PROJECT SUMMARY/ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer death among Chinese in the US. CRC screening prevents cancer and reduces mortality through the removal of precancerous polyps. However, CRC screening is severely underutilized by Chinese in the US with only 47% of Chinese Americans over age 50 reporting having ever completed a CRC screening compared to 73% of non-Hispanic whites. Given these disparities, it is critical to increase Chinese immigrants' participation in cancer prevention efforts. Research indicate community engaged interventions, such as narrative education and patient navigation are promising strategies for increasing CRC screening in vulnerable populations. In this study, we propose to develop and pilot test CoLorectal Cancer Narrative Education and Navigation (CLEAN), a community-engaged intervention consisting of narrative education and patient navigation to improve CRC screening in Chinese immigrants. To develop CLEAN, we will culturally and linguistically adapt Witness CARES, a theory-driven, evidence-based narrative group education program. We will also enhance the program with patient navigation to further promote CRC screening in this vulnerable population. Thus, our specific aims are to: (1) Develop CLEAN by culturally and linguistically adapting and enhancing Witness CARES to support CRC screening among Chinese immigrants; and (2) Pilot test the feasibility, acceptability, and preliminary efficacy of CLEAN for supporting CRC screening in Chinese immigrants. The long-term goal of the proposed research is to improve prevention and early detection of CRC in Chinese immigrants and other underserved groups with the ultimate objective of reducing cancer disparities. The proposed research is directly relevant to Dr. Vang's career goals and objectives and will be used to build a program of research to implement effective interventions aimed at reducing cancer disparities in minorities. Her research activities will be complemented with a well-thought out training plan that will help her acquire new knowledge and skills in: (1) community engaged research, and (2) and randomized controlled trials design and analysis. Given the institution's high quality research environment and resources, and with the guidance of the experienced mentoring team, Dr. Vang will have the support and resources necessary to successfully pursue the proposed research and training aims. Over the course of the 5-year funding period, she will participate in ongoing meetings with her mentors, complete formal coursework and interactive training activities offered at her institution and elsewhere; submit a minimum of 5 first author manuscripts for publication; and attend scientific research conferences to foster national networks with researchers in cancer health disparities. This multimodal training plan will provide Dr. Vang with the comprehensive skills needed to achieve her research aims and professional goal of becoming an independent behavioral health researcher.

PROJECT NARRATIVE Colorectal cancer (CRC) is the second leading cause of cancer death among Chinese in the US. The goal of this proposal is to: (1) develop and pilot test CoLorectal Cancer Narrative Education and Navigation (CLEAN), a community-engaged intervention aimed at improving CRC screening in Chinese immigrants; and (2) provide Dr. Vang with mentored, hands-on and didactic training to acquire new knowledge and skills in community- engaged research and randomized controlled trials. This multimodal research and training plan will help Dr. Vang achieve independence as a behavioral health researcher and contribute to the elimination of cancer health disparities.