Over the past nine years, the Deep South Network for Cancer Control (DSNCC) coalition has successfully established numerous partnerships with local, state, and national partners and trained Community Health Advisors as Research Partners (CHARPs) in Alabama (AL) and Mississippi (MS). Guided by the Community-Based Participatory Research (CBPR) approach, the coalition implemented theory- and evidence-based strategies to increase breast, cervical, and colorectal cancer screening, encourage physical activity, and promote healthy eating in our targeted inner-city communities and rural counties.(1-3) As a result of these strategies, the DSNCC saw a significant increase in breast and cervical cancer screening among many, but not all, African American (AA) women in the targeted counties. Despite our efforts to deliver county-wide health promotion and educational activities, there still remain groups of individuals who have not been screened(4) and have not participated in the physical activity and healthy eating promotion programs offered by the DSNCC. Recognizing that our previous approach, while successful, failed to produce change in two subgroups of populations?(1) the ones who were reached by the intervention but did not get screened or did not change their behaviors;and (2) the ones who were not reached by the intervention?the Community Outreach Core, under the leadership of Drs. Theresa Wynn and Sharon Wyatt and community advisory board members, proposes to develop and implement a Community Action Plan (CAP) to further reduce cancer disparities between whites and AAs by increasing knowledge of, access to, and use of previously tested DSNCC interventions, such as cancer screening, physical activity, and healthy eating among those who were unscreened/unreached by previous educational and outreach efforts. In addition to implementing behavioral strategies to reduce cancer risk, the Outreach Core and the community advisory board will initiate a series of discussions in our targeted counties on biospecimen collection and biobanking. Because this is a new research initiative that has not been explored by the DSNCC, we will begin at the formative evaluation phase, examining the sociocultural factors associated with willingness to provide biospecimens for research purposes and biobanking. The outcomes of these discussions will help us involve the coalition in developing a second CAP, aimed at designing and implementing culturally relevant outreach strategies to increase awareness of and participation in biomedical research and provision of biospecimen. CBPR(5) and the Empowerment Model(6) will be the overall conceptual framework of the Outreach Core, while the Socio-Ecological Model(7) will guide the conduct of health promotion and educational activities. In relation to biospecimen collection, the Social Constructionism(8) will give us a better understanding of the sociocultural and contextual factors associated with biospecimen collection for research purposes in the target audience. The PEN-3(9) will guide biospecimen collection/biobanking formative assessments and CAP development. The Logic Model(10) will guide process, impact, and outcome evaluation. Although DSNCC is targeting 22 counties across AL and MS, the Community Outreach Core will focus on the 14 counties that are not participating in the proposed full research project described in the Research Core, in order to avoid cross contamination with the 8 counties targeted by the research project. Based on the community input, we will tailor the previously tested DSNCC interventions (Cancer Screening Awareness, WALK! Feel Alive, and Body and Soul) to meet the needs ofthe unscreened and unreached;these interventions will be delivered by Community Network Partners (CNPs), comprised of CHARPs, local agents of change, and organizations, while the eight Research Core counties will use a group randomized trial to assess the efficacy of a community-based intervention to reduce body weight among AA women residing in rural communities in the Deep South.
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