Table 4 compares the demographic profiles of the respondents in the four cities. While the profiles of the survey respondents in three of the cities were similar, the Decatur sample was somewhat younger, better-educated and had a smaller percentage of low-income people than did the Atlanta sample.

Table 4. Demographic characteristics of persons surveyed in intervention and comparison cities

Atlanta

Decatur p (Atlanta vs. Decatur) Nashville Chattanooga p (Nashville vs. Chattanooga)
Female

57.6%

55.1%

NS

58.6%

59.7%

NS

Mean age (SE) 41.5 (0.9)

39.6 (0.6)

NS (p=0.07)

42.4 (0.8)

44.0 (0.7)

NS

>50 years old

31.2%

22.8%

<0.001

32.7%

35.9%

NS

<$ 10,000 per year

25.1%

13.0%

O.001

29.3%

31.3%

NS

< High-school completion 19.6%

13.2%

O.001

22.5%

24.1%

NS

Table 5 displays population figures for the four communities of interest, survey sample size and response rates. Four independent samples with similar response rates (66.5-71.1%) were achieved in both the pre and postintervention periods.

Table 5. Target population and survey sample

Atlanta Decatur Nashville Chattanooga
Total population of targeted census tracts

41,927

70,307

67,807

54,875

Adult African-American pop. of targeted census tracts

30,030

44,874

38,951

25,858

Survey sample size (households) at baseline

1,461

1,754

1,482

1,478

Response rate at baseline

70.5%

66.5%

68.0%

70.3%

Survey sample size (households) at follow-up

1,565

1,606

1,561

1,537

Response rate at follow-up

71.1%

67.6%

69.2%

70.5%

Intervention Awareness and Participation

At both intervention and comparison sites, the percentage of respondents indicating they had heard of TCiB increased significantly from pre- to post-intervention (Table 6). The “effect difference”—the magnitude of the change from pre- to postintervention in the intervention city compared to that in the comparison city—was statistically significant in the Tennessee cities but not in the Georgia pair. In Nashville, nearly a quarter of postintervention respondents were familiar with TCiB versus <15% at the other sites. Thirty-five-to-40% of respondents at all four sites claimed to have heard of the Cancer (Canadian Nolvadex is an anti-estrogen used to treat or prevent breast cancer) Prevention Awareness Program even before the intervention. This percentage increased significantly at both Tennessee sites postintervention but at neither of the Georgia sites.

Table 6. Awareness of TCiB programs pre- and postintervention survey responses (percentages)

Atlanta (A)       Decatur (D) (Intervention)    (Comparison)

Nashville (N) (Intervention)

Chattanooga (C) (Comparison)

A vs. D Effect N vs. С Effect

Pre     Post       Pre      Post

Pre

Post

Pre

Post

Difference

Difference

Sample size 987     988      1,116     977 967 971

983

978
Heard of targeting cancer in blacks or TCiB project 8.67    13.12**   8.58     11.98**     9.35 23.63***

8.09

13.89***

0.65

8.48***
Heard of Cancer Prevention Awareness Program34.73    36.13    38.37     42.46     34.50 44.70***

40.31

45.85**

-2.69

4.66
Attended health fair at MSM/MMC2.35     7.35***  2.29      2.94 7.74 13.01***

1.37

2.51 4.35** 4.13**
Received MSM/MMC cancer (Generic Casodex treating prostate cancer) screening1.09     2.31*    0.66      0.99 2.54 3.96

0.60

1.34

0.90

0.68
Attended MSM/MMC cancer prevention talk 2.01      2.02      1.17      1.60 2.73 6.26***

0.81

0.79

-0.42

3.54***
Seen MSM/MMC flyers, posters, brochures 25.84    37.27*** 21.05     24.20 35.1 41.2**

12.62

17.12** 8.27** 1.61
Visited MMC training, referral and resource site 3.8 6.5*

0.30

0.80

2.27

Received cancer information from MSM/MMC8.55    15.19*** 8.08      7.40      15.54   17.26       3.09      3.48          7.32**        1.33pre: preintervention survey; post: postintervention survey; MSM: Morehouse School of Medicine; MMC: Meharry Medical College; * p<0.05 ; ** p<0.01 *** p<0.001

In Atlanta, but not Decatur, respondents to the postintervention survey were significantly more likely than the preintervention respondents to have attended a Morehouse health fair or cancer (Casodex drug is an oral non-steroidal anti-androgen for prostate cancer) screening; to have seen a Morehouse cancer prevention flyer, poster or brochure; or to have received cancer prevention information from Morehouse. The effect difference in the Georgia cities was significant for having seen a flyer, poster or brochure and for having received cancer (Eulexin canadian is used along with drugs such as Lupron to treat prostate cancer) information from Morehouse.

In Nashville, but not Chattanooga, respondents to the postintervention survey were significantly more likely than the preintervention respondents to have attended a Meharry health fair or cancer (Generic Revia may also be used to treat other conditions as determined by your doctor) talk or to have visited the Meharry hospital-based educational site. Both Nashville and Chattanooga respondents reported significantly increased contact with Meharry flyers, posters and brochures. The effect difference in the Tennessee cities was significant only for “attended cancer prevention talk.”

Respondents generally claimed to be familiar with the one-liners even before the intervention. For instance, between 84-89% of respondents at the four sites said they had heard the saying, “Get a Pap smear once a year” before the intervention. For the other seven one-liners, the range of respondents who had heard the saying preintervention was 54-73%. Postintervention, there was a statistically significant increase in the percentage of respondents at all sites except Decatur, who had heard the saying, “Don’t wait too late; check the prostate” (Atlanta, 56% vs. 63%, p=0.0007; Nashville 55% vs. 63%, p=0.005; Chattanooga 57% vs. 64%, p=0.01). For the other seven one-liners, there was no significant increase at any of the sites in the postintervention percentage of respondents who recalled hearing the sayings.

There was a statistically significant increase in the percentage of postintervention respondents in Atlanta who cited Morehouse as an important source from which they obtained cancer-related information (9% vs. 15%, p<0.001), although Morehouse was cited infrequently as a source compared to many others. There was no significant increase from pre- to postintervention survey in the percentage of Nashville respondents citing Meharry as an important source (16% vs. 17%).

In all four cities in both surveys, respondents (71-78%) identified television most frequently as their source of cancer (Hydrea medication is an antineoplastic used to treat certain types of cancer) information. Other sources cited frequently included magazines and books (64-70%), radio (44-53%) and newspapers (45-54%). Healthcare providers were cited by 30-39% of respondents as important sources of can cer information, friends were cited by 28-33% and the American Cancer Society by 29-36%).

The survey asked respondents if they had recently seen or heard information about exercise and cancer, nutrition and cancer, types of cancer screening tests, recommended frequency for cancer screening, where cancer screening is available, how to stop using tobacco, location of smoking cessation programs, chances for surviving cancer (Generic Rheumatrex Treating certain types of cancer, severe psoriasis, or rheumatoid arthritis in certain patients) and where to get cancer information. On each item, there was little variation among sites and little difference between the pre- and postintervention distribution of responses. At all four sites, both pre- and postintervention, approximately 80% of respondents had recently heard about nutrition and cancer, 66-72% had recently heard about types of cancer screening tests, and 50-65% of respondents had recently seen or heard information about the other information items.

Category: Cancer / Tags: cancer prevention, community intervention trial

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