This project proposes the development and testing of a controlled, mail- centered intervention to promote the practice of colorectal cancer screening among African-American adults living in metro Atlanta. The study population will consist of a total 900 individuals aged 50 years and older. A core group of 300 participants will be composed of female members of Quality Living Services, Inc., a senior citizen non- residential center. The purpose of this organization is to provide a comprehensive and coordinated community-based system of services and activities for senior citizens. The membership consists of approximately 1,300 elderly people. Each QLS member who participates in this study will be asked to recruit two male or female relatives or friends including the spouse where possible. The basic study design will consist of a questionnaire survey for colorectal cancer prevention practice prior to and post intervention on 5 random samples selected from the target population over a 2-year period. The survey will also assess participants' physical and psychosocial health status using SF-36 form developed by the New England Medical Center (23, 24). Subjects in each sample will participate in three activities or steps: Baseline Survey (Step I), Intervention (Step II) and Follow-Up Survey (Step III). The cross-sectional baseline survey will measure two issues: (1) Who are the individuals receiving and not receiving colorectal screening services? (2) What are the socio-economic, physical, and psychological health care conditions that influence their cancer screening practice? This project will utilize mail surveillance with telephone follow-up as the primary method of data collection. The intervention component will consist of the provision of educational information by mail, as well as educational meeting and telephone communication. The follow-up survey will consist of two parts. The first part will evaluate only the rates of colorectal cancer screening practice by screening method, before and after intervention. The results will be compared within each sample, between samples and with results from other studies. The second part will evaluate association/correlation analyses and multivariate analysis controlling variables influencing colorectal cancer screening practices among blacks.
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