Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

Posted: December 31st, 2022

Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.


The projects goal is to increase colorectal cancer screening rates in hispanics and since there may not be so much data on that population, you may also add that this population is a vulnerable population
and their Socioeconomic status can also impact.

Through this assignment student will identify a clinical problem and formulate a question in PICO (Population, (any possible) Intervention, Comparison group if appropriate, and Outcome) format to be used as search terms for your research literature review later in the course. The PICO you describe in this paper may or may not end up being the intervention you ultimately select following your review of the literature, but it is a lead off term for your search.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

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*I want my PICO to be this: In the Hispanic community (P), what is the effect of the implementation of Community-based education (I) to promote Colorectal Cancer knowledge and screening rates (O) compared to no intervention (C)? *

The purpose of this paper is to tell us everything you can about the clinical problem you have chosen. The clinical problem must have a link to patient outcomes/population health. This paper is not about your project or the intervention. Stay focused on the problem! This is a scholarly paper. Scholarly papers are to be written in APA 6th Edition format.
Required content and format of the problem identification assignment should include but is not limited to the following items:Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.
1. Introduction (10 points). Introduce the clinical problem from a global perspective, explaining why this is a concern. Then narrow in on clinical problem of interest within your facility. Include a purpose statement at the end of the paragraph introducing the purpose of the paper (identify and describe a clinical problem). Please note the title (level 1 header) preceding this section is the same title as listed on the cover page. DO NOT use a header titled “Introduction” for this is assumed.

Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.
2. Background (15 points). This includes information regarding the problem of interest. Students should approach from a global or national level/concern then drill down to the localized institutional problem. Share the risk factors or causes associated with the problem. Share barriers to addressing the problem. Provide supporting evidence to demonstrate that the clinical problem exists or is a concern within the facility where you will be doing your project. If available, share data from your site, region, or national databases supporting the problem. Do not name your practice site; just describe it thoroughly.
3. Significance (15 points). Share the significance of the problem of interest for clinical practice. Explain why it is important this problem needs to be addressed on a global/national level then drill down to your site/practice. Share the rates of the problem including any morbidity/mortality statistics, if applicable. Associate some financial value to this. Describe how correcting this problem impacts financial status and may improve patient/health care outcomes (do not share your chosen intervention yet though),

4. PICO question (10 points). Introduce/explain what the PICO acronym means and why it is utilized within EBP (e.g. to search the literature). Develop a paragraph about each aspect of this acronym. Present the question that will guide the inquiry into the research literature in PICO format. Clearly align the question with the problem introduced earlier: the patient population, a possible intervention, and intended outcome(s). These PICO elements will serve as the search terms for your later research literature review. The purpose of the literature review will be to uncover possible interventions you can use at your site to address the problem. Your PICO may or may not include the intervention (I) you ultimately select.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

5. Conclusion (5 points).

6. Written in APA (6th edition) format (10 points).

7. Correct spelling, grammar, and punctuation (10 points).

8. Organization and presentation of content (10 points).
This paper should be approximately 8 pages (not including cover page or references).

According to the estimates provided by WHO, in the year 2017, adults diagnosed with CRC were 130,000 those who died were 50,000 (Briant et al., 2018). Among other cancers affecting adults, CRC 3rd most common in the US and the 2nd most commonly diagnosed among Hispanic adults. According to Brenner et al. (2016), the US has witnessed a gradual decline in the incidences and mortalities of CRC since the 1980s and this is attributed to the removal of rectal polyps, increased screening rates, and behavior modification, which address potential risk factors. However, this decline is not evident in all US adults.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

Existing research suggests that Hispanics are at a greater risk of CRC-related mortality and morbidity due to lower education levels, high rates of poverty, being uninsured, and not being able to access healthcare services (Jackson et al., 2016). These disparities are evident in the rates of CRC and screening rates. To address this issue, research suggests that health education programs to improve screening and create awareness are the most effective approach for prevention and improved health outcomes. This paper examines the background information and significance of CRC screening and CRC knowledge among Hispanics. Using the PICO process, a PICO question is formulated to facilitate clinical inquiry to improve knowledge on CRC and screening rates among Hispanics.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.


In the United States, CRC affects close to 5% of the general population. For instance, in the year 2016, there were up to 135,000 new cases (Briant et al., 2018). Besides, it is notably the primary cause of mortalities among Hispanics in the US where every three Hispanic women and men are diagnosed in the life course. Among deaths secondary to cancers, it is the 2nd and the third that causes mortalities among adults of Hispanic origin (Barzi et al., 2017). Hispanics makeup 85% of the population where our facility is located and have high mortality and incidence rates compared to whites, who comprise 13% of the population.

Screening for CRC is vital for early detection and diagnosis since it also increases the survival rates. Although Hispanics are less likely to undergo screening for CRC, it is necessary to identify reasons that lead to very low screening rates in this population. According to a 2017 report by the ACS (American Cancer Society), mortality is reducing at a slower rate among Hispanics in comparison to Blacks and Whites (Barzi et al., 2017). Diagnosis in the late stages and lower screening rates are major contributors to disparities in mortality.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

According to the USPSTF, other ethnicities strictly observe the screening recommendations for CRC. In comparison to Asians, Whites and African Americans, CRC screening rates increased the least among Hispanics. For instance, between the years 2005 and 2013, among adults aged 50-75 years old, the screening rates for whites increased from 41-60%, blacks 35-58% and Asians 27-50%. However, for Hispanics, the rates only increased from 27-41% (Jackson et al., 2016). Besides, there are also disparities in screening between urban and rural dwellers with Hispanics having the least prevalence of CRC screening at 28%. Among African Americans and Whites, the screening prevalence was 35% and 39% respectively. These rates are lower when compared to population s residing in urban regions whose screening prevalence were: Whites (45%), Blacks (42%) and Hispanics (30%).Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

In our healthcare facility, CRC is the commonest diagnosed cancer that causes morbidity and mortality among Hispanics and the majority are diagnosed in the late stages. However, diagnosis in the advanced stages hinders the effectiveness of treatment. The facility has also witnessed high mortality rates among Hispanics living in rural areas. As supported by Ladabaum et al. (2015), this indicates inability to access PCP and follow-up for abnormal findings. It is inarguable that for Hispanics rural dwellers, the hurdles for rural dwelling and being an ethnic minority worsens the situation.

