Healthy People 2000 specifies national health objectives and research priorities that focus on special populations including low-income and ethnic minority groups. Fat and fiber consumption, as well as the development and testing of cancer prevention and control interventions for special populations, are identified priority areas. These objectives and priorities also include attention to disparities in rates of overweight and obesity, cigarette smoking, and levels of physical activity that place low-income and minority groups at greater risk for poor health and disease, including cancer. Further, these objectives specify the establishment of culturally and linguistically appropriate community health promotion programs for racial and ethnic minority groups. In the proposed study, urban, low-income, minority women, who are mothers of preschool children enrolled in Head Start sites located in South Central Los Angeles, will be targeted to test the impact of educational sessions and lay health advisor strategies on cancer prevention behaviors related to diet and nutrition. Associated cancer-related primary prevention behaviors, including cigarette smoking, alcohol use, and exercise, will also be assessed, as well as related knowledge, attitudes, psychosocial, and socioenvironmental factors that may serve as barriers or facilitators of involvement in the intervention program and the adoption cancer prevention behaviors. The research will span a three-year period that will focus on the development, implementation, and evaluation of the cancer prevention strategies. A pretest-posttest quasi-experimental design will be utilized in which Head Start school sites will be matched by size and ethnicity and then randomly assigned to one of three experimental conditions: 1) Cancer prevention class only; 2) Class plus a lay health advisor intervention; or 3) a control group. Thus, the study is designed to evaluate the effectiveness of two levels of intervention (classes vs. classes and lay health advisors) on diet and nutrition behaviors. It is hypothesized that: 1) cancer prevention dietary practices will improve significantly in the experimental groups that receive the cancer prevention classes as compared with the control group; and 2) cancer prevention dietary practices will improve significantly more in the class plus lay health advisor intervention group than in the group receiving the class only.
