Implementation of evidence-based cancer early detection in Black churches

在黑人教堂实施循证癌症早期检测

• 批准号: 8095015
• 负责人: Cheryl L Knott
• 金额: $ 49.09万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-18 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8095015
• 关键词: African American; American; Awareness; Breast Cancer Early Detection; Cancer Control Research; Characteristics; Church; Colorectal; Colorectal Cancer; Communication; Communities; Community Health; County; Early Diagnosis; Environment; Evaluation; Evidence based intervention; Health; Heart; Incidence; Intention; Intervention; Lead; Learning; Localized Malignant Neoplasm; Malignant Neoplasms; Malignant neoplasm of prostate; Maryland; Materials Testing; Modeling; Monitor; NIH Program Announcements; Nature; Outcome; Prostate; Randomized; Randomized Controlled Trials; Religion and Spirituality; Research; Resources; Role; Screening for cancer; Screening procedure; Testing; Time; Training; Translations; Uncertainty; base; cancer health disparity; community setting; design; dissemination research; efficacy testing; evidence base; health belief; implementation research; malignant breast neoplasm; mortality; resource guides; theories

DESCRIPTION (provided by applicant): African Americans suffer a disproportionate burden of incidence and mortality from breast, prostate, and colorectal cancer. Though the causes of these cancer disparities are likely multi-factorial in nature, there are no doubt disparities in early detection that contribute to the mortality disparities. Community-based approaches have been increasing in the effort to raise awareness and early detection for these cancers. However, more often than not, such interventions are tested in randomized controlled trials, become evidence- based, and then fail to reach further implementation in the community. The aim of the proposed project is to identify an optimal implementation strategy using a set of evidence-based interventions that aim to increase early detection of breast, prostate, and colorectal cancer among African Americans as a model. These three interventions will be packaged and interwoven into a single "Cancer Early Detection Ministry" (CEDM), which will be delivered through trained Community Health Advisors in church settings. The implementation and sustainability will be evaluated using the RE-AIM Framework. Fourteen local African American churches will be randomized to a high or a low community autonomy implementation strategy, in which the level of technical assistance is varied (monitoring and evaluation only vs. monitoring/evaluation plus technical assistance and training, respectively). By varying the level of technical assistance, we will be able to determine what level of technical assistance leads to successful implementation and sustainability. We will also identify church organizational capacity characteristics that lead to successful implementation and sustainability. The specific aims of this research are to: (1) Package the three interventions into a single Cancer Early Detection Ministry (CEDM), develop a local cancer screening resource guide, and pilot test the materials and training. (2) Implement the CEDM in 14 churches in Prince George's County, Maryland. We will evaluate the implementation outcomes involving treatment fidelity and identify church organizational capacity characteristics that led to successful implementation. We will compare the two implementation strategies (high vs. low community autonomy) to determine the optimal level of technical assistance necessary for successful implementation. (3) Evaluate the sustainability of the CEDM over a two-year period of time. We will identify church organizational capacity characteristics that led to sustainability, and compare the two implementation strategies (high vs. low community autonomy) to determine the optimal level of technical assistance for successful sustainability. PUBLIC HEALTH RELEVANCE: The proposed project would begin to provide some answers to inform the emerging but critical field of dissemination/implementation research. If more can be learned about ways to effectively disseminate/implement and sustain cancer community-based communication interventions, cancer control research can have significantly greater impact on cancer disparities. In this time of uncertain resources, an effective implementation strategy will be a significant step toward the elimination of disparities in cancer early detection, which would have a significant impact on mortality in African American communities.

描述（由申请人提供）：非洲裔美国人遭受乳房，前列腺和结直肠癌的发病率和死亡率的不成比例。尽管这些癌症差异的原因本质上可能是多因素的，但毫无疑问，早期发现差异会导致死亡率差异。基于社区的方法一直在增加，以提高对这些癌症的认识和早期发现。但是，这种干预措施经常在随机对照试验中进行测试，基于证据，然后无法在社区中实现进一步的实施。拟议项目的目的是使用一组基于证据的干预措施来确定最佳的实施策略，旨在增加非洲裔美国人对乳腺癌，前列腺和大肠癌的早期检测。这三种干预措施将被包装并交织成一个“癌症早期检测部”（CEDM），该部门将通过教会环境中训练有素的社区健康顾问进行。实施和可持续性将使用RE-AIM框架进行评估。十四个非裔美国人教堂将被随机分为高或低社区的自治实施策略，在该战略中，技术援助的水平各不相同（仅监测和评估，分别与监控/评估以及技术援助以及技术援助和培训）。通过改变技术援助的水平，我们将能够确定哪种技术援助导致成功实施和可持续性。我们还将确定教会组织能力特征，从而成功实施和可持续性。这项研究的具体目的是：（1）将三种干预措施包装成一个癌症早期检测部（CEDM），开发当地的癌症筛查资源指南，并试点测试材料和培训。 （2）在马里兰州乔治王子县的14个教堂中实施CEDM。我们将评估涉及治疗保真度的实施成果，并确定导致成功实施的教会组织能力特征。我们将比较两种实施策略（高与低社区自主权），以确定成功实施所需的最佳技术援助水平。 （3）评估CEDM在两年时间内的可持续性。我们将确定教会的组织能力特征，从而实现可持续性，并比较两种实施策略（高与低社区自主权），以确定成功可持续性的最佳技术援助水平。 公共卫生相关性：拟议的项目将开始提供一些答案，以告知新兴但关键的传播/实施研究领域。如果可以了解有效传播/实施和维持基于癌症的社区交流干预措施的方法，那么癌症控制研究可能会对癌症差异产生更大的影响。在这个不确定的资源时代，有效的实施策略将是消除癌症早期发现差异的重要一步，这将对非裔美国人社区的死亡率产生重大影响。