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

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA-IRVINE · 2021 · $412,315

## Abstract

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 test...

## Key facts

- **NIH application ID:** 10374683
- **Project number:** 3R01MD012778-05S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** SUNMIN LEE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $412,315
- **Award type:** 3
- **Project period:** 2017-09-26 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10374683

## Citation

> US National Institutes of Health, RePORTER application 10374683, Culturally Adapted Multilevel Decision Support Navigation Trial to Reduce Colorectal Cancer Disparity among At-Risk Asian American Primary Care Patients (3R01MD012778-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10374683. Licensed CC0.

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