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Cancer Control Research

Abstract

DESCRIPTION: The proposed investigation will study processes and effects of a program to modify cancer-related behaviors among Mexican American women at high risk for contracting cervical cancer. Specifically, the goal of this project will be to encourage Mexican American women who have multiple sex partners to participate in pap smear screening, to moderate sexual contact or use condoms with their sexual partners, and to discourage them from using alcohol, cigarettes and intravenous drugs. The investigators will blend well-developed methodologies from population-based community studies with more recent, successful experiences with outreach to high-risk subpopulations in research on HIV control and apply them to a specific group within a community setting. The proposed research will target two inner-city areas of Houston predominantly populated by Mexican Americans. Study areas providing access to high-risk women will be clearly defined and randomly assigned to treatment or comparison conditions. Preliminary community observation will lead to the development or refinement of research measures and intervention procedures. In each location, baseline and follow-up data will be collected, primarily through brief "intercept" anonymous interviews conducted by a trained "street" survey team. These data will assess cancer-related risks and related intentions and attitudes. A total of 1,500 interviews will be completed over a five-year period, with 500 completed per wave of data collection. Data analysis will establish the relationship between treatment processes and outcomes. Implementation tracking and qualitative data will also be gathered to help interpret quantitative research results. The proposed treatment program is to be adapted from recent experiences with outreach for HIV control, in which hard-to-reach groups are contacted through peer networks and the adoption of risk-reducing behaviors is accelerated by peer modeling. The planned activities in the treatment locations will include recruitment and activation of a network of indigenous volunteers capable of gaining participation from high-risk women. The creation of an accompanying "small" media campaign will use low-literacy and non-written materials in journalistic and other formats to display positive role models from within the study populations.