The aim of this revised application is to develop and evaluate a theory-based intervention delivered in rural churches serving people of diverse socioeconomic levels. The purpose of the intervention is to initiate and maintain changes in nutrition, activity and exercise patterns to meet cancer risk reduction guidelines. The intervention will uniquely combine individual, self-regulatory behavior change procedures with supportive social and environmental components identified as essential for maintaining behavior change by social cognitive theory (SCT; Bandura, 1997). Individual behavior and family-focused change procedures involve tailored information, formulating and evaluating individual behavior change goals, and structuring guided master experiences provided through an electronically mediated health behavior intervention. Supportive components include advocacy and modeling by religious leaders, lay health advisors, and respected members of congregations. In addition, collective goal-setting, feedback, and structured, collective church-based mastery experiences for initiating and sustaining health behavior change will follow an approach based on SCT and used in other community risk reduction interventions. The four- year period of the project will allow ample time to carefully tailor program content and develop software allowing programs to be highly salient with easy access at home or at church. A pilot test, and a large field experiment involving approximately 3000 people (20 percent African American) from moderately large (400 - 800 members) rural churches are planned. A mixed model of covariance will be used with churches as the unit of randomization. A treatment involving the complete SCT-based intervention will be compared to a treatment only involving the instructional programs, and a control condition. Major outcome measures include percent calories from fat, dietary fiber, servings of fruits and vegetables, caloric expenditure in activity, V02Max, and body composition. Measures of SCT determinants will address the theoretical underpinnings of the intervention, and process measures will assess fidelity, dose, and contamination issues.
