Abstract
There are unaesthetic aspects in teaching people about the early detection of colorectal cancer using the fecal immunochemical test. Comics were seen as a way to overcome those unaesthetic aspects. This study used the Asian grocery store-based cancer education venue to pilot-test the clarity, cultural acceptability, and alignment of five colorectal cancer education comics intended for publication in Asian American and Pacific Islander (API) community newspapers. After developing the colorectal cancer education comics, API students asked shoppers to review a comic from their collection and provide feedback on how to make the comic clearer and more culturally pertinent to API readers. To evaluate viewers’ responses, the students gathered such unobtrusive data as: (1) how many of the predetermined salient information points were discussed as the student educators interacted with shoppers and (2) how many comics the shoppers were willing to review. Shoppers were also asked to evaluate how effective the comics would be at motivating colorectal cancer screening among APIs. The students were able to cover all of the salient information points with the first comic. As evidence of the comics’ capacity to engage shoppers’ interest, shoppers willingly evaluated all five comics. Using multiple comics enabled the educators to repeatedly address the four salient colorectal cancer information points. Thus, the comics helped student educators to overcome the unesthetic elements of colorectal cancer discussions, while enabling them to engage shoppers in animated discussions, for far more time than with their conventional didactic educational methods.
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References
American Cancer Society (2016) Cancer facts and figures 2016. American Cancer Society, Atlanta
Colby SL, Ortman JM (2014) Projections of the size and composition of the U.S. population: 2014 to 2060, current population reports, 25–1143. U.S. Census Bureau, Washington, DC
American Cancer Society (2014) Colorectal cancer facts and figures 2014–2016. American Cancer Society, Atlanta
Centers for Disease Control and Prevention (2017) Basic information about colorectal cancer. http://www.cdc.gov/cancer/colorectal/basic_info/index.htm. Accessed 1 April 2017
Ness S (2015) Understanding Colorectal Cancer. Colorectal Cancer. https://conquer-magazine.com/understanding-colorectal-cancer-screening-and-treatment/?utm_source=bronto. Accessed 1 April 2017
American Cancer Society (2015) Cancer Prevention & Early Detection Facts & Figures 2015–2016. American Cancer Society, Atlanta
Wong S, Gildengorin G, Nguyen T, Mock J (2005) Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites. Cancer 104(12 Suppl):2940–2947
Kandula NR, Wen M, Jacobs EA, Lauderdale DS (2006) Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites. Cancer 107(1):184–192
Ma GX, Wang MQ, Toubbeh J, Tan Y, Shive S, Dunli W (2012) Factors associated with colorectal cancer screening among Cambodians, Vietnamese, Koreans and Chinese living in the United States. North American Journal of Medicine and Science 5(1):1–8
Hwang H (2013) Colorectal cancer screening among Asian Americans. Asian Pac J Cancer Prev 14(7):4025–4032
Kimura A, Sin M-K, Spigner C, Tran A, Shin-Ping T (2014) Barriers and facilitators to colorectal cancer screening in Vietnamese Americans: a qualitative analysis. J Cancer Educ 29(4):728–734
Kramer EJ, Kwong K, Lee E, Chung H (2002) Cultural factors influencing the mental health of Asian Americans. West J Med 176(4):227–231
Mousavinezhad M, Majdzadeh R, Akbari AS, Delavari A, Mohtasham F (2016) The effectiveness of FOBT vs. FIT: a meta-analysis on colorectal cancer screening test. Med J Islam Repub Iran 30:366
Goede SL, Rabeneck L, van Ballegooijen M, Zauber AG, Paszat LF et al (2017) Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening. PLoS One 12(3):e0172864
American Cancer Society (2017) Colorectal cancer screening: insurance coverage. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-coverage-laws.html. Accessed 1 April 2017
Sadler GR, Nguyen F, Doan Q, Hong A, Thomas AG (1998) Strategies for reaching Asian Americans with health information. Am J Prev Med 14(3):224–228
Tat J, Nguyen LT, Hung S-YM, Ji JK, Mon D, Chan YY, Tong EK et al (2017) Strategy for sustaining cancer education services for underserved Communities. Medsurg Nurs 26(1):33–43
Nguyen DH, Shimasaki S, Stafford HS, Sadler GR (2010) Health journalism internships: a social marketing strategy to address health disparities. J Cancer Educ 25(3):371–376
Houts PS, Doak CC, Doak LG, Loscalzo MJ (2006) The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Couns 61(2):173–190
Pritzker Military Museum & Library (2012). Training Comics from World War II to the Korean War. http://www.pritzkermilitary.org/explore/museum/past-exhibits/dont-be-dope-training-comics-world-war-ii-and-korea/. Accessed 22 April 2017
Wahowiak L (2014) Health workers, artists partner to deliver messages via comics: tools can influence health behavior. The Nation's Health 44(7):1–16
Furuno Y, Sasajima H (2015) Medical comics as tools to aid in obtaining informed consent for stroke care. Medicine 94(26):e1077
Delp C, Jones J (1996) Communicating information to patients: the use of cartoon illustrations to improve comprehension of instructions. Acad Emerg Med 3(3):264–270
Pew Research Center (2014) Newspapers: daily readership by age. http://www.journalism.org/media-indicators/newspapers-daily-readership-by-age/. Accessed 1 April 2017
Rosenstock IM, Strecher VJ, Becker MH (1988) Social learning theory and the health belief Model. Health Educ Q 15(2):175–183
Adler RB, Rolls JA, Proctor RF (2012) Look: looking out, looking in. Nelson Education, Toronto
Gladwell M (2000) The tipping point: how little things can make a big difference. Little Brown and Company, New York
Dolch EW (1948) Problems in reading. Garrard Press, Champaign
Webb EJ (1966) Unobtrusive measures; nonreactive research in the social sciences. Rand McNally sociology series. Rand McNally, Chicago
Connelly LM (2017) Unobtrusive measures. Medsurg Nurs 26(1):59–61
Acknowledgements
We would like to thank the participating Asian grocery stores: Lucky Seafood, Miramar Cash and Carry, Orient Valley Filipino Cuisine, 99 Ranch Market, Vinh Hung Supermarket, and Zion Market. We also wish to acknowledge donations made to support the program from Dr. Irwin and Joan Jacobs and the UC San Diego Taiwanese American Student Association (TASA). Finally, we thank the entire Asian Grocery Store-Based Cancer Education Program’s cancer outreach team for their contributions, and especially Jinho Jung, Jonjei Ku, Scott Nguyen, Roger Quach, and Martin Somo. We also thank Isaac Quintanilla Salinas, John Tat, and the University of California San Diego Faculty Mentor Program faculty for their guidance.
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Wang, J.L., Acevedo, N. & Sadler, G.R. Using Comics to Promote Colorectal Cancer Screening in the Asian American and Pacific Islander Communities. J Canc Educ 33, 1263–1269 (2018). https://doi.org/10.1007/s13187-017-1241-4
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DOI: https://doi.org/10.1007/s13187-017-1241-4