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African American (AA) men are significantly more likely to die of prostate cancer (PrCA) than other racial groups, and there is a critical need to identify strategies for providing information about PrCA screening and the importance of informed decision making (IDM). To assess whether a computer-based IDM intervention for PrCA screening would be appropriate for AA men, this formative evaluation study examined their (1) PrCA risk and screening knowledge; (2) decision-making processes for PrCA screening; (3) usage of, attitudes toward, and access to interactive communication technologies (ICTs); and (4) perceptions regarding a future, novel, computer-based PrCA education intervention. A purposive convenience sample of 39 AA men aged 37 to 66 years in the Southeastern United States was recruited through faith-based organizations to participate in one of six 90-minute focus groups and complete a 45-item descriptive survey. Participants were generally knowledgeable about PrCA. However, few engaged in IDM with their doctor and few were informed about the associated risks and uncertainties of PrCA screening. Most participants used ICTs on a daily basis for various purposes including health information seeking. Most participants were open to a novel, computer-based intervention if the system was easy to use and its animated avatars were culturally appropriate. Because study participants had low exposure to IDM for PrCA, but frequently used ICTs, IDM interventions using ICTs (e.g., computers) hold promise for AA men and should be explored for feasibility and effectiveness. These interventions should aim to increase PrCA screening knowledge and stress the importance of participating in IDM with doctors.

Background Enhancing the capability of community health centers to implement best practices may mitigate health disparities. We investigated the association of Practice Adaptive Reserve (PAR) to implementation of Patient Centered Medical Home (PCMH) colorectal cancer (CRC) screening best practices (BPs) at community health center clinics in seven states.

Background and Objective: The National Cancer Institute’s (NCI) Community Networks Program Centers (CNPCs) provide community-based participatory research (CBPR)-oriented mentoring and training to prepare early-stage/midcareer investigators and student trainees (trainees) in disparities reduction. This paper describes the academic, mentoring, training, and work–life balance experiences of CNPC-affiliated trainees. Methods: We used a collaborative and iterative process to develop a 57-item, web-based questionnaire completed by trainees from the 23 CNPCs between August 2012 and February 2013. Their CNPC mentors completed a 47-item questionnaire. Descriptive statistics were calculated. Results: The final analytic sample included 189 of 269 individuals (70%) identified as active participants in CNPC research or training/mentoring. Mentors ( n = 45) were mostly non-Hispanic White (77.8%) and 48.9% were male. Mentors published a median of 6 (interquartile range [IQR], 3–12) first-authored and 15 (IQR, 6–25) senior authored manuscripts, and secured 15 (IQR, 11–29) grants from the National Institutes of Health (NIH) and other sources in the previous 5 years. Most trainees ( n = 144) were female (79.2%), 43.7% were underrepresented racial/ethnic minorities, and 36.8% were first-generation college graduates. Over the previous 5 years, trainees reported a median of 4 (IQR, 1–6) publications as first author and 4 (IQR, 2–8) as co-author; 27.1% reported having one or more NIH R01s. Trainees reported satisfaction with their CNPC mentor (79.1%) and confidence in demonstrating most CBPR competencies. Conclusion: The CNPC training program consists of a scientifically productive pool of mentors and trainees. Trainees reported rates of scholarly productivity comparable to other national training programs and provided insights into relationships with mentors, academic pressures, and professional–personal life balance.

Mini-grants are an increasingly common tool for engaging communities in evidence-based interventions for promoting public health. This article describes efforts by 4 Centers for Disease Control and Prevention/National Cancer Institute-funded Cancer Prevention and Control Research Network centers to design and implement mini-grant programs to disseminate evidence-based interventions for cancer prevention and control. This article also describes source of evidence-based interventions, funding levels, selection criteria, time frame, number and size of grants, types of organizations funded, selected accomplishments, training and technical assistance, and evaluation topics/methods. Grant size ranged from $1000 to $10 000 (median = $6250). This mini-grant opportunity was characterized by its emphasis on training and technical assistance for evidence-based programming and dissemination of interventions from National Cancer Institute's Research-Tested Intervention Programs and Centers for Disease Control and Prevention's Guide to Community Preventive Services. All projects had an evaluation component, although they varied in scope. Mini-grant processes described can serve as a model for organizations such as state health departments working to bridge the gap between research and practice.

Cancer prevention and control efforts serve as national priorities, as cancer is the second leading cause of death in the USA. In addition, cancer disparities exist, with racial/ethnic minority, low-income, and uninsured populations suffering the greatest burden. The goal of this paper is to describe the role that effective health communication can play in increasing routine cancer screening among medically underserved populations, thus decreasing persistent health disparities. For this paper, we applied Sorenson’s integrated model of health literacy as a framework for identifying communication gaps and opportunities that can help improve cancer screening specifically at federally qualified health centers (FQHCs). This integrated model consists of four interrelated dimensions: access, understand, appraise, and apply. Employing communication strategies across this health literacy framework has the potential to facilitate improved decision making and cancer screening outcomes among the most underserved populations.

Using a sample of YouTube videos posted on the YouTube channels of organ procurement organizations, a content analysis was conducted to identify the frames used to strategically communicate prodonation messages. A total of 377 videos were coded for general characteristics, format, speaker characteristics, organs discussed, structure, problem definition, and treatment. Principal components analysis identified message frames, and k-means cluster analysis established distinct groupings of videos on the basis of the strength of their relationship to message frames. Analysis of these frames and clusters found that organ procurement organizations present multiple, and sometimes competing, video types and message frames on YouTube. This study serves as important formative research that will inform future studies to measure the effectiveness of the distinct message frames and clusters identified.

African Americans (AA) are more likely to develop and die from cancer than any other racial or ethnic group. This study assessed older and younger/middle-age African-American (AA) men's (1) knowledge and attitudes about prostate cancer (PrCA) and PrCA screening, (2) participation in clinical research, and (3) health and cancer-related decision making. Twenty-eight AA men (14 older, mean age 59.8; 14 younger/middle age, mean age 30.4) received a PrCA education program and completed pre/post education program surveys, as wells as qualitative post education interviews. Younger/middle-age men were more knowledgeable about PrCA and PrCA screening than older males. Older men reported being invited to participate in a clinical trial more often than younger males but were more likely to report that participation in clinical trials was risky and they did not plan to participate in medical research in the future. Younger/middle-age males were more willing to participate in a clinical trial in the future and reported fewer barriers to participation in clinical research. There is potential for using intergenerational communication strategies with older/younger AA male dyads in PrCA interventions.

