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Celebremos La Salud! A Community Randomized Trial of Cancer Prevention (United States)

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Abstract

Background

Compared to non-Hispanic whites, Hispanics in the United States are at higher risk for certain types of cancer.

Methods

In a randomized controlled trial of 20 communities, we examined whether a comprehensive intervention influenced cancer screening behaviors and lifestyle practices in rural communities in Eastern Washington State. Cross-sectional surveys at baseline and post-intervention included interviews with a random sample of approximately 100 households per community. The interview included questions on ever use and recent use of Pap test, mammogram, and fecal occult blood test (FOBT) and sigmoidoscopy/colonoscopy, fruit and vegetable consumption and smoking practices.

Results

We found few significant changes in use of screening services for cervical (Pap test), breast (mammogram) or colorectal cancer (fecal occult blood test (FOBT) or sigmoidoscopy/colonoscopy) between intervention and control communities. We found no significant differences in fruit and vegetable consumption nor in smoking prevalence between the two groups. We found more awareness of and participation in intervention activities in the treatment communities than the control communities.

Conclusions

Our null findings might be attributable to the low dose of the intervention, a cohort effect, or contamination of the effect in non-intervention communities. Further research to identify effective strategies to improve cancer prevention lifestyle behaviors and screening practices are needed.

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References

  1. U.S. Census Bureau (2000) Differences in Population by Race and Hispanic or Latino Origin, for the United States: 1990 to 2000 (Table 4)

  2. U.S. Census Bureau (2001) Population by Race and Hispanic or Latino Origin, for All Ages and for 18 Years and Over, for the United States: 2000 (Table 1)

  3. Ramirez AG, McAlister A, Gallion KJ et al (1995) Community level cancer control in a Texas barrio: Part I—Theoretical basis, implementation, and process evaluation. J Natl Cancer Inst Monogr 18:117–122

    PubMed  Google Scholar 

  4. Kristal AR, Shattuck AL, Patterson RE (1999) Differences in fat-related dietary patterns between black, Hispanic and White women: results from the Women’s Health Trial Feasibility Study in Minority Populations. Public Health Nutrition 2(3):253–262

    CAS  PubMed  Google Scholar 

  5. Mishra SI, Chavez LR, Magana JR, Nava P, Valdez RB, Hubbell FA (1998) Improving breast cancer control among Latinas: evaluation of a theory-based educational program. Health Educ Behav 25(5):653–670

    CAS  PubMed  Google Scholar 

  6. Ramirez AG, Suarez L, Laufman L, Barroso C, Chalela P (2000) Hispanic women’s breast and cervical cancer knowledge, attitudes, and screening behaviors. Am J Health Promot 14(5):292–300

    CAS  PubMed  Google Scholar 

  7. Coronado G, Thompson B, Koepsell TD, Schwartz SM, McLerran D (2004) Use of Pap test among Hispanics and non-Hispanic Whites in a rural setting. Prev Med 38(6):713–722

    Article  PubMed  Google Scholar 

  8. Shah M, Zhu K, Wu H, Potter J (2005) Hispanic acculturation and utilization of cervical cancer screening in the US. Prev Med (November 2005, Epub ahead of print)

  9. Chao A, Gilliland FD, Hunt WC, Bulterys M, Becker TM, Key CR (1998) Increasing incidence of colon and rectal cancer among Hispanics and American Indians in New Mexico (United States), 1969–94. Cancer Causes Control 9(2):137–144

    Article  CAS  PubMed  Google Scholar 

  10. Ries LA, Wingo PA, Miller DS et al (2000) The annual report to the nation on the status of cancer, 1973–1997, with a special section on colorectal cancer. Cancer 88(10):2398–2424

    Article  CAS  PubMed  Google Scholar 

  11. Lawrence D, Graber JE, Mills SL, Meissner HI, Warnecke R (2003) Smoking cessation interventions in U.S. racial/ethnic minority populations: an assessment of the literature. Prev Med 36(2):204–216

    Article  PubMed  Google Scholar 

  12. Puschel K, Thompson B, Coronado GD, Lopez LC, Kimball AM (2001) Factors related to cancer screening in Hispanics: a comparison of the perceptions of Hispanic community members, health care providers, and representatives of organizations that serve Hispanics. Health Educ Behav 28(5):573–590

    CAS  PubMed  Google Scholar 

  13. Gilliland FD, Rosenberg RD, Hunt WC, Stauber P, Key CR (2000) Patterns of mammography use among Hispanic, American Indian, and non-Hispanic White women in New Mexico, 1994–1997. Am J Epidemiol 152(5):432–437

