Integration of Cancer Health Activities Into African American Churches

The proposed project will compare two ways to apply a known-effective cancer educational strategy through African American churches: 1) a standard method vs. 2) a new method in which the churches integrate the strategy into their organizational structure and practice at multiple levels. It will be determined whether this "integrated approach" results in more effective and sustained cancer education and screening activities at both the church and individual levels over time. This project will make important contributions to research in evidence-based medicine and sustainability. In a climate of limited resources, identifying sustainable and effective ways to increase cancer awareness and screening in African American men and women is more important than ever.

Study Overview

• Status: Completed
• Conditions: Breast Cancer; Colorectal Cancer; Prostate Cancer
• Intervention / Treatment: Behavioral: Project HEAL 2.0; Behavioral: Project HEAL

Detailed Description

This population-based application responds to the American Cancer Society Research Scholar Grant, Priority Program in Cancer Control. Recent years have seen a growing research interest in learning how to get known-effective health education strategies to reach more people who could benefit from them. An important part of this growing movement is a focus on sustained impact, or continued program benefit after the funding period is over. It is believed that the best way to achieve this sustained impact is through integrating the program into the host community at multiple levels. This innovative strategy has not been systematically tested in community-based settings, where the most vulnerable people can be reached. Since churches have a historical and ever-growing role in health promotion particularly among African Americans, they are an ideal place to reach this group for cancer education. The proposed project will compare two ways to apply a known-effective cancer educational strategy through African American churches: 1) a standard method vs. 2) a new method in which the churches integrate the strategy into their organizational structure and practice at multiple levels. It will be determined whether this "integrated approach" results in more effective and sustained cancer education and screening activities at both the church and individual levels over time. The educational strategy is one that has been used successfully in previous work: Project Health through Early Awareness and Learning (HEAL). Project HEAL is a series of three cancer early detection workshops (breast, prostate, colorectal) delivered through trained and certified lay peer community health advisors in African American churches. 14 churches will be randomly chosen to conduct either the standard Project HEAL program or an integrated Project HEAL strategy where the churches build the program into their organization in multiple ways (e.g., allocating volunteer or paid staff, space, or funds; policy change; ministry development). The project will be conducted in three phases: 1) refining the integrated approach with community and stakeholder feedback; 2) pilot testing the integrated approach in 2 churches; and 3) conducting the study to comparatively evaluate the standard vs. the integrated approaches in 14 churches. A scientifically rigorous evaluation plan will be used to look at outcomes at both the individual and the church level. This project will make important contributions to research in evidence-based medicine and sustainability. In a climate of limited resources, identifying sustainable and effective ways to increase cancer awareness and screening in African American men and women is more important than ever.

• Study Type: Interventional
• Enrollment (Actual): 446
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • College Park, Maryland, United States, 20742
      • University of Maryland School of Public Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Advisory Panel members: adults ages 21+
• Pastors, representing each of the 14 churches enrolled in the project: active pastor of churches enrolled in the study
• Community Health Advisors
• Self-identified African American
• Adults ages 21+
• Regularly attend church services
• Able to complete Project HEAL training
• Able to recruit 40+ participants for a breast, prostate, or colorectal cancer educational workshop
• Able to lead the breast, prostate, and colorectal cancer workshops
• Workshop Participants
• Self-identified African American
• Adults ages 21+
• Have no history of breast, prostate, or colorectal cancer

Exclusion Criteria:

• Workshop Participants: Men and women who have had breast, prostate, or colorectal cancer

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Integrated Approach; In this approach, rather than developing a separate health ministry, cancer activities could be integrated throughout existing church ministries (e.g. men's, women's, seniors).	Behavioral: Project HEAL 2.0; In this approach, rather than developing a separate health ministry, cancer activities could be integrated throughout existing church ministries (e.g. men's, women's, seniors).
Active Comparator: Standard Comparison; Standard group churches will not be asked to, or provided special encouragement to technical assistance with, institutionalizing health promotion activities in their churches.	Behavioral: Project HEAL; Standard group churches will not be asked to, or provided special encouragement to technical assistance with, institutionalizing health promotion activities in their churches.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Integration of health-relation practices assessed via church survey	Intervention impact on institutionalization at 12 and 24 months	Change from baseline to 12 and 24 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reach: Number of participants from priority population engaged in intervention as assessed by enrollment logs	Participants from priority population engaged in intervention	Up to 4 months
Efficacy: Increased knowledge of cancer as assessment by participant surveys	Cancer-related knowledge	Up to 12 months
Efficacy: Increased self-report of cancer screening as assessment by participant surveys	Self-reported cancer screening	Up to 12 months
Adoption	Cooperation rate of churches	At recruitment/enrollment
Implementation: Extent to which intervention is implemented as intended as assessed by a fidelity checklist completed by staff	Adherence to intervention protocol	Up to 4 months

Collaborators and Investigators

• Sponsor: University of Maryland, College Park
• Collaborators: American Cancer Society, Inc.; Community Ministry of Prince George's County; Access to Wholistic and Productive Living Institute
• Investigators: Principal Investigator: Cheryl L Holt, PhD, Professor

Publications and helpful links

General Publications

• Knott CL, Chen C, Bowie JV, Mullins CD, Slade JL, Woodard N, Robinson-Shaneman BR, Okwara L, Huq MR, Williams R, He X. Cluster-randomized trial comparing organizationally tailored versus standard approach for integrating an evidence-based cancer control intervention into African American churches. Transl Behav Med. 2022 May 26;12(5):673-682. doi: 10.1093/tbm/ibab088.
• Knott CL, Bowie J, Mullins CD, Santos SLZ, Slade J, Rosenberg E, Woodard N, Williams R, Williams RM. An Approach to Adapting a Community-Based Cancer Control Intervention to Organizational Context. Health Promot Pract. 2020 Mar;21(2):168-171. doi: 10.1177/1524839919898209. Epub 2020 Jan 20.

Helpful Links

• CHAMP Lab Website

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2016
• Primary Completion (Actual): June 30, 2022
• Study Completion (Actual): June 30, 2022

Study Registration Dates

• First Submitted: May 18, 2017
• First Submitted That Met QC Criteria: June 5, 2017
• First Posted (Actual): June 6, 2017

Study Record Updates

• Last Update Posted (Actual): November 1, 2022
• Last Update Submitted That Met QC Criteria: October 31, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colorectal Neoplasms
• Other Study ID Numbers: RSG-16-022-01-CPPB

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No