Increasing the participation of Blacks in cancer research is a vital component of a strategy to reduce racial inequities in cancer burden. Community-based participatory research (CBPR) is especially well-suited to advancing our knowledge of factors that influence research participation to ultimately address cancer-related health inequities. A paucity of literature focuses on the role of structural factors limiting participation in cancer research. As part of a larger CBPR project, we used survey data from a statewide cancer needs assessment of a Black faith community to examine the influence of structural factors on attitudes toward research and the contributions of both structural and attitudinal factors on whether individuals participate in research. Regression analyses and non-parametric statistics were conducted on data from 727 adult survey respondents. Structural factors, such as having health insurance coverage, experiencing discrimination during health care encounters, and locale, predicted belief in the benefits, but not the risks, of research participation. Positive attitudes towards research predicted intention to participate in cancer research. Significant differences in structural and attitudinal factors were found between cancer research participants and non-participants; however, directionality is confounded by the cross-sectional survey design and causality cannot be determined. This study points to complex interplay of structural and attitudinal factors on research participation as well as need for additional quantitative examinations of the various types of factors that influence research participation in Black communities.

Introduction Although clinical trials have the potential to provide the most advanced medical treatments and screening options, accrual rates remain low among medically underserved populations. Strategies to enhance clinical trial recruitment are frequently undertaken without developing, implementing, and evaluating communication and educational activities. This study assesses the current clinical trial recruiting efforts taking place at academic medical centers in a southeastern state and explores principal investigators' attitudes and beliefs about how to successfully recruit for clinical trials, in the general population, and in African American and rural communities. Methods An online survey was used to collect responses from clinical trial principal investigators working in a southeastern state's five main academic medical centers. Respondents were asked about their experience with recruitment and recruiting strategies, in general, and in the African American and rural communities. Results Respondents said that it was most difficult to find rural residents to participate in clinical trials ( M = 3.60, SD = .93), followed by the general public ( M = 3.30, SD = .99) and African American residents ( M = 3.15, SD = .99). Investigators most often reported personally recruiting their patients ( M = 3.50, SD = 1.34) and through local doctors ( M = 2.80, SD = 1.20). Principal investigators rarely recruit through faith-based organizations ( M = 1.74, SD = 1.05), or by using radio ( M = 1.62, SD = .90), or television ads ( M = 1.42, SD = .75). Conclusion Clinical trial investigators rarely communicate about clinical research outside of the medical setting or partner with community organizations or local doctors to reach individuals in medically underserved communities. Study implications describe the importance of educating research teams about how best to promote clinical trial awareness and knowledge.

Clinical trials help advance public health and medical research on prevention, diagnosis, screening, treatment, and quality of life. Despite the need for access to quality care in medically underserved areas, clinical trial participation remains low among individuals in rural and African American communities. This study assessed clinical trial research in South Carolina's five main academic medical centers, focusing specifically on clinical trial investigators' perceived barriers to recruitment in the general population and in rural and African American communities. Online survey responses (N = 119) revealed that it was most difficult for investigators to recruit from rural areas and that rural residents were least likely to be represented in medical research, behind both the general public and African Americans. Barriers focusing on communication or awareness proved to be the biggest hurdles to finding potential participants in both the general public and rural communities. Psychological barriers to recruitment were perceived to be most prevalent in African American communities. Study findings provide important insights from the perspective of the clinical trial investigator that will aid in the development of effective communication and education strategies for reaching rural and African American residents with information about clinical trials.

The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) is 1 of 10 networks funded by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI) that works to reduce cancer-related health disparities. In partnership with federally qualified health centers and community stakeholders, the SC-CPCRN uses evidence-based approaches (eg, NCI Research-tested Intervention Programs) to disseminate and implement cancer prevention and control messages, programs, and interventions. We describe the innovative stakeholder- and community-driven communication efforts conducted by the SC-CPCRN to improve overall health and reduce cancer-related health disparities among high-risk and disparate populations in South Carolina. We describe how our communication efforts are aligned with 5 core values recommended for dissemination and implementation science: 1) rigor and relevance, 2) efficiency and speed, 3) collaboration, 4) improved capacity, and 5) cumulative knowledge.

Enhancing the capability of community health centers to implement best practices (BPs) may mitigate health disparities. This study investigated the association of practice adaptive reserve (PAR) with the implementation of patient-centered medical home (PCMH) colorectal cancer (CRC) screening BPs at community health center clinics in 7 states.A convenience sample of clinic staff participated in a self-administered, online survey. Eight PCMH CRC screening BPs were scored as a composite ranging from 0 to 32. The PAR composite score was scaled from 0 to 1 and then categorized into 3 levels. Multilevel analyses examined the relation between PAR and self-reported implementation of PCMH BPs.There were 296 respondents, and 59% reported 6 or more PCMH BPs at their clinics. The mean PAR score was 0.66 (standard deviation, 0.18), and the PCMH BP mean scores were significantly higher for respondents who reported higher clinic PAR categories. In comparison with the lowest PAR level, adjusted PCMH BP means were 25.0% higher at the middle PAR level (difference, 3.2; standard error, 1.3; t = 2.44; P = .015) and 63.2% higher at the highest PAR level (difference, 8.0; standard error, 1.9; t = 4.86; P .0001).A higher adaptive reserve, as measured by the PAR score, was positively associated with self-reported implementation of PCMH CRC screening BPs by clinic staff. Future research is needed to determine the PAR levels most conducive to implementing CRC screening and to develop interventions that enhance PAR in primary care settings.