    Article  CAS  PubMed  Google Scholar 

  14. Lusk SL (1998) Culturally sensitive interventions for Hispanics. AAOHN J 46(12):589–592

    CAS  PubMed  Google Scholar 

  15. Bracht N, Kingsbury L, Rissel C (1998) A five-stage community organization model for health promotion: empowerment and partnership strategies. In: Bracht N (ed) Health promotion at the community level: new advances, 2nd edn. Sage Publications, Thousand Oaks, CA, pp 83–104

    Google Scholar 

  16. Thompson B, Nettekoven L, Ferster D, Stanley LC, Thompson J, Corbett KK (1995) Mobilizing the COMMIT communities for smoking control. In: Thompson B (ed) Community-based interventions for smokers: The COMMIT field experience, Monograph 6. US Department of Health and Human Services Public Health Service National Institutes of Health, National Cancer Institute, Bethesda, MD, pp 53–73

  17. Centers for Disease Control and Prevention (2001) Cigarette smoking-related mortality. http:www.cdc/tobacco/researchdata/healthconsequences/mortali.htm. Accessed 9/20/01

  18. Behavioral Risk Factor Surveillance System (2004) Prevalence Data, Nationwide—2002 Tobacco Use. http://apps.nccd.cdc.gov/brffs/race.asp? Accessed July 6, 2004

  19. Woodruff SI, Zaslow KA, Candelaria J, Elder JP (1997) Effects of gender and acculturation on nutrition-related factors among limited-English proficient Hispanic adults. Ethn Dis 7(2):121–126

    CAS  PubMed  Google Scholar 

  20. Elder JP, Castro FG, de Moor C et al (1991) Differences in cancer-risk-related behaviors in Latino and Anglo adults. Prev Med 20(6):751–763

    Article  CAS  PubMed  Google Scholar 

  21. Otero-Sabogal R, Sabogal F, Perez-Stable EJ, Hiatt RA (1995) Dietary practices, alcohol consumption, and smoking behavior: ethnic, sex, and acculturation differences. J Natl Cancer Inst Monogr (18):73–82

  22. Winkleby MA, Albright CL, Howard-Pitney B, Lin J, Fortmann SP (1994) Hispanic/white differences in dietary fat intake among low educated adults and children. Prev Med 23(4):465–473

    Article  CAS  PubMed  Google Scholar 

  23. Neuhouser ML, Thompson B, Coronado GD, Solomon CC (2004) Higher fat intake and lower fruit and vegetables intakes are associated with greater acculturation among Mexicans living in Washington state. J Am Diet Assoc 104(1):51–57

    Article  PubMed  Google Scholar 

  24. Bermudez OI, Falcon LM, Tucker KL (2000) Intake and food sources of macronutrients among older Hispanic adults: association with ethnicity, acculturation, and lengthy of residence in the U.S. J Am Diet Assoc 100(6):665–673

    CAS  PubMed  Google Scholar 

  25. Centers for Disease Control and Prevention (2002) National Health Interview Survey. http://www.cdc.gov/nchs/nhis.htm. Accessed 8/22/02

  26. American Cancer Society (2003) Cancer facts and figures for Hispanics/Latinos 2003–2005. American Cancer Society, Atlanta, GA

    Google Scholar 

  27. Krieger N, Quesenberry C Jr., Peng T et al (1999) Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, Black, Hispanic, and White residents of the San Francisco Bay Area, 1988–92 (United States). Cancer Causes Control 10(6):525–537

    Article  CAS  PubMed  Google Scholar 

  28. Mills PK, Kwong S (2001) Cancer incidence in the United Farmworkers of America (UFW), 1987–1997. Am J Ind Med 40(5):596–603

    CAS  PubMed  Google Scholar 

  29. Jones AR, Caplan LS, Davis MK (2003) Racial/ethnic differences in the self-reported use of screening mammography. J Commun Health 28(5):303–316

    Article  Google Scholar 

  30. Ramirez AG, Talavera GA, Villarreal R et al (2000) Breast cancer screening in regional Hispanic populations. Health Educ Res 15(5):559–568

    Article  CAS  PubMed  Google Scholar 

  31. Harmon MP, Castro FG, Coe K (1996) Acculturation and cervical cancer: knowledge, beliefs, and behaviors of Hispanic women. Women Health 24(3):37–57

