Search

This study explored whether reactions to the Cancer Genetics Network (CGN) or CGN enrollment differed by receipt of a standard informational brochure versus a targeted version addressing factors previously associated with African Americans’ health behavior decisions and research participation. The 262 participants, identified through tumor registries or clinic contacts, were mailed brochures and completed phone interviews. When asked whether – based on the brochure – they were or were not ‘leaning toward’ CGN enrollment, about 75% of both standard and targeted groups reported leaning toward. When given the opportunity at the end of the interview, 68% enrolled in the CGN. Trust was strongly related to enrollment. Less education, less satisfaction with cancer care, and individualistic rather than collective orientation were associated with lower trust. Education was also bivariately associated with enrollment, but mediation analysis indicated that the operational mechanism of education’s influence on enrollment was through trust.

OBJECTIVE: In the last decade, African-American congregations have been inundated with requests to participate in health promotion activities; however, most are not equipped to effectively participate. We assessed the effect of providing congregation leaders with skills on identifying their own health needs, planning, and implementing their own interventions. METHODS: At baseline, 21 congregational leaders from South East Raleigh, NC were taught methods for developing needs assessments, planning, and implementing health promotion activities tailored for their congregations. After approximately four years, 14 of the 21 congregations were successfully recontacted. RESULTS: At baseline, the congregation leadership ranked diabetes as the ninth (out of 10) most urgent health concern in their communities. However, at follow-up, not only was diabetes identified as the most serious health concern, but most congregations had taken advantage of available community and congregational resources to prevent it. Larger congregations were more likely than smaller ones to take advantage of available resources. CONCLUSIONS: Larger African-American congregations are an effective vehicle by which health promotion messages can diffuse; however, the leadership must be provided with skills to assess health needs before selecting programs most beneficial to their congregations. Mechanisms by which small congregation leaders can participate need development.

Background Middle-aged African American women have the highest incidence and mortality of invasive cervical cancer in the United States and the lowest adherence to pap smear screening. Methods In 2001, we identified factors associated with non-adherence to screening recommendations using three focus group interviews and subsequently developed a questionnaire administered to 144 African American women aged 45 to 65 years. Results The perception that the Pap test was painful was associated with non-adherence to screening recommendations (OR = 4.78; 95%CI: 1.67–13.7). Difficulty to pay for the office visit coupled with perceived pain was associated with a nearly sixfold increase in risk of non-adherence (OR = 5.8; 95%CI: 2.8–15.5). Previously identified barriers to screening including lower education and socioeconomic status, poor access to care, knowledge of and exposure to known risk factors of invasive cervical cancer, cancer fatalism, and perceived racism were not independently associated with non-adherence. Conclusions These data suggest that, among middle-aged African American women, future interventions addressing pain during a Pap test will likely increase acceptability of and adherence to cervical cancer screening. Pain could be addressed either by providing information during the pap test and/or using smaller lubricated speculums.

Prostate cancer incidence is about 70% higher among African Americans compared to Whites. Factors associated with this differential remain unclear, although several studies suggest that genetic factors may play a role. Before epidemiologic research can adequately identify factors associated with this differential, we need studies to determine the feasibility of recruiting and retaining African-American men in cohort studies, especially those that collect biological and questionnaire data.We conducted 4 focus group discussions among African-American men aged 40 to 64 years in North Carolina, and an additional group comprised of their partners, using a semi-structured interview protocol (total N=55 subjects). Data were analyzed with QRS NU*DIST to identify themes.Participants' willingness to participate in cohort studies seemed to be motivated by a perceived risk of prostate cancer. Barriers to participation included mistrust of the research community, poor knowledge of cancer-site specific heterogeneity, anticipated time commitment, and the invasive nature of disease detection procedures. To foster trust and increase disease knowledge, recommended strategies included: partnering with known civic organizations that provide education on risk factors; discussing early signs and symptoms at the point of recruitment; recruiting participants from community clusters; and providing periodic feedback on biologic samples (if collected) to reassure participants of their proper usage.Observational cohort studies focused on African-American men are feasible if certain barriers to participation are addressed.