We successfully implemented a population-based, culturally adapted intervention to address low colorectal cancer screening completion in a US-Mexico border county and were successful at achieving increased screening rates in an underserved area.

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Colorectal Cancer (CRC) is the third most common cancer and the second cause of cancer-related deaths of men and women in the US. Screening through stool tests or colonoscopy can significantly reduce cases. Unfortunately, screening rates in a US-Mexico border county at the time of program implementation was about 57%, which is lower than the national target set at 80%. In El Paso County, Texas, we implemented and evaluated a community-based CRC screening program from 2012-2015 that was designed to increase screening within a predominantly Hispanic, US-Mexico border population. The Against Colorectal Cancer In Our Neighborhoods (ACCION) Program, funded by the Cancer Prevention and Research Institute, was a community-based, multicomponent, CRC program that provided health education, navigation, and no-cost screening and diagnostic testing to men and women 50 to 75 years old who were uninsured or underinsured and due for CRC screening.

In “Implementation and Evaluation of a Large Community-based Colorectal Cancer Screening Program,” we describe all the components of our program. We developed health educational materials, including a flipchart presentation and narrative educational video, both in English and Spanish, that was delivered to community members by a community health worker; we had a patient navigator on staff who reminded participants to complete their screening and assisted in scheduling any follow-up testing necessary; we created a program database to collect all participant demographics, beliefs, and attitudes throughout the program; and we provided navigation assistance to individuals diagnosed with CRC.

Summary of Findings

• We recruited and educated 9,421 individuals.
• More than 93% of participants found the health education sessions to be satisfactory and helpful.
• The community health workers were successful at building rapport with over 170 community-based recruitment sites and were found to be relatable to participants.
• We had a fecal immunochemical test (FIT) completion rate of 77.8% and colonoscopy completion rate of 74.6%, which was a significant increase from the screening rates at the time in El Paso County, Texas.

The community-based CRC program was successful at increasing screening rates among Hispanic population who were uninsured, underinsured and not up to date with screening. The use of community health workers was instrumental in providing culturally tailored education. Lastly, since 2015 there has been continuous funding to continue the program in the El Paso County and expand to West and South Texas.

To learn about our program and its components, read “Implementation and Evaluation of a Large Community-Based Colorectal Cancer Screening Program” in the May 2024 issue of the Journal and Public Health Management and Practice.

Funding for this colorectal cancer prevention program was provided by Cancer Prevention and Research Institute of Texas (CPRIT).

Acknowledgement of Co-Authors:

Navkiran Shokar, MD, MPH, is Professor and Chair of the Department of Population Health and Lead for the Cancer Prevention and Control Program at the University of Texas at Austin Dell Medical School. She was the Program Director for the ACCION program.

Rebekah Salaiz, MS, was the original program coordinator for the ACCION program.

Marc Zuckerman, MD, and Nancy Casner, MS, CCRC were integral partners with the endoscopy center.

Theresa Byrd, DrPH, MPH, RN, Gurjeet Shokar, MD, and Alok Dwivedi, PhD, were research partners who assisted with the development and evaluation of program materials and manuscripts.

Jessica Calderón-Mora, DrPH, MPH, is an Assistant Professor in the Department of Population Health and Operational Director for the Cancer Prevention and Control Program at the University of Texas at Austin Dell Medical School. She has 20 years of experience in cancer prevention among the Latino population.