Spiritually Based Intervention to Increase Colorectal Cancer Awareness Among African Americans: Intermediate Outcomes From a Randomized Trial

Abstract

Colorectal cancer screening, while effective for reducing mortality, remains underutilized particularly among underserved populations such as African Americans. The present study evaluated a spiritually based approach to increasing Health Belief Model–based pre-screening outcomes in a Community Health Advisor–led intervention conducted in African American churches. Sixteen urban churches were randomized to receive either the spiritually based intervention or a nonspiritual comparison of the same structure and core colorectal cancer content. Trained Community Health Advisors led a series of two educational sessions on colorectal cancer early detection. The educational sessions were delivered over a 1-month period. Participants (N = 316) completed a baseline survey at enrollment and a follow-up survey one month after the first session. Both interventions resulted in significant pre/post increases in knowledge, perceived benefits of screening, and decreases in perceived barriers to screening. Among women, the spiritually based intervention resulted in significantly greater increases in perceived benefits of screening relative to the nonspiritual comparison. This finding was marginal in the sample as a whole. In addition, perceived benefits to screening were associated with behavioral intention for screening. It is concluded that in this population, the spiritually based was generally as effective as the nonspiritual (secular) communication.

Acknowledgments

This work was supported by a grant from the Centers for Disease Control and Prevention #5U48DP00046-03 and was approved by the University of Alabama at Birmingham Institutional Review Board (X051004002). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The authors would like to acknowledge the contributions of Shereta Wiley for her assistance with data collection and of Dr. Steven S. Coughlin for his technical assistance from the funding agency.

Notes

Note. Numbers may not sum to 316 or 100% because of missing data. GED = general equivalency diploma.

*Adjusting for clustering effect of churches, beginning score and age. Means shown are unadjusted for covariates. FOBT = fecal occult blood test.

*Adjusting for clustering effect of churches, beginning score and age. Means shown are unadjusted for covariates. FOBT = fecal occult blood test.

*Adjusting for clustering effect of churches, beginning score and age. Means shown are unadjusted for covariates. FOBT = fecal occult blood test.