The goal of this research is to produce Spanish- and English-language versions of a colorectal cancer (CRC) risk factor survey that is easily answered by the three main Hispanic sub-populations in New Mexico - US-born and Mexico-born Mexican Americans and native Spanish New Mexicans. We began by conducting an in-depth review of validated surveys covering the domains of demographics, acculturation, personal and family medical history, diet, height and weight, physical activity, smoking and alcohol use. We next evaluated how New Mexico Hispanics interpret and comprehend survey questions and recall information to answer the questions. Our methodology included, in-person field interviewing of self-identified Hispanics age 40 years and older using cognitive-interviewing techniques. All interviews were conducted by a trained, bilingual interviewer. The survey was tested, revised and retested in a new group of participants who met the eligibility requirements. Three results are highlighted here. First, in a novel approach to reconstructing life histories of body mass index (BMI) and physical activity as indicators of energy balance over time, participants reconstructed their body size (height and weight for BMI estimates), work and leisure time physical activity patterns at age 15, 30, 50 years of age and during the previous year. We noted that respondents a) did not easily understand that the activity levels represented a range of physical exertion from none to vigorous, and b) felt they could not select a level if they had not done any of the example activities listed. The instructions were revised to explain the range and the description of the activity levels simplified incorporating the activities our respondents reported performing. Second, the descriptions provided in the gastrointestinal (GI) cancer and CRC screening questions were confusing. Descriptions were simplified for GI cancer risk questions (e.g. familial polypsis, history of polyps) and the CRC screening questions were replaced with modified versions of Behavioral Health Risk Factor Surveillance Survey questions. Last, a memory aide was designed to help the respondents answer the life history questions. The memory aid and revised versions of life history questions, were tested in a second round of field interviews. The memory aid was determined to be an effective method for reconstructing not only body size and activity pattern history, but also lifetime patterns of cigarette smoking and alcohol use. There is a critical need for this CRC survey in our state, where the incidence of CRC among Hispanics is equal to or higher than the incidence in non-Hispanic Whites.
Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A73.
- Copyright © September 18, 2011, American Association for Cancer Research