ACTION FOR HEALTH:CANCER PREVENTION MODEL OLDER WOMEN

虽然对乳房和子宫颈有有效的筛查方法 对于癌症，利用不足在少数族裔老年妇女中很常见。他们的癌症 在较晚的阶段被诊断出来，预后更差。这些癌症是 对老年人意义重大，因为超过50%的乳腺癌发生在女性 60岁以上。对宫颈癌的筛查导致了发病率的下降 所有非老年人口的死亡率。公共卫生服务，在 其题为《促进健康/预防疾病：2000年目标》报告 国家“，已经确定了未来筛查的目标人群 只有在为克服障碍而制定的干预措施下才能实现 与年龄、种族/民族、收入和教育有关。虽然这件事 共识文件确定乳腺癌筛查目标为 在本十年期间取得的成就，但没有提供满足以下条件的战略 这些目标。 由CWRU开发的健康行动是一种独特的癌症预防 专门设计的课程，旨在克服利用 少数族裔老年妇女的乳腺癌和宫颈癌筛查。该计划 利用训练有素的老年人作为同伴培训师，并结合使用 说教式和基于经验的学习策略。 我们假设健康行动将： .导致70%的计划参与者在利用率方面发生持续变化 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%的参与者感觉健康状况的改善。 .适应后，对农村人口和城市人口的好处是一样的 人口。 长期目标是降低#年乳腺癌/宫颈癌死亡率。 少数族裔老年人通过我们的癌症早期诊断率增加 预防课程。目标是：1)记录 一项针对非洲裔美国人和西班牙裔妇女的计划的有效性 克利夫兰；2)将基于城市的计划的有效性与 北卡罗来纳州农村的课程。 研究设计将是一个多时间序列的准实验 旨在评估健康行动(AFH)癌症预防课程的设计 在俄亥俄州克利夫兰为非裔美国人和西班牙裔长老和飞行员 修改后的AFH癌症预防课程在两个农村地区的项目 北卡罗来纳州各县将增加乳腺癌和宫颈癌 放映。参与者将接受纵向研究，以确定 这些计划的持久影响。每个组中都有比较组 将不接受教育计划并作为控制的州 筛查自然趋势小组。经过验证的 问卷将评估北卡罗来纳州的试点和干预 人口基准期和四个月的随访期。改编版 调查问卷将针对农村和西班牙裔人口进行验证。

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.