DESCRIPTION: The proposed study is a 5-year randomized controlled community
trial to test two interventions designed to promote increased use of colorectal
cancer (CRC) screening. The interventions will be tested in 74 churches in Los
Angeles County and Honolulu with men and women church members ages 50-75. The
interventions comprise a church-level one, Church Leadership Training (CLT) and
a member-level one, Targeted Print (TP). CLT targets pastors and other key
church leaders through training workshops to increase public health awareness
throughout the organization with a focus on promoting CRC screening. This
proposal is a competing continuation application that builds on a previous
trial in Los Angeles churches that successfully tested a targeted print
intervention to increase mammography screening. In this study, TP will target
older church members through mailings that address barriers to CRC screening.
Low to moderate income Asians, blacks, Hispanics and whites will be the focus
population. We propose a 2-site study in Los Angeles and Honolulu using a
randomized longitudinal cohort design within each site. 54 churches from Los
Angeles and 20 from Honolulu will be randomized into 3 study conditions (2
interventions and a minimal contact control). 2,700 church members from Los
Angeles and 1,000 from Honolulu will be followed over 3 years to study the
effectiveness and cost-effectiveness of the 2 interventions on regular CRC
A church-wide evaluation, consisting of extended interviews with pastors and
other key church leaders, will be conducted to develop case studies. This
qualitative assessment will contribute to an appreciation of the impact of
research studies on church organizations. Several strengths of this study
include testing a church-level vs. a member-level intervention to promote CRC
screening, the use of extensive church pilot data to establish the feasibility
of this study, a design that allows generalizations about the efficacy of
church-based health promotion programs, and a quantitative and qualitative
approach that broadens our understanding of using urban churches to reach
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