Thompson 2006.
Methods |
Study design: cluster‐randomized trial Sampling frame: residents of 20 communities in Yakima Valley Sampling method: census data used to over‐sample Hispanic households; every household in small census group was sampled; otherwise households were randomly selected Collection method: cross‐sectional survey, in‐person interviews by trained bilingual project staff Description of the community coalition: Community Advisory Boards were recruited from each of the 10 intervention sites to run projects (content of questionnaires, types of activities that would be done, staff to be hired, types of screening to target, cultural appropriateness of different intervention activities, implementation of activities). CABs consisted of 18 to 24 Hispanic and non‐Hispanic white community members representing a like number of organizations |
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Participants |
Communities: rural agricultural communities in Yakima Valley, Eastern Washington Country: USA Ages included in assessment: adults > 18 years (n = 916), except women > 40 for mammogram (n = 103); adults 50 years or over for colorectal screening (n = 180) Reasons provided for selection of intervention community: increased risk of cancer among Hispanics due to smoking and dietary intake; higher cancer mortality due to screening behaviors Intervention community (population size): 10 Yakima Valley communities (ranging in population from 300 to 7000 each) Comparison community (population size): 10 matched Yakima Valley communities plus 3 Columbia Basin communities (ranging in population from 300 to 7000 each) |
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Interventions |
Name of intervention: Celebremos La Salud Theory: Community Organization Aim: to increase cancer prevention activities including screening behaviors, dietary intake, and smoking cessation among Hispanic and non‐Hispanic residents of Yakima Valley Description of costs and resources: not reported Components of the intervention: comprehensive multi‐level intervention including distribution of informational materials at community events, worksites, and clinics; group education sessions; home “health parties” with project interventionist; wellness van; free or reduced screenings at local clinics; use of trained volunteer “promotoras” to discuss cash incentives for participation Start date: March 2003 Duration: 30 months |
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Outcomes |
Outcomes and measures: cancer screening behaviors; % compliant with screening recommendations (Pap smear, mammogram, fecal occult blood, colonoscopy); dietary intake (fruit and vegetables, fat); smoking (current, ever, never) Time points: baseline and post intervention (timing unclear) |
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Notes | Results stratified by ethnicity, shown for Hispanic only. Separate cohort of 823 individuals > 50 years of age, non‐compliant with colorectal screening at baseline, re‐interviewed at final survey — cohort members in intervention communities no more likely than those in control communities to have ever had or recently had screening Funding source: government |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Method of within‐pair randomization not reported |
Allocation concealment (selection bias) | Unclear risk | Not reported |
Baseline outcome measurement similar | Unclear risk | Not presented, but final rates adjusted for baseline |
Baseline characteristics similar | Low risk | Study authors state: “at baseline, there were no significant differences between communities by treatment arm” |
Blinding of outcome assessment (detection bias) All outcomes | High risk | No blinding |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Independent samples; high response rates |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Not reported |
Protection against contamination | High risk | Some contamination measured |
Selective reporting (reporting bias) | Low risk | Relevant outcomes reported |