    CAS  PubMed  Google Scholar 

  32. O’Brien K, Cokkinides V, Jemal A et al (2003) Cancer Statistics for Hispanics, 2003. CA Cancer J Clin 53(4):208–226

    PubMed  Google Scholar 

  33. del Carmen MG, Montz FJ, Bristow RE, Bovicelli A, Cornelison T, Trimble E (1999) Ethnic differences in patterns of care of stage 1A(1) and stage 1A(2) cervical cancer: a SEER database study. Gynecol Oncol 75(1):113–117

    PubMed  Google Scholar 

  34. Howe SL, Delfino RJ, Taylor TH, Anton-Culver H (1998). The risk of invasive cervical cancer among Hispanics: evidence for targeted preventive interventions. Prev Med 27(5 Pt 1):674–680

    CAS  PubMed  Google Scholar 

  35. Coughlin SS, Uhler RJ, Richards T, Wilson KM (2003) Breast and cervical cancer screening practices among Hispanic and non-Hispanic women residing near the United States-Mexico border, 1999–2000. Family Commun Health 26(2):130–139

    Google Scholar 

  36. Benard VB, Lee NC, Piper M, Richardson L (2001) Race-specific results of Papanicolaou testing and the rate of cervical neoplasia in the National Breast and Cervical Cancer Early Detection Program, 1991–1998 (United States). Cancer Causes Control 12(1):61–68

    Article  CAS  PubMed  Google Scholar 

  37. Coronado GD, Koepsell TD, Thompson B, Schwartz SM, Wharton RS, Grossman JE (2002) Assessing cervical cancer risk in Hispanics. Cancer Epidemiol Biomark Prevent 11(10 Pt 1):979–984

    Google Scholar 

  38. Coughlin SS, Thompson TD, Hall HI, Logan P, Uhler RJ (2002) Breast and cervical carcinoma screening practices among women in rural and nonrural areas of the United States, 1998–1999. Cancer 94(11):2801–2812

    Article  PubMed  Google Scholar 

  39. Rawl SM, Menon U, Champion V (2002) Colorectal cancer screening: an overview of current trends. Nurs Clin North Am 37(2):225–245

    PubMed  Google Scholar 

  40. Wolf RL, Zybert P, Brouse CH et al (2001) Knowledge, beliefs, and barriers relevant to colorectal cancer screening in an urban population: a pilot study. Family Commun Health 24(3):34–47

    CAS  Google Scholar 

  41. Goel MS, Wee CC, McCarthy EP, Davis RB, Ngo-Metzger Q, Phillips RS (2003) Racial and ethnic disparities in cancer screening (Populations at risk). J Gen Intern Med 18:1028–1035

    PubMed  Google Scholar 

  42. Bastani R, Gallardo N, Maxwell A (2001) Barriers to colorectal cancer screening among ethnically diverse and average risk individuals. J Psychosoc Oncol 19(3/4):65–84

    Article  Google Scholar 

  43. Thompson B, Coronado GD, Solomon CC, McClerran DF, Neuhouser ML, Feng Z (2002) Cancer prevention behaviors and socioeconomic status among Hispanics and non-Hispanic whites in a rural population in the United States. Cancer Causes Control 13(8):719–728

    Article  PubMed  Google Scholar 

  44. Hancock L, Sanson-Fisher R, Perkins J, McClintok A, Howley P, Gibberd R (2001) Effect of a community action program on adult quit smoking rates in rural Australian towns: the CART project. Prev Med 32:118–127

    CAS  PubMed  Google Scholar 

  45. Commit Research Group (1995) Community intervention trial for smoking cessation (COMMIT): I. Cohort results from a four-year community intervention. Am J Public Health 85(2):183–192

    Google Scholar 

  46. Shannon J, Kristal AR, Curry SJ, Beresford SA (1997) Application of a behavioral approach to measuring dietary change: the fat- and fiber-related diet behavior questionnaire. Cancer Epidemiol Biomark Prevent 6(5):355–361

    CAS  Google Scholar 

  47. Subar AF, Heimendinger J, Patterson BH, Krebs-Smith SM, Pivonka E, Kessler R (1995) Fruit and vegetable intake in the United States: the baseline survey of the five a day for better health program. Am J Health Promot 9(5):352–360

    CAS  PubMed  Google Scholar 

  48. Sorensen G, Thompson B, Glanz K et al (1996) Work-site based cancer prevention: primary results from the Working Well Trial. Am J Public Health 86(7):939–947

    CAS  PubMed  Google Scholar 

  49. U.S. Preventive Services Task Force (2002) Guide to Clinical Preventive Services, 2nd and 3rd edn. International Medical Publishing Inc., McClean, VA

