S524 Designing Multilingual and Culturally Sensitive Patient Infographics Significantly Increased Colorectal Cancer Screening Rates at Multiple Safety Net Clinics

Introduction: University of California (UC) Davis Medical Center is affiliated with multiple safety net clinics that provide care to underserved non-English speaking patients in Sacramento, California. The colorectal cancer (CRC) screening rates at these clinics were well below the 80% goal from the American Cancer Society National Colorectal Cancer Roundtable, with half of the clinics having a CRC screening rate below 10%. Significant contributors to this low rate include a lack of educational resources in commonly spoken languages at the clinics. A quality improvement project was initiated to provide translated CRC educational materials, assess patient understanding, and increase CRC screening. Methods: With the assistance of UC Davis Translation Services, a translated brochure was created based on an infographic from the American College of Gastroenterology (ACG) CRC Community Education Toolkit. The pamphlet was translated into the 14 languages used at the clinics including Hmong, Vietnamese, Russian, Ukrainian, Tagalog, Chinese (simplified and traditional), Korean, Dari, Hindi, Urdu, Farsi, Punjabi, and Arabic. The infographics were coupled with a Likert scale-based survey and fecal immunohistochemical test (FIT) which were provided to average risk patients between ages 45-75 starting in April 2023 at one clinic and in April 2024 at 5 other clinics, through March 2025. The primary outcome was CRC screening while the secondary outcomes include measures of patient understanding of CRC, patient appreciation of the brochure, and patient plans to pursue CRC screening. Results: The cumulative CRC screening rate increased from 12.3% to 25.1% (P < 0.01) with a total of 384 patients screened. Clinic specific changes in screening rates are notable for significant increases (P < 0.01) in 4 of the 6 clinics. Survey results showed that roughly two thirds of patients were aware of the prevalence of colon cancer and the latest screening guideline. Notably, 90% of patients reported understanding colon cancer screening better, 95% appreciated receiving the brochure in their language of preference, and over 80% planned on pursuing colon cancer screening. Conclusion: By providing FITs paired with translated and culturally appropriate CRC patient brochures we saw a significant increase in CRC screening at a majority of the clinics. Furthermore, survey results showed high rates of patient understanding, appreciation, and motivation to pursue screening after receiving the brochures that were created.