A community-engaged intervention to increase colorectal cancer screening in communities with suboptimal screening

Colorectal cancer (CRC) remains a leading cause of cancer-related death in the United States, with early detection and timely screening critical to improving outcomes. Screening enables the identification and removal of precancerous polyps, directly reducing incidence and mortality. Yet, participation in CRC screening remains suboptimal in some communities, particularly among those who encounter informational, linguistic, or logistical challenges. National survey data indicate that screening rates among populations with limited health literacy and low engagement in preventive care lag behind those of the general population, underscoring a need for tailored strategies that address common patient-reported challenges, such as difficulty understanding medical instructions or navigating appointment systems. To address these gaps, this project proposes to develop and pilot Colorectal Cancer Education and Navigation (CLEAN), an intervention designed to enhance uptake of CRC screening among populations with limited capacity to engage with health information. The CLEAN program incorporates narrative education and patient navigation, both of which have demonstrated promise in improving cancer screening rates. CLEAN will be adapted from Witness CARES, an evidence-based group education model, and further enhanced through structured navigation support to guide patients through the screening process. The aims of this study are to: (1) Adapt and refine CLEAN to be appropriate for individuals with limited familiarity with CRC screening guidelines; and (2) Pilot test the feasibility, acceptability, and preliminary efficacy of CLEAN in supporting screening uptake. This approach emphasizes patient-centered communication strategies and practical navigation tools to promote adherence to recommended cancer prevention guidelines. The proposed research will also support the investigator’s long-term goal of developing and evaluating behavioral interventions to promote early detection and prevention of cancer. The project will be complemented by a comprehensive training plan focused on implementation research and randomized controlled trial methodology. Guided by a highly experienced mentoring team, activities will include mentored research, formal coursework, manuscript preparation, and scientific dissemination. Over the award period, the investigator will publish peer-reviewed manuscripts, present findings at national conferences, and build a research program focused on optimizing preventive cancer care through innovative communication and navigation strategies. This multimodal training plan will provide Dr. Vang with the comprehensive skills needed to achieve her research aims and professional goal of becoming an independent behavioral health researcher.