  50. Coronado GD, Thompson B, McLerran D, Schwartz SM, Koepsell TD (2005) A short acculturation scale for Mexican American populations. Ethn Dis 15:53–62

    Google Scholar 

  51. SAS 9.0 for Windows [computer program] (2002) Version. Cary, North Carolina

  52. Farquhar JW, Fortmann SP, Flora JA et al (1990) Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. JAMA 264(3):359–365

    Article  CAS  PubMed  Google Scholar 

  53. Luepker RV, Rastam L, Hannan PJ et al (1996) Community education for cardiovascular disease prevention. Morbidity and mortality results from the Minnesota Heart Health Program. Am J Epidemiol 144(4):351–362

    CAS  PubMed  Google Scholar 

  54. Mittelmark MB (1999) Health promotion at the community level: lessons from diverse perspectives. In: Bracht N (ed) Health promotion at the community level: new advances, 2nd edn. Sage, Thousand Oaks, CA, pp 3–27

    Google Scholar 

  55. Thompson B, Coronado G, Neuhouser ML, Chen L (2005) Colorectal carcinoma screening among Hispanics and Non-Hispanic Whites in a rural setting. Cancer 103(12):2491–2498

    Article  PubMed  Google Scholar 

  56. Fitzgibbon ML, Stolley MR, Avellone ME, Sugerman S, Chavez N (1996) Involving parents in cancer risk reduction: a program for Hispanic American families. Health Psychol 15(6):413–422

    Article  CAS  PubMed  Google Scholar 

  57. Valdez A, Banerjee K, Ackerson L, Fernandez M (2002) A multimedia breast cancer education intervention for low-income Latinas. J Commun Health 27(1):33–51

    Article  Google Scholar 

  58. Earp JA, Eng E, O’Malley MS et al (2002) Increasing use of mammography among older, rural African American women: results from a community trial. Am J Public Health 92(4):646–654

    PubMed  Google Scholar 

  59. Andersen MR, Yasui Y, Meischke H, Kuniyuki A, Etzioni R, Urban N (2000) The effectiveness of mammography promotion by volunteers in rural communities. Am J Prev Med 18(3):199–207

    Article  CAS  PubMed  Google Scholar 

  60. Commit Research Group (1995) Community intervention trial for smoking cessation (COMMIT): II. Changes in adult cigarette smoking prevalence. Am J Public Health 85(2):193–200

    Google Scholar 

  61. Susser M (1995) The tribulations of trials—intervention in communities. Am J Public Health 85(2):156–158

    CAS  PubMed  Google Scholar 

  62. Feng Z, Thompson B (2002) Some design issues in a community intervention trial. Control Clin Trials 23(4):431–449

    PubMed  Google Scholar 

  63. Fisher EB Jr (1995) The results of the COMMIT trial. Community intervention trial for smoking cessation. Am J Public Health 85(2):159–160

    PubMed  Google Scholar 

  64. Fiore MC, Baker TB (1995) Smoking cessation treatment and the good doctor club. Am J Public Health 85(2):161–163

    CAS  PubMed  Google Scholar 

  65. Hancock L, Sanson-Fisher R, Perkins J, Corkrey R, Burton R, Reid S (2001) Effect of a community action intervention on cervical cancer screening rates in rural Australian towns: The CART Project. Prev Med 32:109–117

    CAS  PubMed  Google Scholar 

  66. Thompson B, Coronado G, Snipes S, Puschel K (2003) Methodologic advances and ongoing challenges in designing community-based health promotion programs. Ann Rev Public Health 24:315–340

    Article  Google Scholar 

  67. Fisher EB, Auslander WF, Munro JF, Arfken CL, Brownson RC, Owens NW (1998) Neighbors for a smoke free north side: evaluation of a community organization approach to promoting smoking cessation among African Americans. Am J Public Health 88(11):1658–1663

    CAS  PubMed  Google Scholar 

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Acknowledgements

This work was supported by a grant (CA74968) from the National Cancer Institute. The authors acknowledge the Community Advisory Board, all the staff in the field office, and respondents to the survey in the Lower Yakima Valley and Columbia Basin of Washington State. This work was approved by the Fred Hutchinson Institutional Review Board (IR File 4344).

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Correspondence to Beti Thompson.

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Thompson, B., Coronado, G., Chen, L. et al. Celebremos La Salud! A Community Randomized Trial of Cancer Prevention (United States). Cancer Causes Control 17, 733–746 (2006). https://doi.org/10.1007/s10552-006-0006-x

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