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Using Comics to Promote Colorectal Cancer Screening in the Asian American and Pacific Islander Communities

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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

  1. American Cancer Society (2016) Cancer facts and figures 2016. American Cancer Society, Atlanta

    Google Scholar 

  2. 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

    Google Scholar 

  3. American Cancer Society (2014) Colorectal cancer facts and figures 2014–2016. American Cancer Society, Atlanta

    Google Scholar 

  4. 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

  5. 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

  6. American Cancer Society (2015) Cancer Prevention & Early Detection Facts & Figures 2015–2016. American Cancer Society, Atlanta

    Google Scholar 

  7. 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

    Article  PubMed  PubMed Central  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. Hwang H (2013) Colorectal cancer screening among Asian Americans. Asian Pac J Cancer Prev 14(7):4025–4032

    Article  PubMed  Google Scholar 

  11. 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

    Article  PubMed  PubMed Central  Google Scholar 

  12. 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

    PubMed  PubMed Central  Google Scholar 

  13. 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

    PubMed  PubMed Central  Google Scholar 

  14. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. 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

  16. 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

    Article  CAS  PubMed  Google Scholar 

  17. 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

    PubMed  Google Scholar 

  18. 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

    Article  PubMed  PubMed Central  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

  21. 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

    Google Scholar 

  22. Furuno Y, Sasajima H (2015) Medical comics as tools to aid in obtaining informed consent for stroke care. Medicine 94(26):e1077

    Article  PubMed  PubMed Central  Google Scholar 

  23. 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

    Article  CAS  PubMed  Google Scholar 

  24. Pew Research Center (2014) Newspapers: daily readership by age. http://www.journalism.org/media-indicators/newspapers-daily-readership-by-age/. Accessed 1 April 2017

  25. Rosenstock IM, Strecher VJ, Becker MH (1988) Social learning theory and the health belief Model. Health Educ Q 15(2):175–183

    Article  CAS  PubMed  Google Scholar 

  26. Adler RB, Rolls JA, Proctor RF (2012) Look: looking out, looking in. Nelson Education, Toronto

    Google Scholar 

  27. Gladwell M (2000) The tipping point: how little things can make a big difference. Little Brown and Company, New York

    Google Scholar 

  28. Dolch EW (1948) Problems in reading. Garrard Press, Champaign

    Google Scholar 

  29. Webb EJ (1966) Unobtrusive measures; nonreactive research in the social sciences. Rand McNally sociology series. Rand McNally, Chicago

    Google Scholar 

  30. Connelly LM (2017) Unobtrusive measures. Medsurg Nurs 26(1):59–61

    PubMed  Google Scholar 

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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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Correspondence to Georgia Robins Sadler.

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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

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