Cervical cancer prevention knowledge deficits persist among women living with HIV/AIDS (WLHA) despite increased risk of developing cervical dysplasia/cancer. We examined associations between WLHA’s cervical cancer prevention knowledge and abnormal Pap test history. We recruited 145 urban and rural WLHA from Ryan White-funded clinics and AIDS service organizations located in the southeastern USA between March 2011 and April 2012. For this analysis, women who reported a history of cervical cancer (n = 3) or had a complete hysterectomy (n = 14) and observations with missing data (n = 22) were excluded. Stata/IC 13 was used to perform cross-tabulations and chi-squared tests. Our sample included 106 predominantly non-Hispanic Black (92 %) WLHA. Mean age was 46.3 ± 10.9 years. Half (50 %) had ≤ high school education. One third (37 %) had low health literacy. The majority (83 %) had a Pap test

To date there is limited published evidence on the efficacy of tobacco control mass media campaigns in China. This study aimed to evaluate the impact of a mass media campaign 'Giving Cigarettes is Giving Harm' (GCGH) on Chinese smokers' knowledge of smoking-related harms and attitudes towards cigarette gifts.Population-based, representative data were analysed from a longitudinal cohort of 3709 adult smokers who participated in the International Tobacco Control (ITC) China Survey conducted in six Chinese cities before and after the campaign. Logistic regression models were estimated to examine associations between campaign exposure and attitudes towards cigarette gifts measured post-campaign. Poisson regression models were estimated to assess the effects of campaign exposure on post-campaign knowledge, adjusting for pre-campaign knowledge.Fourteen percent (n=335) of participants recalled the campaign within the cities where the GCGH campaign was implemented. Participants in the intervention cities who recalled the campaign were more likely to disagree that cigarettes are good gifts (71% vs 58%, p0.01) and had greater levels of campaign-targeted knowledge than those who did not recall the campaign (mean=1.97 vs 1.62, p0.01). Disagreeing that cigarettes are good gifts was higher in intervention cities than in control cities. Changes in campaign-targeted knowledge were similar in both cities, perhaps due to a secular trend, low campaign recall or contamination issues.These findings suggest that the GCGH campaign increased knowledge of smoking harms, which could promote downstream cessation. This study provides evidence to support future campaign development to effectively fight the tobacco epidemic in China.

The Gullah/Geechee (G/G) heritage is rooted in a culture largely dependent on fish and seafood as a primary food source. Research suggests that African-American (AA) fishers in the Southeastern US consume larger amounts of fish, potentially exposing them to higher environmental contaminant levels. This in-depth study was conducted to explore G/G and AA Sea Island attitudes, perceptions, and cultural beliefs about fishing in one urban and two rural South Carolina coastal counties. Results indicated that study participants in rural counties had slightly different perspectives of fishing (e.g. fishing as an essential dietary supplement) than in urban counties where fishing was viewed more as relaxation. Major misperceptions existed in all counties between fish consumption advisories related to pollution versus harvesting restrictions associated with fishing regulations. Providing clear, culturally tailored health messages regarding fish advisories will promote more informed choices about fish consumption that will minimize potential exposures to environmental pollutants.

Clinical trials (CTs) are important for advancing public health and medical research, however, CT recruitment is challenging. The high reading level of CT information and the technical language of providers or researchers can serve as barriers to recruitment. Prior studies on the informed consent process found that consent documents often contain complicated terms. Limited research has examined resources specifically used to recruit individuals into CTs. The purpose of this study was to examine the content and readability of CT recruitment education resources in one U.S. state. Convenience sampling was employed for the collection of CT recruitment materials. A codebook was developed based on previous content analyses and emergent themes from statewide focus groups about CTs. A total of 127 materials were collected and analyzed (37.8% print; 62.2% Web). Most content was focused on treatment-related CTs (60.6%). Inclusion criteria related to specific disease conditions (88.9%) and age (73.6%) were described most often. Only 30% of resources had an explicit call to action. Overall mean readability level was Grade 11.7. Web-based materials were significantly more likely to be written at a higher grade level than print materials (p ≤ .0001). Readability also differed significantly according to resource distributor/creator, CT type, person quoted, and presence or absence of inclusion criteria and an explicit call to action. Our study provides insight into the content and difficulty level of recruitment materials intended to provide initial information about a CT. Future studies should examine individuals' comprehension of recruitment materials and how participation intentions are associated with recruitment messages.

Analyzing data from a telephone survey of rural and urban residents in South Carolina, this study attempts to understand how to better promote clinical trials (CTs) in rural areas. To explore why participation is lower among the rural population, we examine two groups of potential barriers: structural and procedural barriers (limited accessibility, lack of awareness, lack of health insurance) and cognitive and psychological barriers (lack of knowledge, misperceptions, distrust, fear). We then make a series of comparisons between rural and urban residents to see whether rural residents are significantly different from urban residents in terms of structural/procedural and cognitive/psychological barriers they are facing. Findings indicate that there are no significant differences between rural and urban residents in their willingness to participate in a CT. However, rural residents were more likely to perceive limited access to CT sites and lack of awareness of available trials. Rural residents also indicated greater lack of knowledge about CTs. Finally, we found that distrust and fear were important barriers in shaping one’s willingness to participate in a CT. Implications of the findings are discussed in detail.

While African Americans are at a significantly higher risk for developing certain cancers, they also have low rates of participation in cancer research, particularly clinical trials. This study assessed both African American men’s and African American women’s (1) knowledge of and participation in cancer-related clinical research and (2) barriers to and motivations for participating in clinical research. Data were collected from a total of 81 participants. Phase I of this research consisted of qualitative focus groups (all 81 participants). Phase II included quantitative pre/post survey data from an education program (56 participants). Findings from the study revealed that African American men and women had poor knowledge about clinical trials and the informed consent process, limited experience in participating in clinical trials, and they feared and mistrusted cancer research. Participants identified incentives, assurance of safety, knowledge and awareness, and benefiting others as motivators to participate in clinical trials research.

Journalists have a unique opportunity to educate the community about public health and health care. In order for health communication messages to be effective, characteristics of the intended audience must be considered. Limited attention has been given to health journalists' perceptions of their target communities and little is known about how journalists' perceptions may impact the delivery of health information in the news. Fifteen in-depth telephone interviews were conducted with health journalists from varying geographic regions and media market sizes. Interview questions examined health journalists' perceptions of their target communities, the content and delivery of their health-related stories, and the current state of health journalism. Interviews were audio-recorded for transcription and thematic analysis. Health journalists perceived their audiences to be primarily mothers and adults with limited education. Participants reported they often used personal stories and strong headlines to engage their communities. They also stated that their news stories were quite technical and may not have been written at an appropriate reading level for their audience. When asked about the current state of health journalism, participants reported that there were areas for improvement. Journalists stated that increased collaborations with public health practitioners would improve their own understanding of health and medical information and allow them to develop health news content that was more appropriate for their target communities.

