Integration of Cancer Health Activities Into African American Churches

This population-based application responds to the American Cancer Society Research Scholar
Grant, Priority Program in Cancer Control. Recent years have seen a growing research
interest in learning how to get known-effective health education strategies to reach more
people who could benefit from them. An important part of this growing movement is a focus on
sustained impact, or continued program benefit after the funding period is over. It is
believed that the best way to achieive this sustained impact is through integrating the
program into the host community at multiple levels. This innovative strategy has not been
systematically tested in community-based settings, where the most vulnerable people can be
reached. Since churches have a historical and ever-growing role in health promotion
particularly among African Americans, they are an ideal place to reach this group for cancer
education. The proposed project will compare two ways to apply a known-effective cancer
educational strategy through African American churches: 1) a standard method vs. 2) a new
method in which the churches integrate the strategy into their organizational structure and
practice at multiple levels. It will be determined whether this "integrated approach"
results in more effective and sustained cancer education and screening activities at both
the church and individual levels over time. The educational strategy is one that has been
used successfully in previous work: Project HEAL (Health through Early Awareness and
Learning). Project HEAL is a series of three cancer early detection workshops (breast,
prostate, colorectal) delivered through trained and certified lay peer community health
advisors in African American churches. 14 churches will be randomly chosen to conduct either
the standard Project HEAL program or an integrated Project HEAL strategy where the churches
build the program into their organization in multiple ways (e.g., allocating volunteer or
paid staff, space, or funds; policy change; ministry development). The project will be
conducted in three phases: 1) refining the integrated approach with community and
stakeholder feedback; 2) pilot testing the integrated approach in 2 churches; and 3)
conducting the study to comparatively evaluate the standard vs. the integrated approaches in
14 churches. A scientifically rigorous evaluation plan will be used to look at outcomes at
both the individual and the church level. This project will make important contributions to
research in evidence-based medicine and sustainability. In a climate of limited resources,
identifying sustainable and effective ways to increase cancer awareness and screening in
African American men and women is more important than ever.