Although efficacious screening methods exist for breast and cervical cancer, underutilization is common in minority older women. Their cancers are diagnosed at a later stage with a worse prognosis. These cancers are significant for the elderly since over 50% of breast cancers occur in women over age 60. Screening for cervical cancer has contributed to a decline in mortality in all non-elderly populations. the Public Health Service, in its report """"""""Promoting Health/Preventing Disease: Year 2000 Objectives for the Nation"""""""", has determined that the future target population for screening will only be reached with interventions developed to overcome barriers associated with age, race/ethnicity, income, and education. While this consensus document identifies breast cancer screening objectives to be achieved during this decade, it does not provide strategies for meeting these objectives. Action for Health, developed at CWRU, is a unique cancer prevention curriculum designed specifically to overcome barriers int he utilization of breast and cervical cancer screening in minority older women. The program utilizes trained senior adults as peer-trainers and uses a combination of didactic and experience-based learning strategies. We hypothesize that Action for Health will: .result in a sustained change in 70% of program participants in utilization of at least one area of cancer screening: mammography, breast exams and Pap smears. .yield improvement in perceived health status for 70% of the participants. .after adaptation, be as beneficial for a rural population as an urban population. The long range goal is to reduce breast/cervical cancer mortality in minority elders by increased rates of early detection through our cancer prevention curriculum. The objectives are to: 1) document the effectiveness of a program in African-American and Hispanic women in Cleveland; 2) compare the effectiveness of an urban-based program to a curriculum in rural North Carolina. The research design will be a multiple time series quasi-experimental design to evaluate the Action for Health (AFH) cancer prevention curriculum in Cleveland, Ohio for African American and Hispanic elders and pilot projects of a modified AFH cancer prevention curriculum in two rural counties of North Carolina to increase breast and cervical cancer screening. the participants will be studied longitudinally to determine the programs' lasting effects. there will be comparison groups in each state which will not receive the education program and serve as a control group for naturally occurring trends in screening. A validated questionnaire will evaluate the North Carolina pilot and intervention population at baseline and at a four-month follow-up period. The adapted questionnaire will be validated for rural and Hispanic populations.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA001677-02
Application #
3076847
Study Section
Cancer Education Review Committee (CEC)
Project Start
1992-09-04
Project End
1997-08-31
Budget Start
1993-09-01
Budget End
1994-08-31
Support Year
2
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
van Tilburg, Miranda A L; Runyan, Desmond K; Zolotor, Adam J et al. (2010) Unexplained gastrointestinal symptoms after abuse in a prospective study of children at risk for abuse and neglect. Ann Fam Med 8:134-40
Hussey, Jon M; Marshall, Jane Marie; English, Diana J et al. (2005) Defining maltreatment according to substantiation: distinction without a difference? Child Abuse Negl 29:479-92
Lau, Anna S; Leeb, Rebecca T; English, Diana et al. (2005) What's in a name? A comparison of methods for classifying predominant type of maltreatment. Child Abuse Negl 29:533-51
Johnson, Renee M; Kotch, Jonathan B; Catellier, Diane J et al. (2002) Adverse behavioral and emotional outcomes from child abuse and witnessed violence. Child Maltreat 7:179-86
Tessaro, I; Herman, C (2000) Changes in public health nurses' knowledge and perception of counseling and clinical skills for breast and cervical cancer control. Cancer Nurs 23:401-5
Herman, C J; Tessaro, I A; Kavee, A L et al. (1998) An evaluation of professional education efforts for breast and cervical cancer in public health nurses. J Public Health Manag Pract 4:93-101
Shaw, J E; Tessaro, I A; Herman, C J et al. (1997) Predictors of the performance of breast and cervical cancer early detection by public health nurses. Am J Prev Med 13:199-204