|Research suggests newsletters, videos might cut colorectal cancer in churchgoing blacks|
|September 22, 2004|
CHAPEL HILL - Combining newsletters individually customized to the health status and lifestyle of the people reading them, along with culturally tailored educational videotapes, might help prevent colorectal cancer in some at-risk populations, a new study suggests.
The study, conducted by University of North Carolina at Chapel Hill researchers and colleagues, showed that the combined efforts were effective in boosting fruit and vegetable consumption and exercise among black churchgoers in North Carolina. Surprisingly, adding support from lay health advisors -- trusted community members others often turn to when they have questions about health -- did not increase the program's effectiveness.
"The Watch Project was a randomized trial comparing the effectiveness of two strategies to promote colorectal cancer prevention behaviors among 587 African American members of 12 rural North Carolina churches," said study leader Dr. Marci K. Campbell, associate professor of nutrition at the UNC School of Public Health.
"We found that the tailored newsletters and specially designed videotapes boosted fruit and vegetable consumption by more than a half serving a day, on average, and caused our subjects to exercise about 20 percent more than they did before our program."
"Watch" is an acronym for "Wellness for African Americans Through Churches," Campbell said. The American Cancer Society and the U.S. Department of Agriculture supported the study, which involved choosing black churches at random and analyzing knowledge about the cancer and prevention behaviors before and after the educational efforts.
"Among those age 50 and over, we saw a 15 percent increase in the number of people undergoing fecal occult blood tests," she said. "Those tests are the simplest, least expensive way of screening for colon cancer and showing who might need more sophisticated tests, such as colonoscopy, for possible colorectal cancer."
When the researchers analyzed what happened with lay health advisors and their efforts to get the word out, results were disappointing, Campbell said.
No meaningful changes were found in their groups' diets or exercise levels, and those subjects were not more likely to undergo the simple occult blood screening tests than others who served as controls, she said. Part of the problem may have been that spreading information via lay health advisors was too slow to detect in a one-year study.
In fact, when asked later, only 10 percent of participants in the groups assigned to advisor education remembered talking to somebody about colorectal cancer prevention.
A report on the research appears in the current issue of Health Psychology, a professional journal. Besides Campbell, authors include doctoral student Veronica Oates, also in nutrition at UNC; Dr. Aimee James of Kansas University Medical Center; Carol Carr of UNC's Lineberger Comprehensive Cancer Center; doctoral student Marlyn A. Hudson and retired faculty member Ethel Jackson of health behavior and health education at the UNC School of Public Health; biostatistician Dr. Seleshi Demissie of Takeda Pharmaceuticals North America; David Farrell of People Designs in Durham, N.C.; and Dr. Irene Tessaro of West Virginia University.
"The effectiveness of the specially tailored newsletters and videotapes across multiple behaviors is encouraging," Campbell said. "The additional impact on recreational exercise suggests that tailoring to multiple lifestyle behaviors is feasible and could have major health benefits."
Colorectal cancer is the second leading cause of cancer deaths in the United States and accounts for about 15 percent of all cancers diagnosed annually, she said. In 2003, an estimated 57,100 people in this country died from the illness, and about 147,500 new cases were diagnosed.
"African Americans suffer more deaths from colorectal cancer when compared with other population groups in the United States," Campbell said. "In 2001, the colorectal cancer death rate for whites, for example, was about 22 per 100,000. For African Americans, the rate was about 29 per 100,000."
Researchers have previously shown that diets high in fruits, vegetables and fiber and low in fat might reduce the risk of cancer and other chronic health problems by 50 percent when coupled with 30 minutes of moderate to vigorous exercise almost daily. Government health officials recommend at least five servings of fruits and vegetables daily.
This release was researched and written by David Williamson of UNC News Services.
News Services contact: David Williamson, (919) 962-8596