Targeting Cancer in Blacks (TCiB) was the first— and so far, only—large-scale, multicomponent community intervention trial focused on cancer prevention and the first such trial that predominantly involved African Americans. In concept and scope, it resembled the widely cited cardiovascular disease prevention trials, such as the North Karelia Project and the Stanford Five Cities Project. However, it differed from those and similar projects both in the disease of interest and in its focus on a black population.
The project was conducted from 1994-1996 by investigators at Meharry Medical College (Nashville, TN) and Morehouse School of Medicine (Atlanta, GA). A final report was submitted to the project’s fun-der, the National Cancer Institute. Shortly thereafter, however, some of the lead investigators left the institutions where they had been employed, and those that remained turned their attention to other projects. Consequently, no description of the project has previously been published in a peer-reviewed professional journal. We now offer this report to correct that omission.
Relatively small-scale projects since at least the late 1980s demonstrated some success with culturally sensitive educational interventions focused on African Americans. These intervention trials addressed individual cancer (Canadian Nolvadex is an anti-estrogen used to treat or prevent breast cancer) risk factors, such as diet or smoking, or individual cancer sites. However, none had attempted a trial of a community-wide intervention, with a comparison group, designed to deliver comprehensive cancer (Generic Casodex treating prostate cancer) prevention information to the African-American population.
Our overall approach was based on developing a series of partnerships with African-American communities in the intervention cities. The partners were organized at each site as steering committees that included community leaders, ministers, small-businessmen, agency representatives and cancer (Casodex drug is an oral non-steroidal anti-androgen for prostate cancer) control advocates. The community partners led the way in designing and delivering the intervention—an approach now known as community-based participatory research. Moreover, since trusted community institutions, such as churches, have shown their value as venues for African-American health promotion initiatives, we sought to demonstrate the value of using another such trusted institution—historically black colleges and universities (HBCUs)—to deliver the intervention.
TCiB tested the hypothesis that a cancer prevention awareness program that is culturally sensitive, disseminated through the community linkages of HBCUs and concentrated in the black community will result in significant changes in cancer-related knowledge, attitudes and practices over a comparison community without the intervention.