The proposed Program Project will develop and evaluate culturally tailored cancer control interventions to increase the use of early cancer detection in five ethnic groups in the Greater San Francisco Bay Area. The program is administered from the Northern California Cancer Center whose consortial structure encompasses a multi-disciplinary group of affiliated investigators. The target populations reflect the ethnic heterogeneity of this region. The research approach begins from a common Pathways to Screening Framework in which we view the successful adoption of early cancer detection as a continuum starting from basic knowledge and attitudes to the procedural and organizational aspects of the delivery process itself. The proposed projects have leadership from their targeted ethnic groups and focus on aspects of the Pathway that will have the greatest impact on screening behavior based on the investigator's research experience and knowledge of the community. The six projects are: 1. Pathways to Early Cancer Detection for Hispanics. 2. Pathways to Early Cancer Detection for Vietnamese. 3. Pathways to Early Cancer Detection for African Americans. 4. Pathways to Early Cancer Detection of Cervical Cancer for a Multi- Ethnic, Indigent, Emergency Department Population. 5. Pathways to Early Cancer Detection for Chinese Americans. 6. Pathways to Early Cancer Detection for Urban Women. The first three individual projects are extensions of currently NCI-funded cancer control research; the last two are developmental projects. Synergistic aspects of the Program Project, in addition to our use of a common research framework and theme, include the cross-project functions of three central cores in Administration, Cross-Cultural Studies, and Biostatistics and Data Management, the use of the Survey Research Center of the University of California for all major surveys, a coordinated instrument development process, the use of common core questions which will provide a rich database for cross-cultural studies, and common data management and analytic procedures. We anticipate that the proposed research will have immediate application to the NCI's Goal for the Year 2000 and that the culturally tailored interventions and educational materials will benefit similar populations in other areas of the country.
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