African Americans are disproportionately affected by cancer when compared to other racial or ethnic groups. There are a number of social and cultural factors that relate to prevention and screening behaviors that impact cancer mortality rates. Religious/spiritual involvement appears to be one of these factors. We have two ongoing studies that are testing a theoretical model of religious/spiritual involvement and cancer risk, prevention, and screening behaviors, as well as physical and emotional functioning. A set of ten potential mediators are being examined among a national probability sample of African Americans. These are the first known studies to empirically test such models. During the interviews participants were asked if they would be willing to be re-contacted for a subsequent interview. Over 90 percent of participants have indicated yes. We now have a unique and time-sensitive opportunity to conduct a four-year follow-up of these two research cohorts, providing a longitudinal analysis of the relationships being examined in the parent studies. In addition, we propose to conduct a third wave of longitudinal data collection at six years post baseline. These additional waves of data collection will strengthen the meditational analyses in both of the parent studies. This would provide a much-needed longitudinal test of the religion-health connection, and to our knowledge the only longitudinal analysis of mediators of the religion-health connection. Finally, the proposed study would strengthen cause-effect interpretations, something that cannot be done with cross sectional data.
The specific aims of the proposed study are to: (1) Expand two of our ongoing cross-sectional investigations into longitudinal cohort studies, by conducting a four-year and a six-year follow-up assessment among our cohort of 3,173 healthy African American adults;and (2) Develop and disseminate recommendations for practice, based on findings from Specific Aim #1. For example, we will identify mediators and outcomes that appear to be modifiable over time, and make recommendations on how to integrate important mediators through which religious/spiritual involvement impacts behavior, into existing cancer screening and prevention programs for African Americans. This could significantly improve effectiveness of programs delivered in faith-based settings, which could have an impact on cancer disparities.

Public Health Relevance

The proposed study will provide a longitudinal analysis of the role of religiosity/spirituality in health behaviors and outcomes in a national sample of African Americans. Study findings will be disseminated, and will directly inform community-based intervention work aimed at the reduction of cancer health disparities in this population, which suffers a disproportionate burden of cancer.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Health Disparities and Equity Promotion Study Section (HDEP)
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Chollette, Veronica
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University of Maryland College Park
Public Health & Prev Medicine
Schools of Public Health
College Park
United States
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Holt, Cheryl L; Roth, David L; Huang, Jin et al. (2017) Longitudinal effects of religious involvement on religious coping and health behaviors in a national sample of African Americans. Soc Sci Med 187:11-19
Roth, David L; Usher, Therri; Clark, Eddie M et al. (2016) Religious Involvement and Health over Time: Predictive Effects in a National Sample of African Americans. J Sci Study Relig 55:417-424
Le, Daisy; Holt, Cheryl L; Hosack, Dominic P et al. (2016) Religious Participation is Associated with Increases in Religious Social Support in a National Longitudinal Study of African Americans. J Relig Health 55:1449-60
Holt, Cheryl L; Le, Daisy; Calvanelli, Joe et al. (2015) Participant Retention in a Longitudinal National Telephone Survey of African American Men and Women. Ethn Dis 25:187-92
Holt, Cheryl L; Le, Daisy; Saunders, Darlene R et al. (2015) Informed Decision-Making and Satisfaction with a Church-Based Men's Health Workshop Series for African-American Men: Men-Only vs. Mixed-Gender Format. J Cancer Educ 30:530-4
Holt, Cheryl L; Clark, Eddie M; Debnam, Katrina J et al. (2014) Religion and health in African Americans: the role of religious coping. Am J Health Behav 38:190-9
Holt, Cheryl L; Roth, David L; Clark, Eddie M et al. (2014) Positive self-perceptions as a mediator of religious involvement and health behaviors in a national sample of African Americans. J Behav Med 37:102-12
Saunders, Darlene R; Holt, Cheryl L; Whitehead, Tony L et al. (2013) Development of the men's prostate awareness church training: church-based workshops for African American men. Fam Community Health 36:224-35
Debnam, Katrina J; Holt, Cheryl L; Clark, Eddie M et al. (2012) Spiritual health locus of control and health behaviors in African Americans. Am J Health Behav 36:360-72
Roth, David L; Mwase, Isaac; Holt, Cheryl L et al. (2012) Religious involvement measurement model in a national sample of African Americans. J Relig Health 51:567-78

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