TY - JOUR
T1 - The Effect of a Tailored Educational Flyer on Colorectal Cancer Screening Among Rural Residents
T2 - Lessons Learned from a Pilot Randomized Trial
AU - Kim, Jungyoon
AU - Beseler, Cheryl
AU - Leypoldt, Melissa
AU - Subramanian, Roma
AU - Robinson, Tamara
AU - Funkenbusch, Karen
AU - Foster, Jason M
AU - Harris, Susan
AU - Yoder, Aaron M
AU - Hymel, Emma
AU - Watanabe-Galloway, Shinobu
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/11
Y1 - 2024/11
N2 - Background/Objectives: Stool-based tests, such as the fecal immunochemical test (FIT), have been widely used for increasing colorectal cancer (CRC) screening. Small media, such as printed materials or flyers, are known to be an effective intervention to increase CRC screening by fecal tests. However, more evidence is needed to determine whether such small media are effective in improving screening uptake of a mailed FIT intervention targeted at rural populations in the USA. Methods: In this randomized study, 1230 FIT kits were mailed from July to December 2022 to rural Nebraskans aged 45–74 who were not up to date on CRC screening. Half of the participants (n = 608) also received a tailored, one-page, gender-specific educational flyer created based on focus groups with rural residents. Logistic regression was used to determine predictors of returning the FIT. Results: Study participants were predominantly female (76%), non-Hispanic White (83%), and within the age group of 55–64 (43%). Overall, 192 (15.6%) kits were returned (16.1% from the flyer group; 15.1% from the no-flyer group). However, we found no significant differences between the flyer and no-flyer groups (Adjusted Odds Ratio [AOR]: 1.21; 95% CI: 0.88–1.66). Females (AOR: 1.78; 95% CI: 1.19–6.14) and the oldest (65–74) age group (AOR: 5.03; 95% CI: 2.78–8.47) were more likely to return FIT kits than males and the youngest (45–54) age group. Conclusions: A tailored educational flyer was not effective in improving the CRC-screening-rate-by-mailed-FIT approach for rural populations. Future research should explore the content, timing, and mode of delivery of educational interventions as well as other multi-component strategies to improve screening rates. Public health officials might also consider developing strategies targeted at males and younger (45–54) age groups.
AB - Background/Objectives: Stool-based tests, such as the fecal immunochemical test (FIT), have been widely used for increasing colorectal cancer (CRC) screening. Small media, such as printed materials or flyers, are known to be an effective intervention to increase CRC screening by fecal tests. However, more evidence is needed to determine whether such small media are effective in improving screening uptake of a mailed FIT intervention targeted at rural populations in the USA. Methods: In this randomized study, 1230 FIT kits were mailed from July to December 2022 to rural Nebraskans aged 45–74 who were not up to date on CRC screening. Half of the participants (n = 608) also received a tailored, one-page, gender-specific educational flyer created based on focus groups with rural residents. Logistic regression was used to determine predictors of returning the FIT. Results: Study participants were predominantly female (76%), non-Hispanic White (83%), and within the age group of 55–64 (43%). Overall, 192 (15.6%) kits were returned (16.1% from the flyer group; 15.1% from the no-flyer group). However, we found no significant differences between the flyer and no-flyer groups (Adjusted Odds Ratio [AOR]: 1.21; 95% CI: 0.88–1.66). Females (AOR: 1.78; 95% CI: 1.19–6.14) and the oldest (65–74) age group (AOR: 5.03; 95% CI: 2.78–8.47) were more likely to return FIT kits than males and the youngest (45–54) age group. Conclusions: A tailored educational flyer was not effective in improving the CRC-screening-rate-by-mailed-FIT approach for rural populations. Future research should explore the content, timing, and mode of delivery of educational interventions as well as other multi-component strategies to improve screening rates. Public health officials might also consider developing strategies targeted at males and younger (45–54) age groups.
KW - colorectal cancer
KW - education
KW - FIT
KW - intervention
KW - rural
KW - screening
KW - small media
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U2 - 10.3390/cancers16213645
DO - 10.3390/cancers16213645
M3 - Article
C2 - 39518083
AN - SCOPUS:85208374795
SN - 2072-6694
VL - 16
JO - Cancers
JF - Cancers
IS - 21
M1 - 3645
ER -