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Cancer Control Research

Abstract

DESCRIPTION: Available data indicate two broad areas of public health concern for Asian populations in North America: low screening participation rates and increasing adoption of chronic disease risk factors. This proposal focuses on cervical cancer screening and dietary behavior. The research goal is to support the design, implementation, and evaluation of cancer control programs targeting less acculturated ethnic Chinese women. Specific aims are as follows: -- Collect information about cervical cancer screening practices and barriers to, as well as facilitators of, Pap testing participation; design culturally and linguistically appropriate interventions to increase cervical cancer screening rates; and complete two randomized controlled trials to evaluate the effectiveness, feasibility, and costs of alternative Pap testing intervention approaches. -- Develop and evaluate culturally sensitive, practical, and valid instruments to assess dietary habits and changes in habits; and collect information necessary for the design and delivery of nutrition education interventions, including data on food consumption, factors affecting food choices, and channels for nutrition information dissemination. To increase the generalizability of findings, the research will be conducted in two cities: Seattle, Washington and Vancouver, British Columbia. PRECEDE will be used as an over-arching conceptual framework for the project. During all phases of the study, community involvement will be emphasized. In the first phase, qualitative data concerning Pap testing and dietary practices will be collected and analyzed. This information will be used during phases two and three: development of survey instruments, quantitative data collection, and quantitative data analysis; and development of audiovisual and print Pap testing education materials (for use in the intervention programs). Finally, in phase four, we will evaluate two cervical cancer screening interventions: one using outreach workers and the other a direct mail approach. The same population-based samples will be used for the quantitative surveys and Pap testing randomized trials. Nested methodologic work addressing the validity of screening test self-report, and both the reliability and validity of culturally appropriate dietary assessment tools, will be completed.