October 4, 2017

The School of Public Health’s Dr. Sunmin Lee has received a $3.6 million National Institutes of Health RO1 award to address significant cancer disparities in Asian Americans. 

The study, titled “Culturally Adapted Multilevel Decision Support Navigation Trial to Reduce Colorectal Cancer Disparity among At-Risk Asian American Primary Care Patients” will be led by Dr. Lee, an associate professor in the Department of Epidemiology and Biostatistics, who is the principal investigator. The research team also includes UMD School of Public Health faculty co-investigators Dr. Xin He (epidemiology and biostatistics) and Dr. Cheryl Holt (behavioral and community health).

Cancer is the leading cause of death among Asian Americans, and colorectal cancer specifically is the second most common cause of cancer deaths for this group. The higher mortality rates could in part be attributed to substantially lower screening rates among Chinese and Korean Americans compared to other racial or ethnic groups. 

To get more people in for screenings, the team will conduct a randomized controlled trial among 400 Chinese and Korean American primary care patients. The trial will evaluate the patient adherence when they receive multi-level and culturally-sensitive decision support interventions on colorectal cancer screening. 

“This is the first time a culturally-adapted decision support navigation will be used with Chinese and Korean Americans in primary care practice settings,” Dr. Lee said. 

The study will compare colorectal screening outcomes between the Culturally Adapted Decision Support Navigation Intervention and the Advanced Control. 

Patients randomly assigned to the Advanced Control group will receive an informational booklet, a stool blood test kit and a reminder by mail. The group of patients assigned to the Culturally Adapted Decision Support Navigation Intervention group will get the Advanced Control materials, plus additional services, including contacts to help assist in making decisions and navigating the process. 
Patients will also get an individualized screening plan using a theory-based online Decision Counseling Program. Researchers will also share the plan with their primary care physicians, who will encourage the screenings.

Evaluating what types of interventions are best for Asian Americans fills a growing need for linguistically and culturally competent care, more decision support, language facilitation and navigation efforts in care settings, Dr. Lee said. Her previous research projects have developed culturally tailored interventions for Asian Americans to reduce disparities in breast cancer and liver cancer incidence and survival rates.  

Testing these strategies tailored to Chinese and Korean Americans may inform how health care systems support this population and their future implementation may help save lives. 

 

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Sunmin Lee