Engaging partners in the planning, implementation, and evaluation of cancer education programs is critical for improving the health of our communities. A 2-year pilot education intervention on prostate cancer decision making and participation in medical research was funded by the National Cancer Institute. The partnership involving community members and clinical staff at a cancer center was used to develop recruitment strategies and plan for the implementation of the intervention with African-American middle-age and older men and female family members. We assessed partners' perceptions of this community-academic-clinical research collaboration. In year 2, eight project advisory council members were selected among existing partners and year 1 participants to serve as a formal committee. Council members were required to participate in telephone and in person meetings and actively support recruitment/implementation efforts. At the conclusion of the project, 20 individuals (all clinical and community partners, including the eight advisory council members) were invited to complete a survey to assess their perceived impact of the collaboration on the community and provide suggestions for future collaborations. Most partners agreed that their organization benefitted from the collaboration and that various aspects of the advisory council process (e.g., both formal and informal communication) worked well. The most noted accomplishment of the partnership related to leveraging the collaboration to make men more knowledgeable about prostate cancer decision making. Suggested improvements for future collaborations included distributing more frequent updates regarding project successes. Evaluating partners' perceptions of this collaboration provided important recommendations for future planning, implementation, and evaluation of community-based cancer education programs.

Objectives: Physical activity (PA) may reduce risk of developing Alzheimer’s disease (AD). The objectives of this study were to: (a) Compare the content of English and Spanish PA-focused articles in American Association of Retired Persons (AARP) magazines; and (b) Determine whether these articles discuss PA as a potential correlate of AD. Method: AARP (English) and AARP Segunda Juventud (Spanish) magazines were assessed for PA coverage from 2009 to 2010. Articles were analyzed using nonparametric tests. Results: A total of 63 articles discussed PA (48 English; 15 Spanish). In AARP English, 70.8% of articles discussed formal exercise, while 53.3% of Spanish articles discussed formal exercise. Only three English articles mentioned that PA has the potential to reduce risk of AD. No Spanish articles mentioned this association. Discussion: Spanish content did not adequately present cognitive health information. Culturally appropriate media coverage is needed to inform diverse populations about cognitive health and risks of AD.

As part of setting the stage for this supplement to the American Journal of Preventive Medicine, a life-course perspective is presented to assist in understanding the importance of cancer prevention for adults in midlife, a period roughly spanning 20 years between ages 45 and 64 years. Drawing on disciplinary perspectives from the social sciences and public health, several life-course themes are delineated in this article: how specific life transitions present unique opportunities for interventions to inform policy and practice that can improve population health outcomes; how interventions can be focused on those at particular life stages or on the entire life course; and how the onset and progression of chronic conditions such as cancer are dependent on a complex interplay of critical and sensitive periods, and trajectory and accumulation processes. A translational research framework is applied to help promote the movement of applied public health interventions for cancer prevention into practice. Also explored are differences that can affect people at midlife relative to other age cohorts. Specifically, cancer-related risks and care networks are examined, with examples of public health strategies that can be applied to cancer prevention and control. As a conclusion, select methodologic issues and next steps for advancing research and practice are identified.

INTRODUCTION Limited research has examined primary care providers' communication with patients about maintaining cognitive functioning. Our study's objective was to compare the perceptions of consumers and primary care providers related to beliefs and communication practices about lifestyle behaviors beneficial for overall health and for maintaining cognitive functioning. METHODS In 2009, we submitted 10 questions to Porter Novelli's HealthStyles survey and 6 questions to their DocStyles survey. We compared consumers' (n = 4,728) and providers' (n = 1,250) beliefs, practices, and information sources related to maintaining health and cognitive functioning. We made comparisons using nonparametric statistics. RESULTS Approximately 76% of consumers considered their health to be good or very good; 73.4% were concerned or very concerned about the possibility that their memory may worsen with age. Women were significantly more concerned than men, and white consumers were more concerned than black and Hispanic consumers. Consumers reported they believed that intellectual stimulation (86.6%), physical activity (82.6%), and healthful diet (82.5%) prevented or delayed cognitive impairment. Providers reported advising patients to reduce cognitive impairment risk through physical activity (85.9%), intellectual stimulation (80.3%), and social involvement (67.4%). Few consumers (7.8%) reported receiving this information from providers but reported learning about strategies to maintain memory, primarily from television (50.1%), magazines (44.1%), and newspapers (33.7%). CONCLUSION Providers reported advising patients about how to reduce risks of cognitive impairment. Consumers reported receiving this information from other sources. Findings suggest a need to examine and assess media messages and to better understand patient-provider communication about cognitive functioning.

Background Cancer-related beliefs, including cancer fatalism, have been shown to influence Blacks' adherence to cancer screening behaviors. Healthcare discrimination, religious beliefs, income, and education are known determinants of cancer fatalism, however, it is unclear whether other cultural and cancer-related beliefs and/or experiences play a role in fatalistic beliefs. Purpose To determine how sociodemographic characteristics, cancer-related and cultural beliefs contribute to cancer fatalism in a sample of Black adults. Methods A statewide survey was completed by 194 Black adults ≥18 years without a history of cancer from November 2014-July 2015. Sociodemographic characteristics, cancer worry, perceived cancer risk, knowing someone with cancer, mistrust in the medical system, present orientation, religious identity, and religious behaviors were assessed through the survey. Cancer fatalism was measured using a revised version of the Powe Fatalism Inventory. Multiple regression was used to analyze survey data. Results Regression analyses on 131 surveys with complete responses showed that age, income, possessing health insurance, having a present orientation, and engaging in prayer were significant predictors of fatalistic cancer beliefs (R2= 0.26, p Citation Format: Deeonna E. Farr, Heather M. Brandt, Daniela B. Friedman, Cheryl A. Armstead, Sue P. Heiney, Swann A. Adams, Wanda Green, James R. Hébert. Influence of culture and religion on fatalistic cancer beliefs. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A79.

African American (AA) men have signifi­cantly higher mortality rates from prostate cancer (PrCA) than other racial groups. Therefore, there is a critical need to identify strategies for promoting informed PrCA screening decisions among this population. This article details the community-driven, social and behavioral research being imple­mented by a Statewide Cancer Prevention and Control Program (CPCP) to support the development of person-to-person and technological interventions to improve the dissemination of PrCA information to AA men and their families. This article con­cludes with four recommendations to ad­vance future research and practice related to the use of interventions for promoting informed PrCA decision-making among AAs. These recommendations include: 1) informing men about controversial screen­ing recommendations; 2) including families in educational interventions about PrCA; 3) using technology as a modality for dissemi­nating PrCA information when appropriate; and 4) aiming to create interventions that can be translated into community and clini­cal settings. Ethn Dis. 2017; 27(1):55-62; doi:10.18865/ed.27.1.55.

