Designing a randomized controlled trial to evaluate a community-based narrative intervention for improving colorectal cancer screening for African Americans

Erin M. Ellis, Deborah O. Erwin, Lina Jandorf, Frances Saad-Harfouche, Pathu Sriphanlop, Nikia Clark, Cassandre Dauphin, Detric Johnson, Lynne B. Klasko-Foster, Clarissa Martinez, Jamilia Sly, Drusilla White, Gary Winkel, Marc T. Kiviniemi

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective To describe the methodology of a 2-arm randomized controlled trial that compared the effects of a narrative and didactic version of the Witness CARES (Community Awareness, Reach, & Empowerment for Screening) intervention on colorectal cancer screening behavior among African Americans, as well as the cognitive and affective determinants of screening. Methods Witness CARES targeted cognitive and affective predictors of screening using a culturally competent, community-based, narrative or didactic communication approach. New and existing community partners were recruited in two New York sites. Group randomization allocated programs to the narrative or didactic arm. Five phases of data collection were conducted: baseline, post-intervention, three-month, six-month, and qualitative interviews. The primary outcome was screening behavior; secondary outcomes included cognitive and affective determinants of screening. Results A total of 183 programs were conducted for 2655 attendees. Of these attendees, 19.4% (N = 516) across 158 programs (50% narrative; 50% didactic) were study-eligible and consented to participate. Half (45.6%) of the programs were delivered to new community partners and 34.8% were delivered at faith-based organizations. Mean age of the total sample was 64.7 years and 75.4% were female. Conclusion The planned number of programs was delivered, but the proportion of study-eligible attendees was lower than predicted. This community-based participatory research approach was largely successful in involving the community served in the development and implementation of the intervention and study.

Original languageEnglish
Pages (from-to)8-18
Number of pages11
JournalContemporary Clinical Trials
StatePublished - Feb 2018

Bibliographical note

Funding Information:
This study was supported by National Institutes of Health / National Cancer Institute grant R01 CA171935 , and was supported by in part by Roswell Park Cancer Institute and National Cancer Institute (NCI) grants 3P30CA01605 . The authors kindly acknowledge the extensive support of the community members of NYC and WNY, the NYC Community Advisory Board and the First Ladies of Western New York for their contributions to the science and data collection for this study. Special thanks to Ms. Veronica Meadows Ray, Bishop James Bowman, and the University at Buffalo Media Services for their contributions to the development of the Witness CARES video.

Publisher Copyright:
© 2017


  • African American
  • Colonoscopy
  • Colorectal cancer screening
  • Community-based intervention
  • Randomized controlled trial
  • Recruitment

ASJC Scopus subject areas

  • Pharmacology (medical)


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