Cancer among Black Families: Diffusion as a Strategy of Prevention and Intervention

INTRODUCTION The Department of Sociology and Anthropology, the Association of Black Sociologists (ABS), and the National Outreach Initiatives Branch (NOIB)joined a cooperative agreement to strengthen and enhance the National Black Leadership Initiatives on Cancer (NBLIC). The general mission of this project is to reduce the incidence of cancer among African Americans. The specific aims were threefold: 1) to enhance cancer prevention in target communities by enlisting a broad coalition of African American social scientists in identifying and making accessible behavioral models and resources to change individual cancer-related behaviors; 2) to promote the dissemination and adoption of cancer prevention behaviors through NBLIC coalitions that are linked with participants from the National Congress of Black Churches (NCBC), local colleges and universities, and the National Association of Social Workers; and 3) to provide data that lead to modification of community social norms and practices in the direction of health promotion in affected communities. Five urban metropolitan areas were selected for inclusion in the project evaluation based on three factors: 1) the presence of an NBLIC coalition in the city; 2) a high concentration of African American residents; and 3) high rates of cancer among African Americans. The cities chosen for the study are Atlanta, Houston, Miami, New Orleans, and Washington, D.C. These sites serve as the focal points for technical assistance, local organizing, intervention and evaluation of behavioral strategies to prevent cancer. The project is currently in its fifth year, and the information here is based on research conducted as part of an effort to support cancer coalitions and to explore and follow-up on previous research findings. These preliminary findings with respect to women offer some interesting possibilities for intervention and prevention strategies. METHODS The evaluation includes four components, each of which was designed as a means to collect information on changes in cancer-reduction activities. The first component consists of the collection of information from participants in cancer prevention activities, establishing the characteristics of persons in the community who take action toward cancer prevention. The second component, the community demographic profile, provides baseline and followup descriptive information about cancer prevention resources for each of the five sites explored in this study. This component includes the collection of secondary data on cancer incidence, prevalence and mortality for each site. The third component is a survey, in which baseline and follow-up information from representative samples of African Americans in six targeted cities was collected in order to assess the extent to which NBLIC coalition activities have permeated the community. Finally, the fourth component, a study of a subset of survey participants, provides more explanatory information about individual decision-making related to cancer prevention. The methodology for each component is described below. Community Demographic Profiles These profiles provide information about the current infrastructure supporting health promotion and cancer prevention in each community. This formal picture of the community was provided to coalitions to evaluate the match with perceptions of resources reported by survey respondents. Sample: Community Demographic Profiles were used to gather information for each of the five cities included in the sample. Instrument: The Community Demographic Profile was developed in order to construct a description of the community in which NBLIC coalition activities occur. In combination with the initial survey data, this information was made available to coalitions for planning purposes. Responses from participants in cancer prevention programs and survey respondents are analyzed, using bivariate analyses to identify the important relationships among survey variables as well as to determine the effectiveness of specific interventions for achieving change in health promotion attitudes, knowledge, and the adoption of screening and early intervention behaviors. …