Background: Eliminating racially driven cancer inequities requires conducting research with underrepresented groups, such as Black Americans, yet research participation is not comparable with the burden of cancer in this population. Distrust of the healthcare system is often cited as a central reason for Blacks' lower cancer research participation rates. Few studies have explored whether distrust operates alone or in combination with other attitudes toward research to influence Blacks' intention to participate in cancer research. The study purpose was to explain the relationship between healthcare distrust and the intention to participate in cancer prevention research among a group of Southern Blacks. We hypothesized that healthcare distrust would be inversely related to and a significant predictor of intention to participate in cancer prevention research. Methods: A survey tool was developed based on previous qualitative research and administered between November 2014 and July 2015. Eligible respondents identified as Black American, were 18 or older, residents of South Carolina, and had never been diagnosed with cancer. Of the 208 surveys collected, 194 met eligibility criteria. Analyses were restricted to 130 participants with complete responses. Survey items assessed participant demographics, healthcare distrust, and previous research participation. Research related attitudes/beliefs collected included positive and negative beliefs about research participation, social norms around participation, and beliefs about individual and community level outcomes of research participation. Multiple regression models were created to describe the relationship between negative beliefs about cancer prevention research and intention to participate in cancer prevention research. Analyses were conducted in STATA 13. Results: The analytic sample was predominately female (88.5%), employed (73.9%), lived in urban areas (83.9%), and had a high school education or less (55.4%). A large proportion reported being likely or very likely to participate in cancer prevention research (83.4%) but only 34.6% reported previous participation in health research. Intention to participate in cancer prevention research had a slightly negative association with healthcare mistrust (r= -0.19). Healthcare mistrust was predictive of intention to participate in the base model (R2=0.04), but after the addition of control variables healthcare mistrust became an insignificant predictor. The model was strengthened with the addition of scales reflecting positive and negative attitudes, social norms, and outcomes related to cancer prevention research participation (R2=0.40). Except for participation outcomes, all research related beliefs were significant predictors of intention. Additional models were constructed to determine the demographic covariates of research related beliefs. Only the model describing social norms around cancer prevention research was significant (R2=0.17), with gender serving as a significant predictor of the model. Conclusion: Although commonly referenced as a barrier to research participation among Black Americans, healthcare distrust failed to predict intention to participate in cancer prevention research. Social norms regarding participation and positive and negative attitudes toward participation in cancer prevention research were strong predictors of intention, yet beliefs about the outcomes of research had no impact on willingness to participate. This study highlights the need to explore a wider set of attitudes and beliefs in order to determine what drives intention to participate in cancer research in this population. Equally important is the need to explore influences on research participation outside of intention given the disparity between intention and participation in the study sample. Citation Format: Deeonna E. Farr, Heather M. Brandt, Daniela B. Friedman, Cheryl A. Armstead, Sue P. Heiney, Swann A. Adams, Wanda Green, Samira Khan, James R. Hebert. Untangling the influence of healthcare distrust on black Americans' intention to participate in cancer prevention research. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C03.

Introduction To facilitate national efforts to maintain cognitive health through public health practice, the Healthy Brain Initiative recommended examining diverse groups to identify stakeholder perspectives on cognitive health. In response, the Healthy Aging Research Network (HAN), funded by the Centers for Disease Control and Prevention (CDC), coordinated projects to document the perspectives of older adults, caregivers of people with dementia, and primary care providers (PCPs) on maintaining cognitive health. Our objective was to describe PCPs’ perceptions and practices regarding cognitive health. Methods HAN researchers conducted 10 focus groups and 3 interviews with physicians (N = 28) and advanced practice providers (N = 21) in Colorado, Texas, and North Carolina from June 2007 to November 2008. Data were transcribed and coded axially. Results PCPs reported addressing cognitive health with patients only indirectly in the context of physical health or in response to observed functional changes and patient or family requests. Some providers felt evidence on the efficacy of preventive strategies for cognitive health was insufficient, but many reported suggesting activities such as games and social interaction when queried by patients. PCPs identified barriers to talking with patients about cognitive health such as lack of time and patient reactions to recommendations. Conclusion Communicating new evidence on cognitive health and engaging older adults in making lasting lifestyle changes recommended by PCPs and others may be practical ways in which public health practitioners can partner with PCPs to address cognitive health in health care settings.

Program planners work with promotoras (the Spanish term for female community health workers) to reduce health disparities among underserved populations. Based on the Role-Outcomes Linkage Evaluation Model for Community Health Workers (ROLES) conceptual model, we explored how program planners conceptualized the promotora role and the approaches and strategies they used to recruit, select, and sustain promotoras.We conducted semi-structured, in-depth interviews with a purposive convenience sample of 24 program planners, program coordinators, promotora recruiters, research principal investigators, and other individuals who worked closely with promotoras on United States-based health programs for Hispanic women (ages 18 and older).Planners conceptualized the promotora role based on their personal experiences and their understanding of the underlying philosophical tenets of the promotora approach. Recruitment and selection methods reflected planners' conceptualizations and experiences of promotoras as paid staff or volunteers. Participants described a variety of program planning and implementation methods. They focused on sustainability of the programs, the intended health behavior changes or activities, and the individual promotoras.To strengthen health programs employing the promotora delivery model, job descriptions should delineate role expectations and boundaries and better guide promotora evaluations. We suggest including additional components such as information on funding sources, program type and delivery, and sustainability outcomes to enhance the ROLES conceptual model. The expanded model can be used to guide program planners in the planning, implementing, and evaluating of promotora health programs.

African American men report poorer health than do White men and have significantly greater odds for developing chronic diseases partly because of limited physical activity. Understanding how to encourage healthy behaviors among African American men will be critical in the development of effective physical activity messages and programs. Guided by principles of cultural sensitivity and social marketing, this research examined middle-aged and older African American men’s recommended strategies for promoting physical activity to African American men of their age. The authors report results from. 49 interviews conducted with middle-aged (45–64 years) and older (65–84 years) African American men in South Carolina. Four groups of African American men were recruited; middle-aged active men (n = 17), middle-aged inactive men (n = 12), older active men (n = 10), older inactive men (n = 10). Themes related to marketing and recruitment strategies, message content, and spokesperson characteristics emerged and differed by age and physical activity level. Recommended marketing strategies included word of mouth; use of mass media; partnering with churches, businesses, and fraternities; strategic placement of messages; culturally appropriate message framing; and careful attention to selection of program spokespersons. Findings will help in the marketing, design, implementation, and evaluation of culturally appropriate interventions to encourage physical activity among middle-aged and older African American men in the South.

