Evaluation of a spiritually-based intervention to increase colorectal cancer knowledge and screening among church-attending African Americans and Whites

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States and affects all racial and ethnic groups, although taking a particularly heavy toll on African Americans, who are more likely to die from the disease than Whites. Even with the availability of CRC screening, only an estimated 30% of the US population takes advantage of these tests. This suggests that interventions should focus both on increasing awareness as well as decreasing barriers to CRC screening. Culturally-relevant community-based interventions are one way to achieve this goal. The primary purpose of this project is to evaluate the effectiveness of a spiritually-based intervention to increase colorectal cancer knowledge and screening among church-attending African Americans and Whites. The spiritually-based approach involved framing the CRC early detection message with relevant spiritual themes (e.g., balance of healthy body, mind, and spirit; body is a temple of holy spirit which should be taken care of) and scripture, identified and pilot tested with the priority communities. The intervention was implemented in three churches (two African American and one White). It was implemented by Community Health Advisors, who were trained to talk to their fellow church members about CRC, based on spiritually-based print materials developed for the study. Study outcomes included CRC knowledge, perceived barriers to and benefits of screening, actual screening behavior, and participant satisfaction with the program, and were assessed at baseline and six-month and 12-month follow-up through use of self-administered survey. Results are discussed overall and by racial group.