ACTION FOR HEALTH--CANCER PREVENTION MODEL--OLDER WOMEN

尽管存在有效的乳腺癌和宫颈癌筛查方法， 癌症，利用不足是常见的少数老年妇女。 他们的癌症 在后期被诊断出来，预后更差。 这些癌症 对老年人来说意义重大，因为超过50%的乳腺癌发生在女性中 60岁以上 宫颈癌筛查有助于减少 所有非老年人的死亡率。 公共卫生服务，在 该委员会的报告“促进健康/预防疾病： 国家”，已确定，未来的目标人群进行筛查， 只有通过制定干预措施， 与年龄、种族/民族、收入和教育有关。 虽然这 共识文件确定了乳腺癌筛查目标， 在这十年中取得的成就，它没有提供满足战略 这些目标。 行动健康，在CWRU开发，是一种独特的癌症预防 专门设计的课程，以克服利用 少数群体老年妇女的乳腺癌和宫颈癌筛查。 程序 利用受过培训的老年人作为同行培训员，并结合使用 教学和基于经验的学习策略。 我们假设健康行动将： .导致70%的计划参与者的利用率持续变化 至少一个癌症筛查领域：乳房X光检查，乳房检查和 巴氏涂片。 ·70%的参与者的健康状况得到改善。 .在适应之后，对农村人口和城市人口同样有益。 人口 长期目标是降低乳腺癌/宫颈癌死亡率， 通过提高癌症的早期发现率， 预防课程。 目标是：1）记录 一项在非洲裔美国人和西班牙裔妇女中实施的计划的有效性， 克利夫兰; 2）比较城市为基础的计划的有效性， 在北卡罗来纳州的农村地区。 研究设计将是一个多时间序列准实验 设计评估健康行动（AFH）癌症预防课程 在俄亥俄州克利夫兰，为非洲裔美国人和西班牙裔老年人和飞行员 在两个农村地区实施了一项经修改的AFH癌症预防课程项目， 北卡罗来纳州的县增加乳腺癌和宫颈癌 筛选 将对参与者进行纵向研究， 项目的持久影响。 在每一个实验中都有对照组， 不接受教育计划并作为对照的州 自然发生的趋势筛选组。 经验证的 一份调查问卷将评估北卡罗来纳州的试点和干预措施 在基线和4个月随访期的人群中。 适配的 将对农村和西班牙裔人口进行问卷验证。

Although efficacious screening methods exist for breast and cervical cancer, underutilization is common in minority older women. Their cancers are diagnosed at a later stage with a worse prognosis. These cancers are significant for the elderly since over 50% of breast cancers occur in women over age 60. Screening for cervical cancer has contributed to a decline in mortality in all non-elderly populations. the Public Health Service, in its report "Promoting Health/Preventing Disease: Year 2000 Objectives for the Nation", has determined that the future target population for screening will only be reached with interventions developed to overcome barriers associated with age, race/ethnicity, income, and education. While this consensus document identifies breast cancer screening objectives to be achieved during this decade, it does not provide strategies for meeting these objectives. Action for Health, developed at CWRU, is a unique cancer prevention curriculum designed specifically to overcome barriers int he utilization of breast and cervical cancer screening in minority older women. The program utilizes trained senior adults as peer-trainers and uses a combination of didactic and experience-based learning strategies. We hypothesize that Action for Health will: .result in a sustained change in 70% of program participants in utilization of at least one area of cancer screening: mammography, breast exams and Pap smears. .yield improvement in perceived health status for 70% of the participants. .after adaptation, be as beneficial for a rural population as an urban population. The long range goal is to reduce breast/cervical cancer mortality in minority elders by increased rates of early detection through our cancer prevention curriculum. The objectives are to: 1) document the effectiveness of a program in African-American and Hispanic women in Cleveland; 2) compare the effectiveness of an urban-based program to a curriculum in rural North Carolina. The research design will be a multiple time series quasi-experimental design to evaluate the Action for Health (AFH) cancer prevention curriculum in Cleveland, Ohio for African American and Hispanic elders and pilot projects of a modified AFH cancer prevention curriculum in two rural counties of North Carolina to increase breast and cervical cancer screening. the participants will be studied longitudinally to determine the programs' lasting effects. there will be comparison groups in each state which will not receive the education program and serve as a control group for naturally occurring trends in screening. A validated questionnaire will evaluate the North Carolina pilot and intervention population at baseline and at a four-month follow-up period. The adapted questionnaire will be validated for rural and Hispanic populations.