Hispanics are the fastest growing minority group in the U.S. and also have the highest poverty rates in the U.S. They have higher rates of certain types of cancer, are less likely to have cancer screening, and tend to have less knowledge about cancer and cancer prevention than Non-Hispanics. Cancer rates are increasing in this group. This application builds on two years of developmental work in a community that is 65 percent to 75 percent Mexican-American. The overall goals of this proposed project are to increase cancer prevention lifestyle behaviors, specifically to decrease fat consumption, increase fruit and vegetable consumption, and increase smoking cessation rates; and to increase colorectal cancer screening. Twenty communities in the lower Yakima Valley, which has a 40 percent to 50 percent Hispanic population, will be recruited for participation. After an in-person randomized household survey of approximately 100 households per community, communities will be matched and randomized within blocks to an intervention or control condition. In intervention communities, a community board will be established, will hire a field coordinator, mobilize the community, and plan intervention activities, with FHCRC staff serving as facilitators, and local project staff hired to assist the Boards. Community-wide events will be conducted to raise consciousness and increase knowledge about cancer prevention and access to screening. These will be pilot-tested in our developmental study community. Individual activities will focus on one-to-one outreach where volunteers and community people will discuss behavior changes that may decrease the risks of contracting cancer. A nested study will be included to assess the efficacy of an intensive, individual intervention to change dietary behavior among groups of women in the intervention communities. After intervention, another cross-sectional survey will be conducted. Primary outcomes are changes in the behaviors defined in the primary aims. A score of combined changes will also be generated. The sample sizes take into account intraclass correlation and are sufficient to examine differences among Hispanics as well as the entire Valley population. The analysis is based on intent to treat.
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