Prostate cancer (PrCA) is the most commonly diagnosed non-skin cancer among men. PrCA mortality in African-American (AA) men in South Carolina is ~50% higher than for AAs in the U.S as a whole. AA men also have low rates of participation in cancer research. This paper describes partnership development and recruitment efforts of a Community-Academic-Clinical research team for a PrCA education intervention with AA men and women that was designed to address the discordance between high rates of PrCA mortality and limited participation in cancer research. Guided by Vesey's framework on recruitment and retention of minority groups in research, recruitment strategies were selected and implemented following multiple brainstorming sessions with partners having established community relationships. Based on findings from these sessions culturally appropriate strategies are recommended for recruiting AA men and women for PrCA education research. Community-based research recruitment challenges and lessons learned are presented.

Community-based participatory research (CBPR) initiatives such as the National Cancer Institute’s Community Networks Program (CNP) (2005–2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. From July to October 2010, a convenience sample of 80 participants from the 25 CNP national sites completed our 45-item, web-based survey on the training and mentoring of junior investigators. This study assessed the academic productivity and CBPR-related experiences of the CNP junior investigators (n = 37). Those from underrepresented backgrounds reported giving more presentations in non-academic settings (nine vs. four in the last 5 years, p = 0.01), having more co-authored publications (eight vs. three in the last 5 years, p = 0.01), and spending more time on CBPR-related activities than their non-underrepresented counterparts. Regardless of background, junior investigators shared similar levels of satisfaction with their mentors and CBPR experiences. This study provides support for the success of the CNP’s training program, especially effort directed at underrepresented investigators.

The South Carolina Cancer Prevention and Control Research Network, in partnership with the South Carolina Primary Health Care Association, and Federally Qualified Health Centers (FQHCs), aims to promote evidence-based cancer interventions in community-based primary care settings. Partnership activities include (1) examining FQHCs’ readiness and capacity for conducting research, (2) developing a cancer-focused data sharing network, and (3) integrating a farmers’ market within an FQHC. These activities identify unique opportunities for public health and primary care collaborations.

PURPOSE of the Study: We examined messages that the websites of the top cable news companies (MSNBC, FOX, and CNN) conveyed about cognition between January 2007 and March 2010. Drawing on agenda-setting theory, this work assessed the frequency, prominence, and attributes of cognitive topics in messages targeting an aging audience. Design and Methods: We used quantitative content analysis to examine the frequency and prominence of cognitive topics and cognitive goals, as well as how the cognitive discussions were framed. Chi-square analyses were conducted to compare cognitive health information discussed in news items that did and did not target an "aging audience." Qualitative analysis of the aging audience subgroup was used to further examine age-associated cognitive messages. RESULTS: Within the 229 cognitive items identified, we found significantly more coverage of cognitive functioning and unspecified dementia and significantly less coverage of cognitive disease not dementia, specified dementia, and accidents or injury for the aging audience. Our qualitative analysis of news items aimed at an aging audience documented a focus on maintaining functioning and avoiding decline through various individual lifestyle behaviors. However, contextual information about level of cognition to be maintained, particular cognitive functions targeted, specific norms about cognitive aging, and how cognitive function is determined was lacking. Implications: Our research points to a communication gap in the delivery of academic research findings to a lay audience through online journalism. We suggest more clarity by researchers in defining cognitive concepts and measurement of cognitive function for journalistic translation and public consumption. Language: en

The promise of human papillomavirus (HPV) vaccines rests with the ability to promote widespread uptake especially among populations at high risk of cervical cancer and other associated disease outcomes. The purpose of this study was to examine health beliefs and culturally specific influences of HPV vaccine acceptability among African American college females. Approximately 76 percent of participants reported HPV vaccine acceptability. Predictors of acceptability included: higher perceived benefit and lower racial pride. Findings can be used to inform development of campus-based HPV educational approaches to promote widespread HPV vaccine acceptability and safer sex practices among African American college females.

Research suggests that lesbians turn to the Internet for information regarding their sexual health. However, limited research has examined the availability of online sexual health resources for this population. This study evaluated the volume, scope, and readability of sexual health information available to lesbians on the Internet. The top three Nielsen-rated search engines were used to identify websites generated using the search term “lesbian sexual health.” A content analysis was conducted of 25 unique, functioning websites (46 webpages total) and Flesch Reading Ease and Flesch–Kincaid grade levels were calculated. Nearly one third of the websites were located outside the United States; two were U.S. government sites. Although most sites provided information about sexually transmitted infections and HIV/AIDS (52% to 72%), fewer provided information about safer sex practices (12% to 56%), reproductive cancers (24% to 36%), intimate partner violence (16%), family planning issues (0% to 12%), or other preventive health practices, such as mammograms and gynecological exams (4% to 44%) for lesbians. Readability of websites was much higher than recommended for health materials. Lesbians are in need of comprehensive and reliable sexual health information on the Internet. In particular, sexual health messages written in plain language are needed to encourage safer sex and other preventive practices among lesbians.

Objective: Given recent approval for administration of a human papillomavirus (HPV) vaccine to men, it is important to assess the HPV-related perspectives of men and women. The purpose of this study was to examine gender differences in HPV knowledge, beliefs, and vaccine acceptance among college students attending 3 historically black colleges/universities in the Southeast. Participants and Methods: A nonprobability sample of 575 students completed a self-report questionnaire. Results: Males were significantly less likely to have heard of HPV, scored lower in HPV knowledge, were less likely to perceive HPV health outcomes as severe and that there was a benefit to vaccinate, reported fewer cues for vaccine acceptance, and perceived more barriers to vaccination compared to females (all p < .05). Conclusions: The gender disparities demonstrated in this study highlight the need to increase HPV-related communication/education to include men and to extend HPV research to a broader segment of the colleg...

