Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center

Jamie H. Thompson; Melinda M. Davis; LeAnn Michaels; Jennifer S. Rivelli; Melissa L. Castillo; Brittany M. Younger; Marta Castro; Sacha L. Reich; Gloria D. Coronado

doi:10.3122/jabfm.2019.03.180026

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Figure 1.
Boot camp translation overview. FIT, fecal immunochemical test.
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Figure 2.
Participant worksheet for timing and mode of reminders. FIT, fecal immunochemical test.
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Figure 3.
Introduction letter enhancements.

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Table 1.

Characteristics of English and Spanish Language Boot Camp Translation Participants, May 12 to 13, 2017^*

	English-Language Session	Spanish-Language Session
Number of participants (in-person meeting)^†	12	13
Number of patients	10	11
Number of clinic staff	2	2
Boot Camp Translation patients only
Age (years), mean	57.1	56.6
Female, %	60	91
Latino, %	80	100
Medicaid, %	80	36
Uninsured, %	0	36
Annual household income less than $20,000, %	50	82
Less than high school education, %	20	73
Born outside of the United States, %	20	100
Sometimes/often/always need help to read materials from their doctor or pharmacy, %	40	82
Use cell phone to send or receive texts, %	60	82
Use cell phone to send or receive emails, %	40	18

↵* We did not test for statistical significance given the small sample size of the two groups.
↵† This participant characteristics table does not include the Advisory Board members who observed the English- and Spanish-language sessions.

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Table 2.

PROMPT Boot Camp Translation Themes and Participant Quotes

Themes	Quotes
Increase patient awareness about colon cancer and prevention	“People need to know that you can prevent colon cancer.”
	“Yo no sabía de esta prueba, que bueno, podemos decirle a las amistades y familias.” [I did not know about this test, great, we can tell friends and families.]
	“Yo no tenía conocimiento de esto, yo decía esto es para viejitos pero ahora sé que no hay edad.” [I had no knowledge of this, I thought this was for old people but now I know there is no age.]
	“Yo no sabía, que cumpliendo los 50 años que se tenía que hacer esta prueba.” [I did not know that when I turned 50, I had to do this test.]
	“En general nosotros los Latinos vamos al médico para que nos curen y no para prevenir.” [In general, we Latinos go to the doctor to be cured and not to prevent.]
Stress importance of screening	“If you want me to do it, call me next week. If you wait until 4 weeks, I'll have already thrown it away!”
Stress importance of screening	“It's important to get tested, so just get it done.”
Emphasize family as a motivator for screening	“Talking about families is important and a good motivator.”
Emphasize family as a motivator for screening	“Do it for your children and grandchildren.”
Use personalized messages	“I want to get a letter from the doctor.”
Use personalized messages	“I like the personal connection. Treat me like a human being.”
Encourage medical staff to use clear and simple terms when introducing colon cancer screening	“El medico nos dice pero en términos médicos y no entendemos- yo no sabía lo que era.” [The doctor tells us but in medical terms and we do not understand—I did not know what it was.]
	“Varias veces me han mandado esta prueba y no la he hecho, pero ahora si.” [Several times I have been sent this test and I have not done it, but now I will.]