African Americans are disproportionately affected by cancer when compared to other racial or ethnic groups. There are a number of social and cultural factors that relate to prevention and screening behaviors that impact cancer mortality rates. Religiosity/spirituality (RS) appears to be one of these factors. RS is central to the lives of many African Americans, and is related to cancer screening, risk, and prevention behaviors. RS has been proposed to have salutary effects on health in general through several mediators, including but not limited to scriptural influence on health behavior/lifestyle, social support, coping with stress, positive affect or mental health, and social influence. However, research to date has not provided empirical evidence for these mediators. Thus, the relationship between RS and health (including cancer) has gone largely unexplained. This area of research is in great need of theory. At present, studies in this area are guided largely by speculation and modest empirical evidence for these mediators. The proposed study will first identify existing or develop valid and reliable measures of the mediators, and then test a model of RS and cancer-related behaviors among African Americans. A literature review and pilot study suggest that the coping with stress, social support, positive affect/mental health, and scriptural influence on health behavior functions of RS may be among the most promising mediators of this relationship. It is also possible that different mediators may carry different associations with different cancer-related behaviors (e.g., risk vs. prevention vs. screening). We will test a model of RS and cancer risk, prevention, and screening behaviors, including a set of potential mediators. This will be the first known study to empirically test a model of the RS and cancer-related behaviors in African Americans. Finally, we will develop a set of recommendations for church-based cancer communication, based on the study findings. RS has great potential for use in the development of more effective cancer communication interventions for African Americans.
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