Spiritually-based Breast Cancer Communication

描述(由申请人提供)： 乳腺癌是健康差距的一个重要领域，因为非裔美国女性比其他群体的女性更有可能死于这种疾病。尽管在几个健康领域(如高血压、糖尿病、乳腺癌)，已开始出现以教会为基础的、服务于非裔美国人的健康教育干预措施，但很少有人使用包含实际精神内容的交流方法。教会是一种方便而有效的手段，可以接触到原本得不到充分服务的人群，而基于教会的计划在服务这一群体方面一直很有效。然而，仅将教堂作为场所并在这种环境中提供世俗信息显然没有充分利用这些干预的潜力，特别是因为已证明精神因素与乳腺癌结果有重要关联(例如，乳腺癌知识；乳房X光检查的障碍和好处；乳房X光检查的使用)。此外，实证研究表明，健康传播干预措施在满足受众的信仰和价值观时是最有效的。通过将精神健康信息引入这些干预措施，信息的个人相关性增加，信息将更有可能在刺激态度和行为改变方面取得成功。同样重要的是，这一精神信息内容应牢牢植根于理论，解决经经验证明与乳腺癌预后相关的精神因素。通过制定包含精神因素的健康信息，教会健康教育干预措施的有效性可以最大化。这项拟议的试点研究将开发和评估这种基于精神的乳腺癌沟通干预的有效性，在一项随机对照试验中将其与密苏里州圣路易斯市168名非洲裔美国女性中的人口学目标(针对非洲裔美国女性)和标准(非目标)乳腺癌沟通进行比较。这三种方法的有效性将在暴露后立即和一个月后从精化似然模型信息处理的角度进行衡量。研究结果包括参与者对干预措施的认知反应(一个基于理论和经验支持的沟通有效性指数)，以及先前被证明与乳房X光检查使用相关的行为前因素(例如，准备阶段、乳腺癌知识)。如果基于精神的乳腺癌沟通干预被发现在这些结果方面是有效的，它可以进一步发展为更广泛的干预，并在以乳房X光检查为主要结果的全面随机试验中进行测试。

DESCRIPTION (provided by applicant): Breast cancer is an important area of health disparity in that African American women are more likely to die from the disease than women of other groups. Although church-based health education interventions serving African Americans have begun to arise in several health areas (e.g., hypertension, diabetes, breast cancer), very few use a communication approach that contains actual spiritual content. The church is a convenient and effective means of reaching otherwise underserved populations, and church-based programs have been effective for serving this group. However, using the church solely as a venue and providing secular messages in this environment clearly underutilizes the potential for these interventions, particularly because spirituality factors have been shown to have important associations with breast cancer outcomes (e.g., breast cancer knowledge; mammography barriers and benefits; mammography use). In addition, empirical studies have demonstrated that health communication interventions are most effective when they address the beliefs and values of the audience. By introducing spiritual health messages to these interventions, the personal relevance of the message is increased, and the message will be more likely to be successful in stimulating attitude and behavior change. It is also important that this spiritual message content be firmly rooted in theory, addressing spiritual factors empirically shown to be associated with breast cancer outcomes. By developing a health message framed with spiritual factors, the effectiveness of church-based health education interventions can be maximized. The proposed pilot study will develop and evaluate the effectiveness of such a spiritually-based breast cancer communication intervention, comparing it in a randomized controlled trial with both a demographically targeted (for African American women) and a standard (non-targeted) breast cancer communication among 168 African American women in St. Louis, Missouri. Effectiveness of these three approaches will be measured from an Elaboration Likelihood Model information-processing perspective immediately after exposure and one month later. Study outcomes include participants' cognitive responses to the interventions (a theoretically based and empirically supported index of communication effectiveness) as well as pre-behavioral factors previously shown to be associated with mammography utilization (e.g., stage of readiness, breast cancer knowledge). If the spiritually based breast cancer communication intervention is found to be effective in terms of these outcomes, it can be further developed into a more extensive intervention and tested in a full-scale randomized trial with mammography as the primary outcome.