P3180 - Lost in Translation No Longer: Preliminary Results From a Mixed Methods Study of an Initiative to Expand Colorectal Cancer Screening at a Free Clinic in Sacramento

Bao Sean Nguyen, MD¹, Christine Shieh, MD², Alex Zhornitskiy, MD³, Felicia Zhornitsky, MPH⁴, Johnny Nguyen, BS⁴, Sujin Jeong, BS⁴, Timothy Do, BS⁴, Ronald Jan, MD⁴, Ronald Hsu, MD^4
1UC Davis Medical Center, Sacramento, CA; ²University of California, Davis Medical Center, Sacramento, CA; ³UC Davis Health Graduate Medical Education, Sacramento, CA; ⁴UC Davis, Sacramento, CA

Introduction: Located in Sacramento, California, the Paul Hom Free Clinic is the oldest Asian clinic in the United States. Currently, CRC screening rates at Paul Hom are suboptimal (19.5% in 2022) and well below the national goal of 80%. Significant contributors to this low rate are the language barrier and lack of educational resources in the most commonly spoken languages at the clinic. A gastroenterology fellow-led quality improvement project was initiated to provide translated CRC educational materials, assess patient understanding, and increase FIT (fecal immunohistochemical) testing longitudinally at Paul Hom.

Methods: With the assistance of UC Davis Translation Services, a translated brochure was created based on an infographic from the American College of Gastroenterology (ACG) CRC Community Education Toolkit. The pamphlet was translated into Mandarin, Cantonese, Hmong, and Vietnamese. Copies of the pamphlet were coupled with an internally developed Likert scale-based survey and FIT test which was provided to patients between ages 45-75. The primary outcome was increased FIT testing. Secondary outcomes include subjective measures of improved patient understanding of CRC, patient appreciation of the intervention, and patient plans to pursue CRC screening.

Results: In the first two months of the study, a total of 27 FIT tests were returned with screening rates significantly increased from 19.5% to 42.2% (p-value < 0.01). According to the survey results, most patients were aware of the prevalence of colon cancer and the latest screening guideline. Over 70% felt like they benefited from reading the brochure in their native language and plan on pursuing colon cancer screening (Table 1). Since the intervention started, there has been an increase in the number of FIT tests distributed from fewer than 5 per month to over 20 per month (Figure 1).

Discussion: Distributing FIT tests along with a translated CRC screening brochure resulted in an increase in CRC screening rate and patient understanding, appreciation, and motivation to pursue screening. FIT distribution has improved at this clinic fourfold during this preliminary analysis. Future research goals include ongoing longitudinal analysis of FIT test return rates and referral rates for subsequent diagnostic colonoscopies. Next steps will involve expansion of translated materials into more languages for both print and media distribution in partnership with ACG leadership and expansion of this project to other non-English speaking clinics.



Disclosures:


Bao Sean Nguyen, MD¹, Christine Shieh, MD², Alex Zhornitskiy, MD³, Felicia Zhornitsky, MPH⁴, Johnny Nguyen, BS⁴, Sujin Jeong, BS⁴, Timothy Do, BS⁴, Ronald Jan, MD⁴, Ronald Hsu, MD⁴. P3180 - Lost in Translation No Longer: Preliminary Results From a Mixed Methods Study of an Initiative to Expand Colorectal Cancer Screening at a Free Clinic in Sacramento, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.