Messages promoting physical activity (PA) to maintain cognitive health (CH) may increase PA and enhance CH among older persons. This study examined older adults’ perceptions of PA and CH. We conducted 10 focus groups with irregularly active older Black and White women and men ( N = 55), ages 65 to 74 in South Carolina. Constant comparison methods compared themes by gender and race/ethnicity groups. Most participants perceived cognitive decline as a severe threat, and they were primarily concerned about losing their independence. Most reported feeling susceptible to cognitive decline. Although most recognized the link between PA and CH, several White men said the association was not clear. Participants recommended a wide range of PA amounts needed to achieve CH benefits. Many suggested that evidence of PA benefits for CH would enhance message credibility. Participants suggested messages be paired with social support to increase PA. Results suggest a need for evidence-based, credible communication promoting PA and CH.

Little is known about prostate cancer (PrCA) screening information on participatory, interactive, and consumer-generated websites collectively referred to as Web 2.0. A content analysis was conducted of PrCA resources on four highly trafficked Web 2.0 social bookmarking sites. A total of 127 webpages were analyzed. Most content was from news websites (48.9%) and blogs (37.8%). PrCA screening was mentioned on 95.3% of pages; only 30.7% discussed the prostate-specific antigen test. Less than half (43.8%) mentioned current screening guidelines. PrCA content is inconsistent on Web 2.0 sites. Future research should assess the readability and usability of Web 2.0 cancer resources.

The Internet plays a crucial role in the communication of health news and information. This study is the first to examine the volume and scope of health coverage on local television news Websites. Mobilising information (MI), information found in news that can cue people to act on pre-existing attitudes, was also explored. Specifically, this study analysed the content of 278 health stories on 79 local television news Websites during September and October 2007. Data revealed that health stories were present on 64% of the sites examined. Only 30%, however, took advantage of the interactive nature of the Internet by linking the reader to other health sites or giving an e-mail address to obtain additional information. Thirty-two percent of the stories contained MI. Of those stories, locational MI (24%) was significantly more likely to be present than tactical (17%) or identificational (14%) (p 0.05). There were also significant differences between large and small media markets regarding specific health content. Television news Websites produced by large market stations (designated market size (DMA) 1-50) were significantly more likely than very small market stations (DMA 151+) to contain health stories and have a separate health-related Web page.

Being prepared with accurate, credible, and timely information during a disaster can help individuals make informed decisions about taking appropriate actions. Unfortunately, many people have difficulty understanding health and risk-related resources. This exploratory, mixed methods study assessed disaster information seeking behaviors and comprehension of public health disaster preparedness resources by individuals with low literacy. A convenience pilot sample of 20 adult learners (mean age: 53.1) attending a local literacy center were recruited. Health literacy was assessed using Newest Vital Sign (NVS) and modified Cloze (multiple choice) tests on biological terrorism and Avian influenza. In-person interviews were conducted to determine participants’ knowledge, perceptions, and information needs about disasters. Thematic analysis of interviews was conducted using NVivo7. Mean NVS was 3.11/6.00 implying poor health literacy. Mean Cloze scores revealed marginal disaster comprehension (Avian flu: .46/1.00; Biological terrorism: .48/1.00). Over half of participants with inadequate Cloze comprehension self-rated their understanding as “good.” Key themes emerging from interviews were: misperceptions about disasters, limited access to preparedness resources, need for visuals and plain language information, and importance of knowing where to go during a disaster. Study findings advocate for multimedia, plain language, and visual communication to improve adult learners’ self-efficacy in interpreting instructions and acting appropriately in preparing for and responding to disasters.

Background. Mortality from prostate cancer (PrCA) in African-American (AA) men is significantly higher than in European-American (EA) men. Methods. Purposive sampling identified 25 AA men ≥45 years for interviews/focus groups. Participants were asked about cancer information-seeking behaviors, capacity to use information, and recommendations for messages and message delivery. Transcripts were analyzed for themes about PrCA communication. Results. Barriers to information seeking were fear, poor resources, and limited family communication. Participants requested messages stressing men’s “ownership” of PrCA delivered “word-of-mouth” by clergymen, AA women, and AA PrCA survivors. Conclusions. Direct and timely messages about PrCA should be developed for AA men.

Prostate cancer (PrCA) is the most diagnosed cancer among men in the United States, especially among African American (AA) men. The purpose of this formative study was to explore the implications of applying Nutbeam's multidimensional health literacy framework to AA men's understanding of PrCA information. Participants were 25 AA men aged 45 and older in South Carolina. Their functional health literacy was assessed using two modified Cloze tests and the Shortened Test of Functional Health Literacy in Adults (S-TOFHLA). Men also participated in interviews or focus groups during which they were asked questions about PrCA risk, prevention, and screening. Transcripts were reviewed for recurrent themes and analyzed qualitatively using NVivo7. Mean S-TOFHLA was 28.28 (+/-1.98), implying "adequate" comprehension. Mean Cloze was .71 (+/-.05) for a Grade 8 document and .66 (+/-.04) for a Grade 13 document, also showing "adequate" comprehension. Cloze scores for the Grade 8 resource were lower for participants with less education (P = .047). Despite having satisfactory literacy test scores, results from interviews and focus groups revealed participants' limited understanding and misconceptions about PrCA risk. Many wanted information about screening and family history delivered word-of-mouth by AA women and church pastors as few of them had ever received or actively sought out PrCA resources. Using Nutbeam's framework, gaps in health literacy which were not adequately captured by the validated tools emerged during the interviews and focus groups. Study findings provide important implications for PrCA communication with AA men to correct misperceptions about cancer risk and motivate preventive behaviors.

There is growing evidence that healthy behaviors may promote cognitive health. The behaviors include physical activity, heart-healthy diets, and social engagement. Popular print media helps disseminate health information. This study examines the content focused on cognitive health in 5 top—circulating magazines marketed to older people in the United States. All pages (29 881 pages) of each magazine published in 2006 and 2007 were searched. There were 84 articles on cognitive health. Few were by health or science writers. Of the 58 articles on prevention, the contents focused primarily on diet and multiple behaviors, with less on physical activity or social engagement. Less than 20% provided resources to help readers obtain further information. Articles focused on physical activity, with information directing readers to credible resources, and by writers with health or science backgrounds, could enhance the quality of cognitive health communication in popular media.

