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A study is currently in progress to develop and assess the efficacy of digital video, interactive, touchscreen kiosks to deliver tailored, bilingual (Spanish/English), age and gender appropriate colorectal cancer screening information to Latino men and women ages 50 and older. The information modules are guided by formative research with adherent and non-adherent Latinos to identify barriers and facilitators to colorectal cancer screening for low-income, low literacy Latinos. This study is scheduled for completion by August 2010.



An Interactive Colorectal Cancer Screening Promotion Intervention for Latinos

Invasive colorectal cancer can be prevented through regular screening. Healthy People 2010 sets a 50% screening rate as the national goal for having had a FOBT within the past two years and for ever having had a sigmoidoscopy. Yet only 24.4% of Latinos over age 50 had received a FOBT within the past two years and only 46.6% had ever had a sigmoidoscopy, according to 2006 CDC data. These screening rates place Latinos at high risk for diagnoses at an advanced stage of the disease. The challenge is to effectively overcome cultural, linguistic and attitudinal barriers and promote adoption of recommended screening and risk reduction practices by Latinos.


The long-term goal of this study is to develop and evaluate the efficacy of an education intervention that addresses the disparities in colorectal cancer incidence and mortality rates of Latinos. The specific objectives of this study are to: (1) develop culturally and linguistically appropriate colorectal cancer screening and risk reduction information designed for low-income, low literacy Latinos age 50 and over, (2) develop multimedia kiosks that incorporate digital video and touchscreen technologies to deliver an interactive colorectal cancer screening and risk reduction intervention, (3) evaluate the efficacy of the intervention to increase awareness of colorectal cancer risk and promote screening and risk reduction behaviors among low-income, low literacy Latinos, and (4) evaluate the acceptance of the interactive, multimedia kiosk by low-income, low literacy Latinos exposed to the intervention.


The interactive, multimedia kiosks integrate digital video, audio, text, graphics, music and animation to deliver information tailored to the person’s age group (50-64, 65-79), gender and language preference (Spanish/English). A user-friendly interface allows patients to select information through a touchscreen to partake in a self-paced, individualized cancer education experience. The kiosks also will enable patients to notify their providers when they are non-adherent and due for a colorectal cancer test.


The study employs an experimental design in which participants will be randomly assigned to either an intervention or control condition in equal numbers after they are administered a pre-test. The intervention group will be exposed to a multimedia colorectal cancer education intervention; the control group will receive a colorectal cancer brochure, which represents standard care for colorectal cancer education. Six-months from baseline, a post-test will be administered to both groups. These data will be analyzed using chi-square test to compare the study arms to identify behavioral and attitudinal outcomes, multivariate models of the primary outcomes, and repeated measures models of self-efficacy, knowledge, and decisional balance, respectively—at pre- and post-test—using the Generalized Estimating Equation methodology to measure the intervention effects.


This study was funded through the Small Business Innovative Research Grants Program by the National Caner Institute, Multimedia Technology, Health Communication Informatics Research Branch, Behavioral Research Program




Publications pending. Please check back later for an update.



Research Team

Project Management

Armando Valdez, PhD, Principal Investigator

Cathy Wu, Project Associate


Subject-matter Experts

Rene Salazar, MD, Division of General Internal Medicine, University of California-San Francisco

Marilyn Winkleby, PhD, MPH, Stanford Prevention Research Center, Stanford School of Medicine

Maria Fernandez, PhD, School of Public Health, UT Health Science Center, University of Texas-Houston



Susan L. Stewart, PhD, Comprehensive Cancer Center, University of California-San Francisco


Collaborating Clinics


Gardner Family Health Network, Inc. San Jose

Reymundo Espinoza, MPH, Chief Executive Officer

Efrain Coria, B.S., CPA, Chief Operation Officer

Gloria Sanchez, FNP, Family Practice - Women's Clinic


EastValley Community Health Center, Inc. West Covina, CA

Alicia Martini, Chief Executive Officer




Production Team

Production scheduled for May – August, 2009. Please check back later for an update.