Reducing Colorectal Cancer to Uninsured Latinos
Ann O'Malley, MD, MPH
This project was funded in early 2003 through the Special Populations Network developmental research projects. Latinos, especially if uninsured, have significant potentially avoidable cancer mortality from colorectal cancer, despite lower incidence rates, compared to the white non-Latino population. A portion of this excess mortality is due late-stage detection and to non- or low-use of cancer screening services. La Clinica del Pueblo, Spanish Catholic Center (which has two clinics serving adults), and Arlington Free Clinic are active partners in the Latin American Cancer Research Coalition (SPN-E. Huerta UO1). These organizations serve the primary care needs of uninsured Central Americans in Washington DC, and the metro suburbs of Maryland and Virginia. Findings from a chart review done at these sites revealed that the colorectal cancer screening rates were extremely low (approximately 8% of patients over age 50 years have had an FOBT in the past two years). Initial qualitative work at these sites indicated that increasing FOBT rates is a priority of clinic providers, and a knowledge gap among patients. The purpose of this developmental grant application is to examine patient and provider barriers to the utilization of fecal occult blood tests for colorectal cancer screening among uninsured Latinos seeking services at these safety net primary care sites. Eight focus groups of patients (1 female and 1 male per clinic) and two focus groups of clinical providers (combined from the four sites) will be carried out. A moderator guide will be developed and professional, culturally appropriate bilingual moderators will conduct the focus groups in neutral neighborhood settings. All focus groups will be transcribed verbatim and analyzed according to accepted qualitative analytic techniques. Findings from this qualitative needs assessment will guide a future RO1 intervention targeting regular colorectal cancer screening at these safety net primary care clinics. Such research has the potential to decrease the disproportionate late-stage colorectal cancer burden experienced by the population served by the Latin American Cancer Research Coalition clinics.
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