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Culturally Adapted Multilevel Decision Support Navigation Trial to Reduce Colorectal Cancer Disparity among At-Risk Asian American Primary Care Patients

Award Number: R01MD012778
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY Cancer is the leading cause of death among Asian Americans, and mortality from colorectal cancer (CRC) is ranked as the second most common in cancer deaths among Asian Americans. However, recent data show that CRC screening rates are substantially lower for Chinese and Korean Americans (CKAs) compared with other racial/ethnic groups. To date, a small number of community-based studies have reported on the use of single level (participant level only) interventions to increase CRC screening rates among CKAs; however, very little is known about the impact of multi-level (patient-oriented and provider-oriented) interventions on CRC screening adherence among CKA patients in primary care setting. Furthermore, our preliminary data indicate physician's recommendation as the strongest facilitator of CRC screening among CKAs. Thus, the primary objective of the study is to address this important knowledge gap by conducting a randomized controlled trial to determine the impact of a multi-level culturally-sensitive decision support intervention on CRC screening adherence among 400 CKA primary care patients. Previous studies found that facilitating patient decision-making through decision support and providing patient navigation can increase CRC screening among diverse primary care patients. We will culturally adapt existing evidence- based decision support navigation intervention (CA-DSNI) and test its efficacy among 200 CKA men and 200 CKA women aged 50 to 75 eligible for CRC screening. We will recruit the participants from primary care physicians (PCPs) clinics. The study is designed to compare CRC screening outcomes between the CA-DSNI and the Advanced Control (AC). Those randomized to the AC will receive an informational booklet, a stool blood test kit and a reminder by mail. Those randomized to the CA-DSNI will receive everything the AC receives. Additionally, we will provide decision support and navigation contacts to participants, develop an individualized screening plan using a theory-based online Decision Counseling Program, share the plan with the participants' PCPs, and have PCPs to encourage the screening to participants. Using outcomes data collected by survey and medical record review, we will: (1) determine overall CRC screening adherence in the CA-DSNI vs. the AC; (2) measure change in CRC screening decision stage in the CA-DSNI vs. the AC; and (3) Assess CRC screening test-specific (stool blood test vs. colonoscopy) adherence in the CA-DSNI vs. the AC. Additionally, we will evaluate intervention reach, effectiveness, adoption, implementation, and maintenance using interview data. IMPACT: This study represents the first instance in which CA-DSNI will be used with CKAs in primary care practice settings to address a significant cancer disparity. With growing need for linguistically and culturally competent care, more decision support, language facilitation, and navigation efforts may come into care settings. Therefore, having tested interventions ready for the target population will be timely, and medical systems may benefit from having multilevel best practices known and tested for CKAs.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	UNIVERSITY OF CALIFORNIA IRVINE	160 ALDRICH HALL	IRVINE	CA	92697	ORANGE	USA	Minority Health and Health Disparities Research	000	6	12/19/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $740,459 )
2022	2022	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	000	6	12/1/2021	NON-COMPETING CONTINUATION	$666,413
2022	2022	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	001	6	4/27/2022	NON-COMPETING CONTINUATION	$74,046
														Subtotal = $740,459

Issue Date FY: 2021 ( Subtotal = $955,353 )
2021	2021	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	001	5	3/15/2021	NON-COMPETING CONTINUATION	$69,543
2021	2021	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	000	5	11/25/2020	NON-COMPETING CONTINUATION	$473,495
2021	2021	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	002	5	4/8/2021	SUPPLEMENT FOR EXPANSION	$412,315
2021	2019	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	004	3	6/1/2021	NON-COMPETING CONTINUATION	$152,384
2021	2019	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	008	4	8/19/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$299,504
2021	2019	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	007	3	8/19/2021	NON-COMPETING CONTINUATION	-$152,384
2021	2019	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	005	4	6/1/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	-$299,321
2021	2018	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	006	2	8/19/2021	NON-COMPETING CONTINUATION	-$147,120
2021	2018	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	003	2	6/1/2021	NON-COMPETING CONTINUATION	$146,937
														Subtotal = $955,353

Issue Date FY: 2020 ( Subtotal = $105,651 )
2020	2019	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	006	4	9/4/2020	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$299,321
2020	2019	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	003	4	6/1/2020	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$105,651
2020	2019	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	002	4	5/19/2020	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2020	2019	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	005	3	9/4/2020	NON-COMPETING CONTINUATION	-$152,384
2020	2019	UNIVERSITY OF CALIFORNIA, IRVINE	141 INNOVATION DR STE 250	IRVINE	CA	92617	ORANGE	USA	Minority Health and Health Disparities Research	001	4	5/13/2020	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$578,623
2020	2019	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	000	3	5/13/2020	NON-COMPETING CONTINUATION	-$578,623
2020	2018	UNIVERSITY OF MARYLAND, COLLEGE PARK	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	004	2	9/4/2020	NON-COMPETING CONTINUATION	-$146,937
														Subtotal = $105,651

Issue Date FY: 2019 ( Subtotal = $731,007 )
2019	2019	UNIVERSITY OF MARYLAND	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	000	3	5/15/2019	NON-COMPETING CONTINUATION	$731,007
														Subtotal = $731,007

Issue Date FY: 2018 ( Subtotal = $741,792 )
2018	2018	UNIVERSITY OF MARYLAND	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	000	2	6/19/2018	NON-COMPETING CONTINUATION	$741,792
														Subtotal = $741,792

Issue Date FY: 2017 ( Subtotal = $764,859 )
2017	2017	UNIVERSITY OF MARYLAND	3112 LEE BLDG 7809 REGENTS DR	COLLEGE PARK	MD	20742	PRINCE GEORGES	USA	Minority Health and Health Disparities Research	000	1	9/26/2017	NEW	$764,859
														Subtotal = $764,859

Grand Total All Awards = $4,039,121

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Culturally Adapted Multilevel Decision Support Navigation Trial to Reduce Colorectal Cancer Disparity among At-Risk Asian American Primary Care Patients

Award Number: R01MD012778

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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