Despite significant efforts, African Americans continue to experience excess rates of morbidity and mortality from cancer compared to individuals from other ethnic and racial groups. Primary access to cancer screening services plays an important role in reducing racial disparities in cancer outcomes;however, data from national surveys demonstrate that some individuals continue to be underserved. Even though free and low cost screening programs have been developed, these services may be under-utilized among African Americans. Increasingly, navigator programs for cancer care are being developed and evaluated in clinical settings to facilitate access to cancer diagnosis and treatment. However, to be effective at reducing cancer disparities in underserved populations, navigator programs are needed at all phases of the cancer care continuum, including early detection, and should be available in community settings. In response to }PAR-07-283, Community Participation in Research,} we propose to develop and evaluate a community-based navigator program for cancer care through an established academic-community partnership consisting of investigators from the University of Pennsylvania and representatives from community-based organizations who are participating in the West Philadelphia Consortium to Address Disparities.
The specific aims of the study are as follows: (1) to develop and implement a community-based navigation (CBN) program for cancer control in a medically underserved population;(2) evaluate uptake of the CBN program among African Americans based on socioeconomic factors, psychological variables, and sociocultural factors;and (3) evaluate the effects of the program in terms of perceived barriers and benefits to cancer screening. We predict that women and those with greater knowledge about cancer and perceived risk will be most likely to participate in the CBN program. We also predict that sociocultural factors (e.g., cultural beliefs and values and social support) will be associated with participation such that individuals with lower levels of present temporal orientation and those with less social support will be most likely to participate in the program. Further, we hypothesize that compared to those who decline, individuals who participate in the CBN program will report greater increases in adherence to cancer screening recommendations and perceived benefits to screening and greater reductions in perceived barriers. This study will be implemented in two phases. In Phase I, we will develop a community- based navigator program that targets African American men and women ages 50 to 75 in West Philadelphia through an academic-community partnership and in Phase II, we will identify predictors of program adoption and will evaluate the impact of this program among community residents. This study will provide empirical data on the psychological and behavioral impact of a community-based approach for facilitating primary access to cancer care services in a medically underserved population. Cancer is the second leading cause of death among African Americans. This study will provide empirical data on individuals who are most and least likely to use a community-based approach for facilitating primary access to cancer screening and will also evaluate the psychological and behavioral impact of this approach in a medically underserved population.

Public Health Relevance

Cancer is the second leading cause of death among African Americans. This study will provide empirical data on individuals who are most and least likely to use a community-based approach for facilitating primary access to cancer screening and will also evaluate the psychological and behavioral impact of this approach in a medically underserved population.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA132656-05
Application #
8301729
Study Section
Special Emphasis Panel (ZRG1-HOP-S (52))
Program Officer
Chou, Wen-Ying
Project Start
2008-09-17
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2014-07-31
Support Year
5
Fiscal Year
2012
Total Cost
$464,107
Indirect Cost
$135,381
Name
University of Pennsylvania
Department
Psychiatry
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Halbert, Chanita Hughes; Briggs, Vanessa; Bowman, Marjorie et al. (2014) Acceptance of a community-based navigator program for cancer control among urban African Americans. Health Educ Res 29:97-108
Halbert, Chanita Hughes; Bellamy, Scarlett; Briggs, Vanessa et al. (2014) Intervention completion rates among African Americans in a randomized effectiveness trial for diet and physical activity changes. Cancer Epidemiol Biomarkers Prev 23:1306-13
Halbert, Chanita Hughes; Bellamy, Scarlett; Briggs, Vanessa et al. (2014) Collective efficacy and obesity-related health behaviors in a community sample of African Americans. J Community Health 39:124-31
Weathers, Benita; Barg, Frances K; Bowman, Marjorie et al. (2011) Using a mixed-methods approach to identify health concerns in an African American community. Am J Public Health 101:2087-92
Halbert, Chanita Hughes; Bellamy, Scarlett; Bowman, Marjorie et al. (2010) Effects of integrated risk counseling for cancer and cardiovascular disease in African Americans. J Natl Med Assoc 102:396-402