This application proposes to utilize the dissemination products developed by the Access to Breast Care (ABC4WT) project to develop a colorectal community outreach program for Fecal Immunochemical Testing for Screening and Treatment of Occult Preneoplasia (FIT-STOP) in the South Plains (COG-2) led by TTUHSC-UMC Cancer Center. Need: The human and economic burden of colorectal cancer (CRC) in West Texas is stark; COG-2 has largely Hispanic population with significantly higher breast cancer incidence and mortality for CRC at 40.3/100,000 people (TX avg. = 37.8/100,000 people), and 16.3/100,000 people (TX avg. = 13.9/100,000 people), respectively. Out 15 counties proposed as target region, 11 hav...

Read More

This application proposes to utilize the dissemination products developed by the Access to Breast Care (ABC4WT) project to develop a colorectal community outreach program for Fecal Immunochemical Testing for Screening and Treatment of Occult Preneoplasia (FIT-STOP) in the South Plains (COG-2) led by TTUHSC-UMC Cancer Center. Need: The human and economic burden of colorectal cancer (CRC) in West Texas is stark; COG-2 has largely Hispanic population with significantly higher breast cancer incidence and mortality for CRC at 40.3/100,000 people (TX avg. = 37.8/100,000 people), and 16.3/100,000 people (TX avg. = 13.9/100,000 people), respectively. Out 15 counties proposed as target region, 11 have a CRC screening rate of < 40% (TX avg. = 60%). The risk factors for screening noncompliance is Hispanic race (43%) and lack of health insurance (28.1%). These statistics result from socioeconomic, educational, cultural and geographical barriers impeding access to healthcare. This is further complicated by lack of healthcare providers in distant counties. COG-2 is one of least covered area by CPRIT prevention grants. FIT-STOP's strategic approach of public-private-community partnerships will utilize the established network from ABC4WT project to target the uninsured/underinsured population of the South Plains for education, awareness, screening and prevention through FIT-STOP. Overall Project Strategy: The strategy of public-private-community partnership has been extremely successful in the past and will be utilized for outreach to target CRC screening as new focus to enhance screening/prevention in COG-2. This model utilizes the evidence-based approaches of "Train the Trainer", culturally sensitive educational materials, community activists, the "precede-proceed" model, and use of "multiple intervention" approach for completion of screening. Specifically, FIT-STOP will target the population of COG-2 via an educational and awareness campaign utilizing traditional and social media. County focused events will target people 45 and older for screening FIT with pre-stamped return envelops. Reminders and follow-up will be ensured through prospective data tracking. All positive tests will be offered colonoscopy and work up. Outreach and resource identification will be available to all income levels, but ethnic minorities and rural communities will be primary targets. The "no cost" services will be provided to uninsured/underinsured population who do not qualify for other indigent care funds. Specific Goal: The overarching goal is to reduce the rate of advanced CRC in COG-2. Measurable interim objectives include (i) Increase the awareness and utilization of FIT screens among target population for primary prevention via detection of pre-cancerous lesions, and secondary prevention via early detection of cancers, (ii) Increase the compliance with follow up colonoscopies and polypectomy in a timely manner. We project to reach over 500,000 people via non-interactive educational and outreach activities; serve 8,000 unique individuals with over 100,000 direct services. Significance and Impact: FIT-STOP project resulted from a highly impactful ABC24WT program using the scaffolding for the public-private-community partnership in addressing healthcare disparities. Since FIT is a sensitive test that allows simple treatment of precancerous polyps, we expect an efficient drop in rate of advanced cancers in COG-2, which will directly translate into increased survival and improvement in quality of life for many families. We expect to replicate the same outcome that was achieved in Panhandle for breast cancer with similar strategy; the mortality of breast cancer dropped from one of the highest to one of the lowest over a decade. This project has resulted from dissemination products from previous funded projects. The proposed expansion is likely to strengthen and expand partnerships and provide much needed access to healthcare in underserved regions of Texas. In addition, translation of dissemination products into a new service line will provide insights for other programs through the state on efficient and effective utility of dissemination products. FIT-STOP will ultimately reduce the human and economic burden of CRC in the target regions by decreasing incidence and mortality. By lowering advanced CRC in the population, FIT-STOP will tackle the economic burden on the state posed by treatment of advanced diseases in uninsured/underinsured population. Since snaring of polyps prevents CRC, and early disease is curable, these people are likely to remain productive members of society. In our experience, people benefiting from such programs have given back to the community through volunteerism and advocacy. Although the aim of FIT-STOP project is to reduce CRC, we anticipate serendipitous advantages from community collaboration strengthening relationships for other projects important to local communities.

Read Less