人中,干预措施在提高粪便免疫组织化学试验摄取方面的可接受性和有效性,以及使用基于家庭的方法对这些个体实施癌症筛查干预措施的益处。建议在南亚社区内实施干预措施,作为日常护理的一部分。试验注册ISRCTN72829325,2018年7月10日。
BACKGROUND: Colorectal cancer screening, including faecal immunohistochemical test, is an effective method for detecting colorectal cancer early. Nevertheless, faecal immunohistochemical test uptake among South Asian ethnic minorities is low because they have limited knowledge of and face barriers in accessing colorectal cancer screening. Tailored education and appropriate messaging has potential to convey to this population group the importance of colorectal cancer screening.
OBJECTIVE: This study aimed to assess the acceptability and effectiveness of a family-based multimedia intervention to raise awareness of colorectal cancer screening and increase the uptake of faecal immunochemical tests among South Asian older adults.
METHODS: A cluster-randomised controlled trial with a wait-list control group.
METHODS: Three-hundred and twenty dyads of South Asian older adults and their younger family members were recruited at South Asian community centres and non-governmental organisations providing support services to local South Asians in six Hong Kong districts.
METHODS: Group allocation of dyads during cluster randomisation was based on the group assignment of the district where they were recruited. The intervention comprised a multimedia health talk, conveying the importance of colorectal cancer screening and support from younger family members in encouraging their older relatives to undergo screening. Site coordinators assisted participants in accessing faecal immunohistochemical test. The primary outcome was increased uptake of faecal immunohistochemical test among South Asian older adults. Secondary outcomes included younger family members\' encouragement of their older relatives to undergo faecal immunohistochemical test and their readiness to assist their relatives with the test. Acceptability of the intervention was measured by dyad satisfaction with the intervention.
RESULTS: The proportion of older adults participating in faecal immunohistochemical testing was significantly higher among intervention dyads compared with controls (71.8% vs 6.8%, p < 0.001). No significant within-group change was observed on the willingness of younger family members in the intervention group to encourage older adults to undergo faecal immunohistochemical test, nor their readiness to assist older adults in doing so, although a decrease in both outcomes was observed among the control group. Most participants (>86%) were satisfied with the intervention.
CONCLUSIONS: Our findings demonstrate the acceptability and effectiveness of the intervention in enhancing faecal immunohistochemical test uptake among South Asian older adults, and the benefit of using a family-based approach in the implementation of cancer screening interventions for these individuals. Implementation of the intervention as a component of usual care within South Asian communities is recommended. Trial registration ISRCTN72829325, 10 July 2018.