Against Colorectal Cancer in Our Neighborhoods, a Community-Based Colorectal Cancer Screening Program Targeting Low-Income Hispanics: Program Development and Costs

Health Promot Pract. 2015 Sep;16(5):656-66. doi: 10.1177/1524839915587265. Epub 2015 May 16.


Background: Colorectal cancer is the second leading cause of cancer-related death in the United States. Despite universal screening recommendations, screening rates in the United States remain suboptimal, especially among the poor, the uninsured, recent immigrants, and Hispanics. This article describes the development of a large community-based colorectal cancer screening program designed to address these disparities.

Method: The Against Colorectal Cancer in our Neighborhoods program is a bilingual, evidence-based, theory-guided, multicomponent community screening intervention, targeting the uninsured and developed using a systematic planning process. It combines community health worker-led outreach, bilingual and culturally tailored community education, and no-cost screening with provision of the fecal immunochemical test or colonoscopy and navigation services. A detailed process and outcome evaluation is planned. Program development cost calculated prospectively (in 2011 dollars) using a societal perspective and micro-costing methods was $243,278, of which $180,344 was direct cost.

Discussion: The detailed description of the development processes and costs of this health promotion program targeting low-income Hispanics will inform health program decision makers about the resource requirements for planning and developing new programs to reduce disease burden in communities.

Keywords: Latino race/ethnicity; behavioral theories; cancer prevention and screening; community-based participatory research; health disparities; health promotion; program cost.

MeSH terms

  • Aged
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / prevention & control*
  • Colorectal Neoplasms / psychology
  • Community Health Services / economics
  • Community Health Services / methods*
  • Feces / chemistry
  • Female
  • Health Behavior
  • Health Care Costs
  • Health Education / economics
  • Health Education / methods*
  • Health Promotion / economics
  • Health Promotion / methods*
  • Hispanic or Latino* / psychology
  • Humans
  • Male
  • Medically Uninsured
  • Middle Aged
  • Poverty
  • Program Development / economics
  • Program Evaluation
  • Texas