Understanding the impact of colorectal cancer education: a randomized trial of health fairs

Katherine J. Briant, Lei Wang, Sarah Holte, Adriana Ramos, Nathan Marchello, Beti Thompson

Regular screening for colorectal cancer (CRC) reduces morbidity and mortality from this disease. A number of factors play a role in the underutilization of CRC screening; populations with the lowest CRC screening rates are least likely to be aware of the need for screening or have knowledge about screening options. The overall purpose of this project was to assess two methods for increasing knowledge about CRC in a health fair context: one, by using a health educator to provide CRC information at a table, or two, to provide a tour through a giant inflatable, walk-through colon model with physical depictions of healthy tissue, polyps, and CRC. We participated in six community health fair events, three were randomized to incorporate the use of the inflatable colon, and three used a standard display table method. We used a pre/post-design to look for changes in knowledge about CRC before and after participating in a health fair. We examined descriptive statistics of participants using frequencies and proportions. McNemar's test for paired binary data was used to test whether there were significant differences in the distribution of correct answer percentage from pre to post and from pre to follow up. Linear regression (GEE) was used to investigate whether there was a significant difference in the change from pre- to post-intervention in the percentage of correct answers on knowledge of tests available to detect CRC and awareness of risk factors for CRC between participants at sites with the inflatable colon compared to participants at sites without the inflatable colon. Participants (n = 273) were recruited at the six health fairs. Participants in health fairs with the inflatable colon had higher knowledge at post-test than participants in health fairs with tabling activities, that is, without the inflatable colon; however, the difference was not significant. One month follow-up after each health fair showed virtually no recollection of information learned at the health fairs. The use of an inflatable colon may be an innovative way to help people learn about CRC and CRC screening; however, it is not significantly more effective than conventional table display methods. Further research is needed to associate intention to obtain screening after touring the inflatable colon with actual screening. Future research could explore ways to better retain knowledge at long-term follow-up.