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

描述（由申请人提供）：阿巴拉契亚社区不成比例地受到许多与癌症发病率和死亡率相关的主要风险因素的影响，这些因素适合一级和二级预防。与我们的社区合作伙伴的广泛参与表明了社区对癌症预防整体方法的强烈偏好;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的、训练有素的非专业健康顾问定制干预措施“信仰移山”（R 01 CA 108696），以管理文化上适当的CBPR干预措施。与肯塔基州东南部农村的70个信仰机构合作，我们建议管理，评估和传播一个量身定制的健康和癌症预防计划，重点是四个最常见的预防活动，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，包括调整饮食和促进体育活动（针对所有慢性病和结肠直肠癌），以及癌症筛查（针对结肠直肠癌、宫颈癌和乳腺癌）。 与我们的信仰移动山脉和癌症控制方法相一致，信仰组织将赞助一个“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，参与者将选择一个或多个健康活动（戒烟，能量平衡，癌症筛查）;然后，训练有素的非专业健康顾问将提供这些健康活动的每一个模块。戒烟将包括文化相关的库珀-克莱顿方法（结果：戒烟）。对于那些针对饮食调整和体育活动，农村阿巴拉契亚修改健康身体/健康精神计划将管理（结果：饮食变化和体育活动参与）。量身定制的癌症筛查推广将基于我们目前的Faith Moves Mountains设计（结果：接受任何推荐的CRC筛查测试，宫颈癌的Pap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CBPR癌症预防健康方法将进行定性过程评估访谈，并与俄亥俄州州立大学的合作伙伴合作，将干预措施传播到医疗服务不足的阿巴拉契亚俄亥俄州。这种合作将促进成功的干预传播到更多的农村阿巴拉契亚人口与癌症的健康差异率高。

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.