Table 3.

Eleven Interventions to Increase African American Colorectal Cancer Screening

CRC screening Intervention name	Date and Place of intervention	Which minorities were targeted?	Was the intervention evaluated/successful in increasing minority CRC screening?	Citation
1.Wellness for African Americans through Churches (WATCH)	2000, five rural eastern North Carolina counties	African American adults	TPV intervention achieved a 15% increase in fecal occult blood testing screening. Those who spoke with a lay health advisor were significantly more likely to get a non-invasive screening test. Among those 50 years and older who received the newsletter/video intervention, there was an increase in colorectal cancer screening.	Campbell, M.K., James, A., Hudson MA,& et al.(2004). Improving multiple behaviors for colorectal cancer prevention among African American church members. Health Psychol,23(5):492–502
2.Provider Education Intervention to Improve Colorectal Cancer Screening Rates among African American Patients	Prior to 2007, Washington D.C.	Health care providers and their African American patients aged 50 and older	There was no statistical difference in the rates at which rectal exams and fecal occult blood tests were conducted before and after the intervention. There was a statistically significant increase in the performance of endoscopic assessments performed from 26.7% pre-intervention to 59.1% post- intervention.	Friedman, M., and Borum, M.L. (2007). Colorectal cancer screening of African Americans by internal medicine resident physicians can be improved with focused educational efforts. J Natl Med Assoc., 99(9):1010–1012.
3.A Tailored Telephone Outreach Program to Increase Screening in Urban African Americans	2000–2003, New York City Metropolitan Area	African Americans 52 years and older	CRC screening was documented in 61 of 226 (27.0%) intervention participants and in 14 of 230 (6.1%) controls (prevalence rate difference=20.9%; 95% CI = 14.34, 27.46). Compared with the control group, the intervention group was 4.4 times more likely to receive CRC screening within 6 months of randomization.	Basch, C.E., Wolf, R.L., Brouse, C.H., et al. (2006). Telephone outreach to increase colorectal cancer screening in an urban minority population. Am J Public Health, 96(12):2246–2253.
4.Continuous Quality Improvement in Federally Qualified Health Centers	January2000– January2005, Chicago, IL	Lower income African-American and Hispanic patients over 50 years old	At 1-year follow-up, rates of screening completion had increased from 11.5% to 27.9 percent (p< .001), and physician recommendation had increased from 31.6% to 92.9% (p< .001).	Khankari, K., Eder, M., Osborn, C.Y., & et al. (2007). Improving colorectal cancer screening among the medically underserved: a pilot study within a federally qualified health center. J Gen Intern Med,22(10):1410–1414.
5.Increasing Colorectal Cancer Screening in an Urban Public Hospital by Reducing Health System Barriers	May-June 2003, Bronx borough of New York City	African-American and Hispanic adults aged 50 and older	The likelihood of keeping the screening appointment after the patient navigators were hired increased by nearly three-fold and the amount of broken appointments decreased dramatically (67% to 3%). The proportion of uninsured persons and Medicaid-insured persons who received a screening increased significantly. The proportion of screenings that had a patient navigator associated with them increased significantly.	Nash, D., Azeez, S., Vlahov, D., & Schori, M. (2006). Evaluation of an intervention to increase screening colonoscopy in an urban public hospital setting. J Urban Health, 83(2):231–243
6.Increasing Colorectal Cancer Screening in Rural African American Women	Prior to 2004, a rural southeastern state	African American women aged 50 and older	Experimental Full Intervention(s) Group 61% (n = 33) participated in FOBT. Modified Intervention(s) Group 46% (n = 15) participated in FOBT Control Group 15% (n=5) participated in FOBT at 1 year follow up. Participants in the Cultural and Self-Empowerment Group and those with greater knowledge of colorectal cancer were more likely to participate in fecal occult blood testing at the end of the 12-month period.	Powe, B.D., Ntekop, E., & Barron, M. (2004). An intervention study to increase colorectal cancer knowledge and screening among community elders. Public Health Nurs,21(5):435–442.
7. Offering Colorectal Cancer Screening and Education to Uninsured Minorities	July 2001–June 30 2003, Montgomery County, Maryland	Lower income and uninsured African American, Hispanic and Asian adults, aged 50 and older	Over half of the participants who were eligible for invasive screening scheduled appointments. Over half of the total registrants completed some type colorectal cancer screening, and of those, ninety percent were minorities.	Sarfaty, M., and Feng, S. (2006). Choice of screening modality in a colorectal cancer education and screening program for the uninsured. J Cancer Educ,21(1):43–49.
8.Colorectal Cancer Screening Intervention Trial (CCSIT)	January 2003–April 2005. Atlanta GA	African Americans	Among completers, there were significant increases in knowledge in both educational cohorts. By the 6 month follow- up, 17.7% (11/62) of control group members reported having undergone screening, as compared to 33.9% (22/65) of the group education cohort (p = 0.039).	Blumenthal, D., Smith, S., & Alema- Mensah, E. (2010). A Trial of Three Interventions to Promote Colorectal Cancer Screening in African Americans. Cancer,116(4): 922–929.
9.Training African American PCP to perform colonoscopy	October 1999–July 2006, South Carolina	African American patients of trained African American PCPs (study group) vs. untrained PCPs (comparison group)	African American patients in the study group showed a >5-fold increase (8.9% pre training vs 52.8% post-training), with no change among whites (18.2% vs 25.0%).	Xirasagar, S., Thomas, G., Burch, J., & et al. (2011). Colonoscopy screening rates among patients of colonoscopy-trained African American primary care physicians. Cancer,117(22): 5151–5160.
10.A Randomized Controlled Trial of the Impact of Targeted and Tailored Interventions on Colorectal Cancer Screening	2001–2002, Philadelphia PA	Male and female patients of the Jefferson Family Medicine Associates, Serving a substantial African American population (58%)	Screening rates in study groups were 33% in the control group, 46% in the SI group, 44% in the TI group, and 48% in the TIP group. Screening was found to be significantly higher in all 3 intervention groups compared with the control group (odds ratio [OR] of 1.7 [95% confidence interval (95% CI), 1.3–2.5], OR of 1.6 [95% CI, 1.2–2.1], and OR of 1.9 [95% CI, 1.4–2.6], respectively)	Myers, R., Sifri, R., Hyslop, T., & et al. (2007). A randomized controlled trial of the impact of targeted and tailored interventions on colorectal cancer screening. Cancer,110:2083–2091.
11.Prostate, Lung, and Colorectal Cancer Screening Trial	1999–2002, Detroit, Michigan	African American men ≤ 55 years	No statistically significant differences in adherence rates for flexible sigmoidoscopy screening for colorectal cancer.	Ford, M., Havstad, S., Vernon, S., & et al. (2006). Enhancing adherence among older African American men enrolled in a longitudinal cancer screening trial. Gerontologist,46:545–550.