Breast cancer is an important area of health disparity in that African American women are more likely to die from the disease than women of other groups. Although church-based health education interventions serving African Americans have begun to arise in several health areas (e.g., hypertension, diabetes, breast cancer), very few use a communication approach that contains actual spiritual content. The church is a convenient and effective means of reaching otherwise underserved populations, and church-based programs have been effective for serving this group. However, using the church solely as a venue and providing secular messages in this environment clearly underutilizes the potential for these interventions, particularly because spirituality factors have been shown to have important associations with breast cancer outcomes (e.g., breast cancer knowledge; mammography barriers and benefits; mammography use). In addition, empirical studies have demonstrated that health communication interventions are most effective when they address the beliefs and values of the audience. By introducing spiritual health messages to these interventions, the personal relevance of the message is increased, and the message will be more likely to be successful in stimulating attitude and behavior change. It is also important that this spiritual message content be firmly rooted in theory, addressing spiritual factors empirically shown to be associated with breast cancer outcomes. By developing a health message framed with spiritual factors, the effectiveness of church-based health education interventions can be maximized. The proposed pilot study will develop and evaluate the effectiveness of such a spiritually-based breast cancer communication intervention, comparing it in a randomized controlled trial with both a demographically targeted (for African American women) and a standard (non-targeted) breast cancer communication among 168 African American women in St. Louis, Missouri. Effectiveness of these three approaches will be measured from an Elaboration Likelihood Model information-processing perspective immediately after exposure and one month later. Study outcomes include participants' cognitive responses to the interventions (a theoretically based and empirically supported index of communication effectiveness) as well as pre-behavioral factors previously shown to be associated with mammography utilization (e.g., stage of readiness, breast cancer knowledge). If the spiritually based breast cancer communication intervention is found to be effective in terms of these outcomes, it can be further developed into a more extensive intervention and tested in a full-scale randomized trial with mammography as the primary outcome.
| Holt, Cheryl L; Lee, Crystal; Wright, Katrina (2008) A spiritually based approach to breast cancer awareness: cognitive response analysis of communication effectiveness. Health Commun 23:13-22 |
| Holt, Cheryl L; Clark, Eddie M; Klem, Patrick R (2007) Expansion and validation of the spiritual health locus of control scale: factorial analysis and predictive validity. J Health Psychol 12:597-612 |
| Holt, Cheryl L; Klem, Patrick R (2005) As you go, spread the word: spiritually based breast cancer education for African American women. Gynecol Oncol 99:S141-2 |
| Holt, Cheryl L; Kyles, Annika; Wiehagen, Theresa et al. (2003) Development of a spiritually based breast cancer educational booklet for African American women. Cancer Control 10:37-44 |
