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
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)
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
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)
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
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