title: Cluster Randomized Trial of a Church-Based Peer Counselor and Tailored Newsletter Intervention to Promote Colorectal Cancer Screening and Physical Activity Among Older African Americans.
abstract: Action Through Churches in Time to Save Lives (ACTS) of Wellness was a cluster randomized controlled trial developed to promote colorectal cancer screening and physical activity (PA) within urban African American churches. Churches were recruited from North Carolina (n = 12) and Michigan (n = 7) and were randomized to intervention (n = 10) or comparison (n = 9). Intervention participants received three mailed tailored newsletters addressing colorectal cancer screening and PA behaviors over approximately 6 months. Individuals who were not up-to-date for screening at baseline could also receive motivational calls from a peer counselor. The main outcomes were up-to-date colorectal cancer screening and Metabolic Equivalency Task (MET)-hours/week of moderate-vigorous PA. Multivariate analyses examined changes in the main outcomes controlling for church cluster, gender, marital status, weight, and baseline values. Baseline screening was high in both intervention (75.9%, n = 374) and comparison groups (73.7%, n = 338). Screening increased at follow-up: +6.4 and +4.7 percentage points for intervention and comparison, respectively (p = .25). Baseline MET-hours/week of PA was 7.8 (95% confidence interval [6.8, 8.7]) for intervention and 8.7 (95% confidence interval [7.6, 9.8]) for the comparison group. There were no significant changes (p = .15) in PA for intervention (-0.30 MET-hours/week) compared with the comparison (-0.05 MET-hours/week). Among intervention participants, PA increased more for those who participated in church exercise programs, and screening improved more for those who spoke with a peer counselor or recalled the newsletters. Overall, the intervention did not improve PA or screening in an urban church population. These findings support previous research indicating that structured PA opportunities are necessary to promote change in PA and churches need more support to initiate effective peer counselor programs.
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA University at Buffalo, Buffalo, NY, USA lucialeo@buffalo.edu.
authors.forename: Lucia A
authors.initials: LA
authors.lastname: Leone
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA University of Texas, Dallas, TX, USA.
authors.forename: Marlyn
authors.initials: M
authors.lastname: Allicock
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pignone
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Joan F
authors.initials: JF
authors.lastname: Walsh
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: La-Shell
authors.initials: LS
authors.lastname: Johnson
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Janelle
authors.initials: J
authors.lastname: Armstrong-Brown
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Carol C
authors.initials: CC
authors.lastname: Carr
authors.affiliation: New York University, New York, NY, USA.
authors.forename: Aisha
authors.initials: A
authors.lastname: Langford
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Andy
authors.initials: A
authors.lastname: Ni
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Marci K
authors.initials: MK
authors.lastname: Campbell
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D003376:Counseling / Q000379:methods; D055088:Early Detection of Cancer / Q000379:methods*; D015444:Exercise / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina; D010506:Periodicals as Topic; D015397:Program Evaluation; D012068:Religion and Medicine; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: African American; church-based; colorectal cancer screening; peer counseling; physical activity; tailored health messages