DESCRIPTION (provided by applicant): Background African Americans experience disproportionate morbidity and mortality from colon and rectal cancers. Diets high in fruits and vegetables and moderate to vigorous physical activity all have the potential to significantly reduce colon cancer incidence and mortality, as well as risk for other co-morbidities. However, surprisingly, there have been relatively few empirically tested health behavior (diet and physical activity) interventions in African American colon cancer survivors. One reason may relate to the challenges of developing successful interventions, particularly for minority populations; thus, it may be particularly worthwhile to adapt programs which have demonstrated effectiveness in one population group to other segments of the population. The WATCH (Wellness for African Americans Through Churches) Project was a randomized trial in 12 rural North Carolina churches that demonstrated the effectiveness of a mailed tailored print and video (TPV) intervention consisting of four individually tailored newsletters and targeted videotapes to improve these behaviors. Results showed significant improvements (p<.05) for fruit and vegetable consumption (0.6 servings) and recreational physical activity (2.5 MET hours per week). Aims Here, we propose to conduct a pilot study (e-WATCH) to investigate whether the WATCH tailored print messages and videotapes can be effectively and efficiently disseminated to a different group of African Americans (colon cancer survivors) and using a different delivery channel or method (electronic technology via the internet). Secondary aims are to determine whether this intervention results in improvements in secondary outcomes, specifically self-efficacy and social support for improving health behaviors; and to use process evaluation measures to assess the feasibility, acceptability, and potential for wider dissemination of the e- WATCH program. Methods To accomplish these objectives, we will develop a password-protected website for e-WATCH that participants will access via the internet. Eligible participants will be African American males and females in North Carolina (n=200), 40-79 years, diagnosed with either Stage I or II colon cancer who have successfully completed treatment for their disease and who are at least 6 months post-diagnosis. Participants will be randomly assigned to receive the culturally and individually tailored intervention or the control condition (n=100 per group). They will complete a baseline survey online (querying on diet, physical activity, demographics, and psychosocial factors) and then will receive the WATCH tailored feedback and information (including the videotapes in digitized format) via the internet over a 5-6 month period after baseline data collection. Approximately six months after baseline, participants will complete a second survey assessing the same health behavior and psychosocial factors as at baseline. Control participants will receive a "delayed" intervention. Process and outcome evaluation measures collected pre- and post-intervention will assess exposure, cognitive processing, use of information, and acceptability. Evaluation will test whether this method of disseminating the WATCH program utilizing new technology produces comparable results to the previous randomized trial findings (i.e., the WATCH project). Significance This pilot study would inform on the potential to use the internet to deliver a culturally and individually tailored health behavior intervention in African American colon cancer survivors and whether such a program can be efficacious and feasible in this population, as well as on the extent to which psychosocial mediators such as social support and self-efficacy affect intervention effectiveness in this population. This project would also contribute to the understanding of how successful health promotion interventions can be modified for use in different segments of the population and for alternative forms (channels) of delivery.
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