LBPO.PR01 · 预防研究 · Late-Breaking
GRACCE 项目：一项由社区主导、同伴驱动的教育项目，通过提高意识、预防和筛查应对年轻成人中日益上升的早发性结直肠癌
Project GRACCE: A community-led, peer-driven education program to address rising early-onset colorectal cancer through awareness, prevention, and screening among young adults
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摘要 Abstract
中文摘要
背景：结直肠癌（CRC）在 50 岁以下成人中的发病率正以惊人的速度上升。尽管国家指南已更新，将筛查起始年龄从 50 岁降至 45 岁，但对 CRC 风险、早期症状和筛查的认识仍然有限，尤其是在年轻成人和服务不足的社区中。这一知识差距导致诊断延迟、就诊时疾病已属晚期以及结局差距的扩大。
方法：我们与患者主导的倡导团体 Angelic Warrior Foundation 合作，将循证干预措施《在我们社区抗击结直肠癌》（ACCION）改编为 GRACCE 项目（Getting Real About Colorectal Cancer Education，切实认识结直肠癌教育）。GRACCE 采用三节工作坊系列，培训来自北卡罗来纳州五所大学的学生大使。随后大使们准备并开展了同伴主导的校园教育会议。我们对大使进行了前后知识评估，并对参会者进行了会后调查，以评估可行性、可接受性和 CRC 知识的改善。
结果：九名受训学生大使在五所校园和一个社区组织举办了教育会议，覆盖 126 名参会者。大使们在 CRC 生物学、危险因素和筛查方面的知识取得了有意义的提升。在参会者中，95 人（77%）完成了调查。参会者报告对教育会议的满意度很高（各领域 M = 4.7/5），感知到的知识显著提升（CRC：M = 4.8；筛查：M = 4.8；危险因素：M = 4.8），以及参与预防行为的强烈意愿，包括增加锻炼（M = 4.7）、了解家族史（M = 4.7）以及与亲人谈论 CRC 筛查（M = 4.6）。定性反馈突显了对早发性 CRC 风险、筛查指南和差距的新认识，以及对个人故事讲述的强烈共鸣。
结论：GRACCE 项目表明，一种由社区主导、同伴驱动的教育模式是可行的、文化上有共鸣的，并能有效改善年轻成人的 CRC 知识和激发预防意愿。通过将流行病学证据与社区参与相衔接，GRACCE 弥补了导致早发性癌症上升的认识关键缺口。这一模式为可扩展的干预措施带来了希望，可减轻差距并扭转当前 CRC 发病率的趋势。
查看英文原文 English abstract
Background: Colorectal cancer (CRC) incidence is rising at alarming rates among adults under 50. Despite updates to national guidelines lowering the starting age for screening from 50 to 45, awareness of CRC risk, early symptoms, and screening remains limited, especially among young adults and underserved communities. This knowledge gap contributes to diagnostic delays, advanced disease at presentation, and widening disparities in outcomes.
Methods: In partnership with the Angelic Warrior Foundation, a patient-led advocacy group, we adapted Against Colorectal Cancer in Our Neighborhoods (ACCION)-an evidence-based intervention into PROJECT GRACCE (Getting Real About Colorectal Cancer Education). GRACCE trained student ambassadors from five North Carolina universities using a three-session workshop series. Ambassadors then prepared and delivered peer-led campus education sessions. We conducted pre-post knowledge assessments with ambassadors and post-session surveys with attendees to assess feasibility, acceptability, and CRC knowledge improvement.
Results: Nine trained student ambassadors hosted education sessions across five campuses and one community organization, reaching 126 attendees. Ambassadors demonstrated meaningful gains in knowledge about CRC biology, risk factors, and screening. Among attendees, 95 (77%) completed surveys. Attendees reported high satisfaction with the education sessions (M = 4.7/5 across domains), significant perceived knowledge gains (CRC: M = 4.8; screening: M = 4.8; risk factors: M = 4.8), and strong intentions to engage in preventive behaviors, including exercising more (M = 4.7), learning family history (M = 4.7), and talking to loved ones about CRC screening (M = 4.6). Qualitative feedback highlighted new awareness of early-onset CRC risk, screening guidelines, and disparities, as well as strong resonance with personal storytelling.
Conclusions: PROJECT GRACCE demonstrates that a community-led, peer-driven education model is feasible, culturally resonant, and effective in improving CRC knowledge and motivating preventive intentions among young adults. By bridging epidemiological evidence with community engagement, GRACCE addresses critical gaps in awareness contributing to the rise in early-onset cancers. This model holds promise for scalable interventions that can mitigate disparities and reverse current trends in CRC incidence.
利益披露 Disclosure
R. Hirschey, None..
J. Xu, None..
J. Minser, None..
A. T. Brenner, None..
S. Wheeler, None..
P. Duggins, None.