This project is a collaboration between the Prevention Research Center of Michigan and the University of North Carolina.
Colorectal cancer (CRC) is a preventable disease that currently kills more than 50,000 Americans each year. Prevention and early detection are key to reducing morbidity and mortality from CRC. African Americans experience higher morbidity and mortality from CRC compared to other population groups in the US. Screening and early detection of adenomatous polyps has been shown to be effective and cost effective to reduce CRC morbidity and mortality, however the rate of screening is currently low in populations at risk for the disease. Reducing health disparities in CRC incidence and mortality will require the development and dissemination of effective and cost effective strategies that are culturally appropriate and encourage awareness, motivation, and social and environmental support for appropriate screening and follow-up.
Research conducted by this investigative team and others has demonstrated the efficacy of partnering with African American churches to conduct health promotion efforts that can improve health and ultimately reduce disparities in CRC and other cancers and chronic diseases. The objective of this study is to develop, implement, and evaluate the effectiveness, in a community-based sample of African American churches in urban areas of Raleigh-Durham North Carolina and Flint Michigan, a multi-component program aimed at increasing CRC screening among adults age 50 and over.
To meet this objective, researchers conducted extensive formative and pilot work in order to adapt existing evidence-based interventions previously developed by our research team into a coordinated multi-component and theory-based intervention designed to be culturally appropriate and to meet the needs of urban African Americans. These interventions included personally custom-tailored health communications and targeted videos, interpersonal peer counseling based on motivational interviewing (MI) principles, use of decision aids (DAs) to help participants make informed choices about CRC testing, and church activities to enhance social and environmental support and reduce barriers to screening. Community-based participatory methods were used throughout the study, based on extensive expertise of the research team and partnerships with community organizations reaching urban African Americans through faith-based initiatives. Researchers conducted a group-randomized controlled trial (RCT) that will compare an innovative CRC screening intervention to a control condition that will receive a previously tested fruit and vegetable intervention.
The ultimate goal of the study was to increase the adoption and maintenance of health practices that are recommended to reduce the risk of morbidity and mortality from CRC.