CRC is treatable and preventable. However, in the advanced form, its prognosis is very poor. Therefore, early diagnosis and detection increase treatment success and survival outcomes. Underutilization of screening plays a significant role in staging and diagnosis of CRC where the unscreened are at a higher risk of diagnosis in the advanced stages (Martinsen et al., 2016). Similar to the inequity rates of CRC, disparities in the rates of CRC screening and adherence to screening guidelines contribute to high incidences of CRC among Hispanics. This is has been attributed to geography, ethnicity and socioeconomic status. As supported by Shokar et al. (2015), there are more barriers for rural dwelling Hispanics such as long-distance traveling in search of care, inability to access PCPs and specialists, uninsured people. Those with a lower income and lower education levels will rarely follow the screening guidelines for CRC.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.


Present guidelines for 2020 Healthy People on adult percentage for individuals aged 50-75 years reveals that people who received screening for CRC is 70%. The national survey data indicates that the US is currently at 62 % ( Briant et al., 2018). However, when this data is systematically analyzed by ethnicity/race, the disparities become so evident. Hispanic adult men and women (48.5%) rarely go for CRC screening in comparison to Whites (63%) and Black Americans (60.5%). The rates are much lower among Spanish-speaking Hispanics (30.5%) and uninsured Hispanics (11%) (Bryant et al., 2018). Similarly, based on our facility’s statistics, there exist disparities in the incidence and mortality rates of CRC among ethnic and racial minority groups. CRC-related mortality and morbidity is even worse among ethnic and racial minority groups living in rural areas, more so Hispanics.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

CRC is a major cause of mortalities among Hispanics in the US. It accounts for 22% of deaths among Hispanics who suffer a high burden of cancer compared to other ethnic minority groups. Research shows that a diagnosis of CRC among Hispanics has implications for patients, families and the nation. According to the National Cancer Institute, the approximate direct medical and mortality costs and indirect morbidity costs of cancer in 2016 were more than $260 billion and CRC constitutes more than 10% of this burden (Wittich et al., 2019). As more Hispanics get diagnosed in late stages and require more expensive treatment, it is expected that these costs will continue to increase. Evidence also suggests that the patient costs of treating CRC in a lifetime exceed $4,500. Today, apart from direct medical costs, these costs include travel and out-of-pocket expenses and time.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

Other costs for Hispanic CRC patients and their families are emotional costs. Families and patients are at high risk of suffering from depression, anger or anxiety. The complex nature of both conditions results in a very poor prognosis. Combining the financial and emotional costs reduces income for most patients already with a poor social-economic status. This has wide-ranging consequences including an inability to meet financial commitments, reducing general spending in a household and reduced income.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.

PICO Question

PICO is an evidence-based model for clinical inquiry. The PICO framework is used to frame and answer a clinical question and develop strategies to search for literature. The acronym stands for P-population/problem, I-chosen intervention, C-comparison, O-expected outcome. In this context, the PICO discusses as follows:


Among adult Hispanics, CRC is the 2nd most frequently diagnosed cancer. Among Hispanic women, it is the 3rd major cause of death and 2nd among men of Hispanic origin. Hispanics are at high risk of a CRC diagnosis in the late stages, and this has a poor prognosis. The high mortality and incidence rates are attributed to their poor socioeconomic status, low education levels, lack access to healthcare services, specialists and PCPs.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.


Increasing knowledge, awareness and screening of CRC are opportunities that improve population health outcomes. As suggested by Bryant et al., (2018), this can be done through social engagement where individuals are advised to take part in CRC screening by friends and family to inspire CRC behaviors among Hispanic rural or urban dwellers. Previous interventions proved effective to increase screening for CRC among Hispanics. Nevertheless since majority of the interventions were effected in PC settings, majority of the underserved Hispanics who lacked access to care and those who were uninsured miss out. In this context, education will be implemented in a community setting. Community educators will educate and inspire individuals from the Hispanic population to go for screening using culturally appropriate education materials.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.


The comparison is not providing community-based education


Hispanics are less likely to undergo screening and seek care in when CRC is in the late stages. The intended outcome is to increase the rates of CRC screening, and knowledge on CRC, which will ultimately improve survival rates and impact health disparities.

PICO Question

In the Hispanic community (P), what is the effect of the implementation of Community-based education (I) to promote CRC knowledge and screening rates (O) compared to no intervention (C)?

Population Hispanic community
Intervention Community-based intervention
Comparison No community-based intervention
Outcome Promote CRC knowledge and screening rates



CRC is undeniably an issue of public health significance in the US among Hispanics. The rates of screening are generally increasing apart from rural dwelling Hispanics who show a different trend. Potential barriers for the existing disparities in the incidence and mortality rates and screening among Hispanics are poverty, lack of access to specialists and PCPs, uninsured, lack of access to health facilities among others. Research supports community-based education to advance Hispanics knowledge on CRC, awareness, and screening. This intervention promotes healthy seeking behavior and improves survival rates.Community-Based Education to Promote CRC Knowledge and Screening among Hispanics.


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