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Cancer Control Research

5R01CA073981-06
Switzer, Boyd R.
NCI DIETARY GUIDELINES IN AFRICAN AMERICAN CHURCHES

Abstract

ABSTRACT=African Americans are affected by cancer and heart disease more than whites, yet dietary interventions are not very culturally sensitive for African Americans. The aims of this church-based study are: 1. to identify barriers and motivators on dietary change among African Americans; 2. to use the barriers and motivators to develop culturally sensitive ways to increase knowledge, and promote attitude and dietary behavior change (lower fat, increase fiber and variety of fruits and vegetables; 3. to evaluate the effectiveness of the interventions on achievement and adherence to the NCI guidelines using both process and outcome evaluation; and 4. to examine the effect of dietary changes on selected psychosocial, biochemical and anthropometrical parameters. The n = 1800 African America congregants will be 18 years old and over, from lower to upper SES with 30 participants from each of 10 churches in 6 North Carolina communities. One demonstration church will help pilot test the intervention aspects based on known barriers and motivators and develop intervention aspects based on barriers and motivators newly identified by qualitative methods. Three counties each will be randomly assigned to early and delayed interventions based on the Health Behavior in Cancer Prevention Model nested in the Stages of Readiness for Change in the context of the PRECEDE Mode. Congregation level interventions include educational food events, health fairs, and pastoral assistance with bulletins, sermons, and counseling techniques to support dietary change efforts by congregants. Small group interventions include kitchen committee workshops and a congregant speaker's bureau. At the individual level a computer-tailored person bulletin and self-help "Food for Health" packet will assist lay health counselors, while inspirational booklets and audiotapes tailored to stages of change will use Scriptures, testimonials, and music to promote adherence to the NCI guidelines. Measures include Dietary Risk Assessment, a food frequency questionnaire, waist-hip measures, body mass index and serum cholesterol, vitamins A and E, carotenoids, sex hormone binding globulin, and hormones (estradiol and testosterone). Qualitative and quantitative data will be analyzed with applicable techniques. After intervention, congregations will be more knowledgeable about food-related diseases; key groups will cook healthier; individuals will have healthier lifetime eating patterns.


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