It is this study's aim to identify effective nursing interventions for economically disadvantaged black and white elderly persons that will result in increased compliance with the American Cancer Society's colorectal screening recommendations. The quasiexperimental pretest-posttest two-by-two design study of educator and program will investigate the effect of four different nursing interventions on colorectal screening behavior. The Social Learning Theory provides the theoretically basis for this research. The interventions are: (1) Traditional with Non-Elderly Method (control group), (2) Adaptation for Aging Changes with Non-Elderly Method, (3) Traditional with Elderly Educator Method, and (4) Adaptation for Aging Changes with Elderly Educator Method. The Adaptation for Aging Changes Methods will adapt content for aging changes, and the Elderly Educator Methods will use elderly person as teachers and as actors in the slide-tape presentation. Content presented in each of the four interventions will be based on the American Cancer Society's colorectal slide-tape presentation. The sample will consist of 575 black and white low-income participants at South Carolina's Council on Aging congregate meal sites. One year after the interventions, subjects will be re-interviewed to determine participation in three colorectal screening procedures and the subjects' knowledge of colorectal cancer. The dependent variables will be the probability of having had each of the three procedures, occult stool testing, rectal examination, and proctosigmoidoscopy. The independent variables will be the four nursing interventions. Control variables will be knowledge of colorectal cancer, exposure to cancer, sensory abilities, instrumental activities of daily living, demographic variables, and previous experience with each of the colorectal screening procedures. Logistic regression and multivariate categorical analyses will be performed. This research deals with a priority area of the National Cancer Institute and the American Cancer Society, early detection of cancer. It also targets their highest priority group for health education during the 1990's, the black and the poor. Nontraditional nursing interventions to increase compliance with colorectal screening will be evaluated. Interventions found to be effective could be repeated through congregate meal sites for the elderly throughout the United States.
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