Faith Moves Mountains: A CBPR Appalachian Wellness & Cancer Prevention Program

描述（由申请人提供）：阿巴拉契亚社区受到许多与癌症发病率和死亡率相关的主要危险因素的影响，这些因素适合一级和二级预防。我们社区合作伙伴的广泛参与表明社区对癌症预防的整体方法有强烈的偏好；拟议的干预措施扩展了我们三年前发起的成功的基于信仰、训练有素的非专业健康顾问量身定制的干预措施“信仰移山”(R01CA108696)，以实施文化上适当的 CBPR 干预措施。我们与肯塔基州东南部农村地区的 70 个信仰机构合作，建议管理、评估和传播量身定制的健康和癌症预防计划，重点关注四种最常见的预防活动，这些活动有可能大大预防和降低癌症发病率和死亡率。这些预防活动包括戒烟（针对所有慢性病、宫颈癌和肺癌）；能量平衡，包括饮食调整和促进身体活动（针对所有慢性病和结直肠癌 (CRC)）以及癌症筛查（针对结直肠癌、宫颈癌和乳腺癌）。 与我们的“信仰移山”和癌症控制方法一致，信仰组织将赞助“启动活动”或健康博览会，参与者将接受健康风险评估（基线）。然后参与者将选择一项或多项健康活动（戒烟、能量平衡、癌症筛查）；然后，经过培训的非专业健康顾问将提供有关每项健康活动的模块。戒烟将包括文化相关的库珀-克莱顿方法（结果：戒烟）。对于那些以饮食调整和体育活动为目标的人，将实施一项农村阿巴拉契亚改良的健康身体/健康精神计划（结果：饮食改变和体育活动参与）。量身定制的癌症筛查促销活动将基于我们当前的“信念移山”设计（结果：收到任何推荐的 CRC 筛查测试、宫颈癌巴氏涂片测试和/或乳房 X 光检查）。为了评估干预措施但保持与社区规范一致，我们将采用交错干预设计。在整个项目中，RE-AIM 模型将为我们的评估提供信息。在第三阶段，这种预防癌症的 CBPR 健康方法将进行定性过程评估访谈，并与俄亥俄州立大学的合作伙伴合作，向医疗服务不足的阿巴拉契亚俄亥俄州传播干预措施。这项合作将有助于向癌症健康差异率较高的其他阿巴拉契亚农村人口传播成功的干预措施。

DESCRIPTION (provided by applicant): Appalachian communities are disproportionately affected by many of the leading risk factors associated with cancer incidence and mortality, factors amenable to primary and secondary prevention. Extensive involvement with our community partners has demonstrated strong community preference for a holistic approach toward cancer prevention; The proposed intervention extends our successful faith-based, trained lay health advisor tailored intervention, "Faith Moves Mountains," (R01CA108696) initiated three years ago, to administer a culturally appropriate CBPR intervention. Working in partnership with 70 faith based institutions in rural Southeastern Kentucky, we propose to administer, evaluate, and disseminate a tailored wellness and cancer prevention program focused on four of the most common prevention activities that have the potential of greatly preventing and reducing cancer morbidity and mortality. These prevention activities include smoking cessation (targeting all chronic diseases, cervical and lung cancer); energy balance including dietary modification and physical activity promotion (targeting all chronic diseases and colorectal cancer (CRC)), and cancer screenings (targeting CRC, cervical, and breast cancer). Consistent with our Faith Moves Mountains and cancer control approach, faith-based organizations will sponsor a "kick off event" or health fair in which participants will undergo a health risk appraisal (baseline). Participants will then select one or more wellness activities (smoking cessation, energy balance, cancer screening); then, trained lay health advisors will offer modules on each of these wellness activities. Smoking cessation will include the culturally relevant Cooper-Clayton method (outcome: smoking abstinence). For those targeting dietary modification and physical activity, a rural Appalachian modified Healthy Body/Healthy Spirit program will be administered (outcome: dietary change and physical activity participation). Tailored cancer screening promotion will be based on our current Faith Moves Mountains design (outcome: receipt of any recommended CRC screening test, Pap test for cervical cancer, and/or mammogram). To assess the intervention but remain consistent with community norms, we will employ a staggered intervention design. Throughout the project, the RE-AIM model will inform our evaluation. During phase three, this CBPR wellness approach to cancer prevention will undertake qualitative process evaluation interviews and disseminate the intervention to medically underserved Appalachian Ohio in collaboration with partners at Ohio State University. This collaboration will facilitate dissemination of successful intervention to additional rural Appalachian populations with high rates of cancer health disparities.