Abstract A019: Community-based intervention leads to increased cancer knowledge and prevention behaviors in a rural population
Authors: Fredrick Cody , Eggen Amanda T. , Amessoudji Amy , Downs Tracy M. , Jacobs Elizabeth A. 
Published: August 2020

Abstract
Introduction: We conducted a community-based participatory research pilot project to adapt Cancer Clear & Simple (CC&S) for easier dissemination in a rural population, and to evaluate the impact of providing this education on cancer knowledge and risk reduction behaviors.
Procedures: We conceived and implemented this project collaboratively with local rural partners, including a multicounty rural electric cooperative. Our aims were to (1) conduct qualitative interviews with community stakeholders, past CC&S participants, and a sample of prospective participants, and use the findings to revise CC&S for easier dissemination; and (2) test whether CC&S increased cancer knowledge and risk-reduction behaviors by randomizing 66 community members to either the CC&S condition (n=32) or meal planning control condition (n=34) in two rural communities. We surveyed participants before the intervention, immediately following, and 6 months later. We collected data both online and in paper-based surveys, and through clinic verification of reported cancer screenings at 6 months.
Results: We found cancer knowledge increased from pre- to post-intervention for the CC&S group (63% to 81%, p &lt; .001) but not the control group (56% to 59%, p = .23) and, further, the increased knowledge of CC&S participants was sustained at 6 months. The CC&S group was more confident about talking with their doctors about cancer (4.7 v. 4.3, p &lt; .001) and reducing cancer risk (4.7 v. 4.2, p &lt; .001) after the intervention than before, and their increased confidence was sustained 6 months later. We also found a greater intent to participate in cancer risk-reduction behaviors immediately after the intervention for the CC&S group versus the control (99% v. 95%, p = .08) and significantly greater levels of self-reported healthy behaviors among the CC&S group versus the control at 6 months (87% v. 74%, p = .02). Further, 59% of participants consented to allowing clinic-based objective confirmation of screening rates, but numbers of participants due for screening tests resulted in limited power to employ these data as an outcome.
Conclusions: We found that the modified version of CC&S increased cancer knowledge and the intent to participate in risk-reduction behaviors, and likely led to sustained healthy behaviors over time. The research team also confirmed that participants would consent to clinic verification of their screening behavior. As this was a pilot, we plan to conduct a study with a larger number of participants and a cohort of rural residents across a broader, more diverse rural geography.
Citation Format: Cody Fredrick, Amanda T. Eggen, Amy Amessoudji, Tracy M. Downs, Elizabeth A. Jacobs. Community-based intervention leads to increased cancer knowledge and prevention behaviors in a rural population [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A019.