Appalachian communities are disproportionately affected by many of the leading risk factors associated with cancer incidence and mortality, factors amenable to primary and secondary prevention. Extensive involvement with our community partners has demonstrated strong community preference for a holistic approach toward cancer prevention;The proposed intervention extends our successful faith-based, trained lay health advisor tailored intervention, "Faith Moves Mountains," (R01CA108696) initiated three years ago, to administer a culturally appropriate CBPR intervention. Working in partnership with 70 faith based institutions in rural Southeastern Kentucky, we propose to administer, evaluate, and disseminate a tailored wellness and cancer prevention program focused on four of the most common prevention activities that have the potential of greatly preventing and reducing cancer morbidity and mortality. These prevention activities include smoking cessation (targeting all chronic diseases, cervical and lung cancer);energy balance including dietary modification and physical activity promotion (targeting all chronic diseases and colorectal cancer (CRC)), and cancer screenings (targeting CRC, cervical, and breast cancer). Consistent with our Faith Moves Mountains and cancer control approach, faith-based organizations will sponsor a "kick off event" or health fair in which participants will undergo a health risk appraisal (baseline). Participants will then select one or more wellness activities (smoking cessation, energy balance, cancer screening);then, trained lay health advisors will offer modules on each of these wellness activities. Smoking cessation will include the culturally relevant Cooper-Clayton method (outcome: smoking abstinence). For those targeting dietary modification and physical activity, a rural Appalachian modified Healthy Body/Healthy Spirit program will be administered (outcome: dietary change and physical activity participation). Tailored cancer screening promotion will be based on our current Faith Moves Mountains design (outcome: receipt of any recommended CRC screening test, Pap test for cervical cancer, and/or mammogram). To assess the intervention but remain consistent with community norms, we will employ a staggered intervention design. Throughout the project, the RE-AIM model will inform our evaluation. During phase three, this CBPR wellness approach to cancer prevention will undertake qualitative process evaluation interviews and disseminate the intervention to medically underserved Appalachian Ohio in collaboration with partners at Ohio State University. This collaboration will facilitate dissemination of successful intervention to additional rural Appalachian populations with high rates of cancer health disparities.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Resource-Related Research Projects (R24)
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Special Emphasis Panel (ZMD1-RN (01))
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Dankwa-Mullan, Irene
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University of Kentucky
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Schoenberg, Nancy E; Bundy, Henry E; Baeker Bispo, Jordan A et al. (2015) A rural Appalachian faith-placed smoking cessation intervention. J Relig Health 54:598-611
Schoenberg, Nancy E; Studts, Christina R; Hatcher-Keller, Jenna et al. (2013) Patterns and determinants of breast and cervical cancer non-screening among Appalachian women. Women Health 53:552-71
Kruger, Tina M; Howell, Britteny M; Haney, Alicia et al. (2012) Perceptions of smoking cessation programs in rural Appalachia. Am J Health Behav 36:373-84
Schoenberg, Nancy E; Howell, Britteny M; Fields, Nell (2012) Community strategies to address cancer disparities in Appalachian Kentucky. Fam Community Health 35:31-43