Introduction Older men are at increased risk for prostate cancer. As seniors turn to the Internet for cancer information, it is important that the resources they locate about lifestyle behaviors and screening are culturally appropriate and easy to understand. This study was a comprehensive analysis of prostate cancer risk as portrayed on the Internet with assessment of content readability and cultural sensitivity. Methods We selected Web sites about prostate cancer risk and prevention by comparing common sites across three top-rated search engines (Google, Yahoo!, and MSN). A total of 70 Web sites on prostate cancer containing a Web page on risk factors or prevention or both for racial and ethnic populations were included. We assessed readability of one page per Web site using Simple Measure of Gobbledygook (SMOG), Flesch-Kincaid (FK), and Flesch Reading Ease (FRE) measures. Cultural sensitivity of the Web page was evaluated using the Cultural Sensitivity Assessment Tool (CSAT) and questions from a cultural sensitivity checklist. Results Mean readability of Web pages was Grade 12.90 (high school graduate level) using SMOG and Grade 11.20 according to FK. Mean FRE was 45.04 (fairly difficult to read). The mean CSAT score was 2.78 and classified as culturally sensitive. Of the 36 Web pages considered culturally sensitive (CSAT >2.50), 75% did not portray images of representative racial or ethnic individuals as intended readers or as being at high risk for prostate cancer. Older adults and seniors were identified as intended readers on 73% of Web pages. Conclusion Online cancer resources are targeting appropriate age groups (high-risk older adults). However, the pages required fairly high-level reading skills and had limited cultural sensitivity. These factors make the pages unsuitable for diverse Internet users.

Inappropriate use of antibiotics in humans and animals contributes to decreased antimicrobial susceptibility in bacteria of medical importance. Resistant bacteria being transferred from animals to humans are causing public health concern. In-person interviews were conducted with 20 dairy farmers in rural counties of South Carolina to determine farmers' knowledge and attitudes about prudent antibiotic use among livestock. Four focus groups (n = 22) were also conducted to ascertain farmers' specific information needs about proper antibiotic use. Survey results showed that participants (100%) typically determined a need for antibiotic treatment using symptom assessment and reported following some form of operating procedures regarding administration of antibiotics. Few farmers (32%) had actual written antibiotic protocols. Preferred information sources about antibiotics were veterinarians (100%) and other dairy farmers (50%). Most farmers (86%) were not concerned that overuse of antibiotics in animals could result in antibiotic resistance among farm workers. Qualitative analysis of focus groups revealed significant barriers to following proper antibiotic procedures including limited finances and lack of time. The need for bilingual educational resources for Hispanic/Latino dairy workers was expressed. Desired formats for educational materials were posters, flowcharts, videos, and seminars. Education of South Carolina dairy farmers by veterinarians and public health professionals on the appropriate use of antibiotics in dairy cattle is needed to ensure antibiotic effectiveness in both animals and humans.

Printed cancer information often is written at or beyond high school reading levels, despite lower average literacy abilities of the public. The objectives of this exploratory study were twofold: (1) to evaluate older adults' comprehension of breast (BC), prostate (PC), and colorectal (CC) cancer information; and (2) to determine if comprehension of BC, PC, and CC information varies according to text readability. Comprehension of printed cancer resources was evaluated with 44 community-dwelling older adults using the Cloze procedure and recall questions. Participants' comprehension scores were compared with Simple Measure of Gobbledegook (SMOG) readability scores (

Cancer prevention educational resources intended for members of ethnically diverse populations should be tailored to the specific cancer knowledge and beliefs of individual ethnic groups. Culturally sensitive printed materials on cancer prevention have been proposed in the literature.1) To explore definitions of the term cultural sensitivity (CS) and their application to the development and testing of cancer prevention education materials for ethnic minority groups; and 2) to assess the use of instruments or scales used to measure the CS of cancer information resources.A list of articles explicitly on the CS of cancer prevention education materials was assembled by searching the databases of PubMed, CancerLit, PsycINFO, and Sociological Abstracts for articles published between 1994-2004.Ten studies that met inclusion criteria were included in this review. Most articles included breast cancer resources (90%) and targeted African American populations (70%). Few studies defined the term CS (n=4). Only three studies employed instruments to evaluate the CS of printed cancer information resources, and none of them explicitly listed standard measures of validity or reliability.Best practice definitions and guidelines for culturally sensitive cancer prevention education need to be established. Ethnic minority individuals' cancer-related knowledge and beliefs must be incorporated into all printed cancer education efforts.

to assess the readability level of Web-based information on leading incident cancers.websites on breast, prostate, and colorectal cancers were selected for analysis by comparing the first 100 hits across 10 popular search engines. A total of 100 websites on breast (n=33), prostate (n=34), and colorectal (n=33) cancers were included in the final analysis.readability was assessed using SMOG, Flesch-Kincaid (F - K), and Flesch Reading Ease (FRE) measures. SMOG was hand-calculated on 10 - 30 lines of continuous text. Identical text was entered into Microsoft Word 2002 where F - K and FRE scores were determined automatically by the word processor.the mean readability score of the cancer websites was Grade 12.9 using SMOG and Grade 10.7 according to F - K. The mean FRE score was 45.3, a score considered 'difficult'. Colorectal cancer websites were most difficult to read compared to breast and prostate cancer websites. All measures indicated that prostate cancer websites were written at the lowest readability. Significantly higher reading levels were required for concluding paragraphs of Web articles compared to introduction paragraphs.findings suggest the need for readable cancer information on the Web. Health promoters, health informaticians, medical journalists, and web page editors must collaborate to ensure the use of plain language to match the literacy skills of consumers.

Ethnic minority populations prefer cancer information that is respectful of their customs and beliefs about health and illness. Community newspapers are an important source of cancer information for ethnic groups. Our purpose is to evaluate the cultural sensitivity of cancer information in mass print media targeting ethnic minority readership. We assessed for cultural sensitivity 27 cancer articles published in English-language ethnic newspapers (Jewish, First Nations, Black/Caribbean, East Indian) in 2000 using the Cultural Sensitivity Assessment Tool (CSAT). We found that the overall average CSAT score of 27 cancer articles was 2.71. (Scores2.50 were classified as culturally insensitive.) Articles in First Nations newspapers were more culturally sensitive according to the CSAT (X=2.86), followed by articles in Black/Caribbean (X=2.79) and Jewish (X=2.78) papers. Cancer articles from East Indian newspapers had a mean CSAT score of 2.30 and were classified as culturally insensitive. Four articles were considered culturally sensitive but did not mention ethnic populations as intended readers or as high-risk groups for cancer. We found that, using the CSAT measure, overall, cancer articles in ethnic newspapers included in this study were culturally sensitive. Given limitations of this instrument, we recommend an additional checklist for evaluating the cultural sensitivity of printed cancer information.